Cirrhosis Synthesis

1. What are the common manifestations of alcoholic cirrhosis? Which of these are secondary to

Cirrhosis is the 11th leading cause of death by disease in the United States. Almost one half of these are alcohol related. About 25,000 people die from cirrhosis each year.

Gil’s assessment, we can look back to see the relatable factors. First, Hispanics usually carry high rates of abstinence from alcohol than other ethnicities, but those that do consume alcohol, often have higher rates of binge drinking (NIH, 2017). Not only does higher rates of binge drinking occur, but Hispanics also have a higher risk for developing alcohol-related liver disease, more so than whites (NIH, 2017). His health history shows that he, at times, consumes alcohol excessively, which is one of the main causes of cirrhosis (Nordqvist, 2015). Excessive consumption of alcohol for men is considered as drinking more than 21 units per week (Nordqvist, 2015). His chronic back pain is showing to affect his physical activity and although an evaluation should be done to see its underlying cause, this is a typical finding in ascites (Health Reference Center, 2017). Ascites is an accumulation of fluid within the abdominal cavity, which is a common complication of cirrhosis. His diagnosis of hyperlipidemia may cause fat to gather in the liver and lead to worsening of the disease (NIH, 2017). His stressful living situation can have a negative impact, physically and mentally, to the body. Stress releases natural killer cells (NKT) that expand in the liver (Franciscus, 2015). This contributes to worsening of liver disease by causing cell death (Franciscus, 2015). Sometimes impaired blood flow can be detected by the part of the brain, controlling

A great proportion of alcohol metabolism occurs in the liver; this is also the primary location of the production of glucose from the breakdown of glycogen (glycogenolysis) or from the breakdown of non-carbohydrate sources - amino acids, pyruvate, glycerol (gluconeogenesis). Alcohol is detoxified and removed from the blood through a process called oxidation. Oxidation prevents the alcohol from accumulating and destroying cells and organs. Alcohol is metabolised by an enzyme in the liver cells known as alcohol dehydrogenase (ADH). ADH and ALDH oxidise ethanol into acetate. First ADH breaks down alcohol into acetaldehyde and then another enzyme, aldehyde dehydrogenase (ALDH) rapidly breaks down acetaldehyde into acetate. Acetate is further metabolised and eventually leaves the body as carbon dioxide and water. This oxidation process consumes 2 NAD+ generating 2 NADH. The high concentration of excess NADH produced inhibits gluconeogenesis by preventing the oxidation of lactate to pyruvate. Instead, it causes the reverse reaction to occur, resulting in lactate to accumulate – this can result in acidosis (lactic acid build-up) and hypoglycaemia from the lack of glucose produced. Pyruvate is the first designated substrate of the gluconeogenesis process which can then be used to synthesise glucose, hence why when alcohol is inhibited, gluconeogenesis doesn’t

The foundation for a Drug Free World (2017) outlines the effects of binge drinking for an individual, including drowsiness, vomiting, and liver disease. Valley Sleep Centre (2016) suggests that alcohol causes drowsiness, due to alcohol’s sedative effect (substance that relieves anxiety and helps you fall asleep). On the other hand, New Health Advisor (2014) exclaims that vomiting is caused by the excessive consumption of alcohol, and it is the reaction to get rid of the extreme amount of alcohol in the body’s system. Alcoholic cirrhosis, a type of liver disease is considered by Patient (2015) to be when the liver loses its capability to function efficiently, and is caused by around 10 years of heavy

Minor amounts of alcohol are metabolized to acetaldehyde in the digestive tract, revealing the tissues to acetaldehyde’s harmful effects.

Prolonged and chronic ethanol (ETOH) use has devastating effects on the gastrointestinal (GI) tract. ETOH is easily absorbed from the intestine and diffuses quickly throughout the body. The bulk of the ETOH is metabolized in the liver. ETOH abuse produces functional and structural changes in the GI tract, such as in the stomach, small intestine, liver, and pancreas (Geokas, Lieber, French, & Halsted 1981). The National Institute on Alcohol Abuse and Alcoholism website (2005) sites statistics indicating 28,175 deaths in 2005 were a direct result of liver cirrhosis. The website goes on to state, “In 1997, liver cirrhosis was the 10th leading cause

The pathophysiology of alcoholism begins after alcohol the ingestion of alcohol. It is absorbed and unaltered through the stomach and intestines. Next it is distributed throughout the body through the blood and absorbed by all tissues and fluids (Huether, 2012, p. 72). Furthermore, in the liver the alcohol blood content is metabolized into acetaldehyde by the enzymes process of alcohol dehydrogenase (ADH), the microsomal ethanol oxidizing system (MEOS), and catalase (Huether & McCance, 2012). Next, the metabolizing effects the central nervous system (CNS) and exhibits a depressant action. It is first expressed in the subcortical structures of the brain. This has an effect of disorientation of motor skills and intellect. With an increase in blood alcohol concentration, the medullary centers become depressed and as a result affects respiration (Huether & McCance, 2012). In addition, the effects of alcoholism encourage hepatic and gastric changes. The hepatic effect is caused by acetaldehyde, in which, induces inflammation, fatty deposits and enlargement of the liver (Huether & McCance, 2012).

