Liver Failure & Cirrhosis

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Few days ago, I admitted a middle aged male patient to medical ICU for elevated liver function tests. He had been previously diagnosed with a hepatic mass suggestive of hepatocellular carcinoma. On this admission, his liver function tests were over 5000 which showed he was in full liver failure.

Patients with liver failure have many comorbidites and require a dedicated physician to spend ti and meticulously manage their health and wellbeing.

Having received a diagnosis of cirrhosis, you may feel afraid and confused. Many people are not prepared to deal with their diagnosis and find it difficult to obtain information and support. It is important to remember that being diagnosed with cirrhosis is not the end of the world. People with cirrhosis can have completely normal liver function and remain well for many years. Progression from cirrhosis to more advanced liver disease or liver cancer
(hepatocellular carcinoma) does not happen in every case.

How will cirrhosis affect my health?

• A rise in blood pressure in the veins coming from the intestines to the liver.
Blood tries to get back to the heart by bypassing the liver through connecting veins, which are not normally open. These veins are found in the gullet (oesophagus), stomach and lower bowel. Increased pressure can lead to rupture and life-threatening bleeding.

• Increased fluid retention in your abdomen - a condition called ascites.
Ankle swelling can also occur. This results from increased blood pressure plus a reduction in blood protein levels normally produced by the liver.

• Easy bruising and bleeding because clotting factor levels in the liver platelets are also reduced.

• The liver may no longer be able to clear drugs from the bloodstream, causing some people to become more sensitive to the effects of pharmaceutical and illicit drugs.

• The liver may lose the ability to clear waste products from the blood. One of the effects of this can be confusion or coma when such wastes affect the brain. This is called encephalopathy. Jaundice is the name given to the yellow pigmentation of the skin and eyes, which occurs when the liver cannot clear bilirubin from the body.

• ‘Fatty liver’ or steatosis. This is where excess fat is deposited in the liver.

Don’t be afraid to ask your specialist or doctor for further information about your condition. If you don’t understand what they are saying, ask them to explain it until you do understand. Cirrhosis can be a serious condition and it is important that any concerns you have about your health are clarified and your questions are answered. People close to you are often in the best position to provide you with support because they care for you.

Hepatitis Councils in the states and territories can provide you with information and, in some cases, link you with other people with cirrhosis who are interested in sharing their experiences. This type of support can be beneficial – it can help you realize you are not alone and also provide you with a different perspective or suggestions about how to manage your health and lifestyle.

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