Liver cirrhosis is an advanced stage of liver scarring or fibrosis.
The most common causes of liver cirrhosis include:
Research shows that liver fibrosis and cirrhosis are reversible, provided the underlying cause is diagnosed at an early stage and optimally treated. The reversal of fibrosis or cirrhosis is more likely when the liver scarring is in the early stages. Once cirrhosis is at an advanced stage, medications are primarily used to control the symptoms or complications of cirrhosis.
The Child-Pugh classification is a scoring system that determines the degree of liver failure in patients with cirrhosis. This, in turn, allows doctors to prognosticate the disease course and predict patient survival. The classification system is also a gauge of the likelihood of complications developing. For example, patients at Stage C cirrhosis are more likely to develop variceal haemorrhage than those at Stage A.
The Child-Pugh scoring system takes into consideration five factors, and allocates points based on specific factors. The total number of points the patient scores determines which stage he is in.
Based on the Child-Pugh classification, liver cirrhosis can be grouped into 3 stages:
Patients often have no symptoms or may experience non-specific symptoms such as fatigue and lethargy. The one-year survival rate is up to 100%.
Patients at this stage have increased blood pressure within the major veins in the liver. Complications such as esophageal varices and ascites may occur. The one-year survival rate for patients at this stage is about 80%.
Apart from ascites, patients may experience more symptoms, including extensive itchiness, loss of weight and appetite, confusion, swelling of the lower leg, breathlessness, jaundice, and internal bleeding from varices. Patients at this stage have the lowest one-year survival rate—approximately 45%. At this stage, the chance of regression of cirrhosis and fibrosis is low, and such patients may be referred and assessed for liver transplantation.
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