The liver plays a pivotal role in material metabolism, such as synthesis of proteins, detoxification, and storage. Liver lesions will inevitably lead to a change in related metabolic network. Cirrhosis, often preceded by hepatitis and steatosis, is a condition in which the liver does not function properly due to long-term damage. Cirrhosis resulted in 1.2 million deaths in 2013, up from 0.8 million deaths in 1990 [1]. Independent of the cause, treatment of cirrhosis partly depends on the underlying cause, with the principle of preventing worsening and complications.

Liver disease resulting from alcohol affects more than two million Americans and is one of the primary causes of illness and death. The liver frees the body of harmful substances, such as alcohol. While the liver breaks down alcohol, it produces toxins that can be even more dangerous than the alcohol consumed (“Beyond Hangovers: Understanding Alcohol's Impact Your Health” 13). “These by-products damage liver cells, promote inflammation, and weaken the body’s natural defenses. Eventually, these problems can disrupt the body’s metabolism and impair the function of other organs” (“Beyond Hangovers: Understanding Alcohol's Impact Your Health” 13). A condition called steatosis is the result of fat build up in the liver and is the

Some preventions that can be done to avoid having cirrhosis is to stop bad habits such as large alcohol consumption, cigarette smoking and eating too much. Antioxidant-rich foods and drinks can prevent cirrhosis as well. People who have specific conditions should take some antiviral medicine to prevent the complications of getting hepatitis B or C. By doing this, the next step that could have happened which is getting cirrhosis would be prevented. All patients with cirrhosis who are positive for HBsAg should get an oral antiviral therapy using entecavir or tenofovir antiviral medicines.

"Many alcoholics exhibit swollen and tender livers. The prolonged use of large amounts of alcoholism without adequate diet may cause serious liver damage, such as

The abuse of alcohol over long periods of time may also cause diseases such as cirrhosis, acute alcohol hepatitis, and the most severe liver disease. Cirrhosis is a disease in which the liver becomes so scarred that the patient lacks sufficient healthy tissue to perform the organ?s functions. Once you?ve got it, you are stuck with it. (Gross, 6) The worst thing about these diseases is that you will not know you have them unless you are medically examined on a regular basis. Alcohol consumption is a large contributor to the development of several types of cancer- mostly dealing with the neck and brain. We know that cancer kills and therefore it is safe to say that in some cases, alcohol can be deadly. It is important to realize that alcoholism is a disease. A heavy drinker will experience the effects of withdrawal syndrome (which include hypertension, anxiety, disorientation, hallucinations, and seizures) if he decides to stop drinking. Being addicted to alcohol is similar to being addicted to any other drug in that once one starts using, it is tough to live without. It is also a ?gateway drug? just as marijuana and other sedatives. (Bennett, Woolf, 13-23)

Alcohol has no beneficial attributes on a person’s health. Alcohol can have several harmful effects on human organs. Some organs in the human body that are damaged by alcohol consumption are the brain, kidneys, and liver. The human liver is the one organ that suffers the most damage. As stated in an article published by the National Institute on Alcohol Abuse and Alcoholism, “Because the liver is the chief organ responsible for metabolizing alcohol, it is especially vulnerable to alcohol – related injury” (NIAAA, 2005). Regular use of alcohol can lead to alcoholic liver disease (ALD). The severity of ALD can vary based on several different factors. Some of these factors include gender, age, the amount consumed, and how often alcohol is used. “ALD includes three conditions: fatty liver, alcoholic hepatitis and cirrhosis” (Alcohol Alert, 2005).

The largest internal organ in the human body is the liver. The liver functions in many ways for the survival of the human body. Such as producing blood proteins which help clotting, haemoglobin (oxygen transport), storing glucose, eliminating harmful toxins in the bloodstream, breakdown of saturated fats and producing cholesterol (Robinson, 2016). Mr McGrath has 5 years past history of Alcoholic Cirrhosis in which there is irreversible scarring of the liver and ultimately preventing the liver from functioning properly. Complications of Cirrhosis such as Ascites, variceal bleeding, hepatic encephalopathy, jaundice, hypoxia, ecchymosis and high risk of infection are not uncommon with patients like Mr McGrath (Chalasani, 2013), (Robinson, 2016) and (Moore & Aithal, 2006).