END STAGE LIVER DISEASE is a term used for advanced stages of liver disease, like liver failure and liver cirrhosis. There are many different types of liver diseases. No matter what type of liver disease you are suffering, they are progressive in nature. Whether you have a liver infection caused by a virus, attacked by your own immune system, or any kind of chemical injury, the basic danger will remain the same.
Common causes of ESLD
When a chemical, virus or disease attacks the liver, liver cells are damaged and there is scar formation. This scar formation is known as Fibrosis. Fibrosis is progressice in nature and it has happened over years. When scar formation takes place in the whole liver it is known as liver cirrhosis. Some common causes are heavy drinking, fatty liver, inherited diseases and autoimmune diseases.
The most common is heavy alcohol consumption and chronic hepatitis c.
Common Causes are Explain Below
- Alcohol related liver disease: Heavy alcohol consumption over years can cause scarring of liver which is irreversible. Although it varies from person to person.
- Chronic hepatitis C: Hepatitis C is a chronic infection which spreads through an infected person’s blood. It causes inflammation and damage to the liver over years that can lead to cirrhosis.
- Chronic hepatitis B and D: Hepatitis B like Hepatitis C causes swelling and infection of the liver. Hepatitis D is another type of infection that occurs in people who already have hepatitis B.
- Nonalcoholic fatty liver disease: This is more common disease which ocurs in obese, diabetic, cardiac and prsons who are on steroid therapy. It causes fat cells to accumulate in liver and eventually causes liver cirrhosis.
- Autoimmune disease: This type of disease occurs when the body’s own immune system starts attacking liver cells. It can cause inflammation and damage to the liver. Females are more prone to this disease.
- Inherited diseases: Cystic fibrosis, Wilson’s disease and glycogen storage are inherited diseases. They interfere with the normal functioning of the liver.
- Drugs and other toxins: Other causes are drug reactions and prolonged exposure to toxic substances. These conditions can lead to ESLD.
Symptoms of ESLD
In earlier stages of liver disease, it becomes inflamed. Usually, the patient is unaware, but if this inflammation is left untreated it leads to scarring of the liver. Liver scarring hampers the normal functioning of the liver. Liver scarring ( Fibrosis) and inflammation can be reversed with proper treatment and diet management. But if it is left untreated, it can lead to liver cirrhosis.
Common symptoms includes
- Loss of appetite
- Itching
- Weight loss
- Weakness
- Nausea
- Vomiting
- Pain in abdomen
- Spider like blood vessels
- Bloating
- Muscle cramps
- Trouble sleeping at night
- Depression
Complications assosiated with ESLD
These symptoms appear in early stages of liver disease. But in the absence of treatment they can lead to following complications: .
- Jaundice – in this condition the liver is unable to function properly and it is not able to flush out enough bilirubin. It causes accumulation of bilirubin which causes yellowish skin and eyes.
- Fluid accumulation in the abdomen( Ascites)- When liver damage progresses to an advanced stage, there is fluid accumulation in the legs and in the abdomen known as ascites.
- Increased risk of internal bleeding – Vomiting of blood or the presence of black stool due to internal bleeding. Internal bleeding occurs when the liver stops producing essential proteins needed for blood clotting.
- Mental confusion – Liver Is unable to detoxify the body due to the high level of toxic substances in the body. There is a hampered functioning of the brain. The buildup of toxins in the brain is called hepatic encephalopathy. It can cause memory loss, poor concentration, and a change in sleep habits.
- Portal hypertension: In normal conditions, blood is carried to the spleen and intestine through portal veins. But in cirrhosis, this process is slowed down which increases pressure in portal veins. This condition is called portal hypertension.
- Esophageal varices: Portal hypertension can lead to enlargement of blood vessels in the esophagus. Enlarged blood vessels are more likely to burst due to increased pressure, which can lead to internal bleeding.
- Liver cancer: Liver cirrhosis can cause hepatocellular carcinoma which is very common.
How is life expectancy determined?
Life expectancy of end stage liver disease can be determined with two most common methods ie CTP ( Child -Turcotte- Pugh) and model for end stage liver disease(MELD) score. .
1. CPT SCORE
It is a system for assessing the progression of liver disease. It determines the increasing severity of liver disease and survival rate of a person. It includes five scores which state the present situation of the liver. .
The five clinical measures include
- Total bilirubin
- Serum albumin
- Prothrombin time
- Ascites
- Hepatic encephalopathy
Depending on the points, the interpretation of clinical measures is as follows: .
Class A
- 5 to 6 points
- Severity of liver disease is less
- Survival rate – 95%
Class B
- 7 to 9 points
- Severity of disease moderate
- Survival rate – 75%
Class C
- 10 to 15 points
- Most severe
- Survival rate -50%
2. MELD
This score is specifically done for end stage liver disease to prioritize adult patients for liver transplants. It is calculated on the basis of below three points :
- Total bilirubin
- International normalized ratio
- Creatinine
Levels of MELD
- Greater than 25 ( Severely ill)
- 24 to 19
- 18 to 11
- Less than or equal to 10 ( Less severe)
As cores increase patients are referred for liver transplant.
Life expectancy of ESLD:
The life expectancy of ESRD totally depends upon the patient’s condition and severity of the liver disease. We can determine the survival rate with the help of two methods which specifically gives an idea about severity and need for a liver transplant. As per Ayurveda, the main treatment is by avoiding the cause of disease. We can increase life expectancy by proper herbal medicines and changing our lifestyle such as avoiding alcohol intake, limit the salt intake, and add more green leafy vegetables in your diet. Try to have a positive mindset as a positive mind is all we need for a healthy body.
Dr. Vikram Chauhan (MD-Ayurvedic Medicine) is an Expert Ayurveda Consultant in Chandigarh (India). He has vast experience of herbs and their applied uses. He has successfully treated numerous patients suffering from various ailments, throughout the world. He is CEO and Founder of Krishna Herbal Company and Planet Ayurveda in Chandigarh, India. He researched age old formulas from ancient Ayurvedic text books to restore health and save human beings from the worst side-effects of chemical-based treatments.
