cirrhosis liver

ABOUT THE LIVER

The liver is one of the most important organs in the human body, performing many essential functions that are necessary for healthy day-to-day living. The primary job of the liver is to clean the bloodstream of harmful substances by filtering out a wide range of pathogens like viruses and bacteria. The liver is also responsible for detoxifying chemical and metabolizing drugs, producing proteins that help blood to clot normally and controlling blood sugar & cholesterol levels.

While a healthy liver has an amazing ability to repair itself, chronic damage to the liver cells can lead to scarring and eventually cirrhosis.

WHAT IS LIVER CIRRHOSIS?

Liver Cirrhosis is a progressive liver disease that occurs when the cells in the liver get damaged and scar tissue is formed. This scar tissue replaces the soft, healthy liver tissue and the scar tissue builds up, the liver hardens and slowly cuts off blood circulation in this extremely vital organ. As a result, the liver’s many important functions are hampered. Cirrhosis is the most severe stage of liver scarring and if left untreated can lead to serious complications, such as kidney failure, malnutrition, diabetes and liver cancer.

WHAT IS THE LONG-TERM IMPACT OF CIRRHOSIS?

Cirrhosis is chronic and progressive condition, i.e. it lasts for a long time and get worse as time passes. Children with cirrhosis need continuous medical monitoring and treatment for the rest of their lives.

WHAT ARE THE SYMPTOMS OF CIRRHOSIS IN CHILDREN?

In the early stage of the condition, cirrhosis often produces no symptoms. However, a child with cirrhosis may have symptoms that re because of the underlying medical condition that’s causing the liver damage.

Over time, as the condition progresses, a child may have the following symptoms:

• Loss of appetite
• Nausea or vomiting
• Weight loss or difficulty in gaining weight
• Weakness
• Abdominal pain or swelling
• Appearance of spider-like blood vessels on the skin.

As cirrhosis progresses, it could lead to additional serious issues, including:

• Jaundice
• Bruising or bleeding easily or nosebleeds
• Swelling of the legs or abdomen from fluid build-up. In the legs, the fluid build-up is called edema; and in the abdomen, it is called ascites.
• Confusion or difficulty in thinking caused by the build-up of waste products from food in the bloodstream
• Kidney failure

Since the flow of blood through the liver is hampered in cirrhosis, the pressure in the portal vein (vein that enters the liver) may rise. This condition is known as Portal Hypertension and results in its own symptoms and complications. The increased blood pressure in the portal vein can affect the blood circulation in the lungs and could cause Hepatopulmonary Syndrome and Esophageal Varices.

Hepatopulmonary Syndrome is a rare condition that interferes with the ability of the lungs to supply oxygen to the rest of the body.

Esophageal Varices i.e. enlarged or swollen veins on the lining of the tube connecting the throat to the stomach.

WHAT CAUSES CIRRHOSIS IN CHILDREN?

The following conditions can lead to cirrhosis in children:

• Biliary Atresia
  Condition where the bile ducts are blocked or become narrow obstructing the passage of bile from the liver to the gallbladder and intestines.
• Autoimmune Hepatitis
  This is an immune system disorder that causes the immune cells to attack the liver as if it were an infection.
• Chronic Viral Hepatitis or Hepatitis C
  In hepatitis C, the liver swells to encourage the formation of scar tissue.
• Cystic Fibrosis
  This is an inherited chronic disease that results in the clogging of the liver and other organs with thick mucus leading to scarring.
• Alpha-1 Antitrypsin Deficiency
  This is a genetic disease that prevents the liver from building a protein it normally releases into the bloodstream.
• Primary Sclerosing Cholangitis (PSR)
  PSR is an acquired condition that results in inflammation and narrowing of the bile ducts around the liver.
• Wilson’s Disease
  This is a not-so-common inherited disorder that prevents the body from getting rid of excess copper found in many foods resulting in a buildup of copper in the liver.
• Fatty Liver Disease
  As the name, this condition is characterized by a buildup of fat in the liver that can lead to scarring

HOW IS CIRRHOSIS DIAGNOSED IN CHILDREN?

Pediatric Gastroenterologists base the diagnosis of cirrhosis on a combination of symptoms, medical history, physical exam and blood tests. A liver biopsy may be done to confirm the diagnosis and to also determine the extent of damage to the liver.

HOW IS CIRRHOSIS IN CHILDREN TREATED?

In most cases, there is no cure for cirrhosis. Children with cirrhosis need continuous care for the rest of their lives where the main aim of treatment is to protect the liver from further scarring and address the underlying medical condition that is the cause of liver damage. And in some case Liver Transplant becomes necessary.

WHAT, YOU AS A MOTHER SHOULD KNOW ABOUT CIRRHOSIS?

If your child is diagnosed with liver cirrhosis, you should definitely do the following:

• Healthy diet for the child: Since the liver helps the stomach absorb various nutrients, eating healthy is extremely important for children with cirrhosis or any other liver disease. You should speak to your child’s pediatric gastroenterologist about caloric supplements or special formulas that help in healthy weight gain and development.
• Regular Monitoring of your Child’s Health: Cirrhosis can lead to complications in other organs and systems and hence regular checkups and monitoring is crucial. Regular checkups and monitoring helps your child’s pediatric gastroenterologist keep a watchful eye on the child and treat complications easily.
• Medication: You must consult your child’s pediatric gastroenterologist before giving the child any new medications or supplements and that includes vitamins as well. This is because a damaged liver is not able to break down medicine as quickly as a healthy liver and prescription drugs or over-the-counter medicines or vitamins or herbal supplements might be more potent for a child with cirrhosis.