_When the liver begins to deteriorate, it goes through several stages before eventually resulting in a complete deterioration of the liver. If the signs are recognized early on then a more serious situation can be avoided. If it is not caught early, it may lead to the need for a liver transplant or lead to a more dire result--death.
Inflammation Inflammation of the liver is the first stage of liver disease. An inflamed liver can be due to excessive drug or alcohol use. It may also be the result of another condition such as certain forms of hepatitis and Wilson's disease. The liver will become enlarged and red. Sometimes pain is also involved, but more often there is no discomfort in this primary stage. If discovered in this stage, the chances of repairing the liver are very good.
Liver inflammation refers to the presence of special cells called inflammatory cells in the liver. Chronic inflammation is inflammation that persists over a long period of time. It leads to changes in liver structure, slowed blood circulation, and the death of liver cells (necrosis). Chronic inflammation eventually causes scar tissue to form, a condition known as fibrosis. By controlling liver inflammation, you can control progression to fibrosis.
Fibrosis The next stage of liver disease is fibrosis. Fibrosis is essentially scar tissue, which results from the liver being inflamed for a lengthy period of time. Scar tissue begins to accumulate and take the place of healthy liver tissue. The scar tissue prevents the liver from functioning properly and inhibits the blood from flowing through it as it should.
Early fibrosis can be difficult to diagnose because it is often asymptomatic. If a blood test indicates fibrosis of the liver, typically, a liver biopsy will be performed. A liver biopsy requires a needle to remove a small sample of liver tissue so that doctors can assess the extent of liver damage and stage the degree of fibrosis.
Several scales are used to stage fibrosis. One common classification is a scale from 0 to 4 where
Stage 0 indicates no fibrosis;
Stage 1 indicates enlargement of the portal areas by fibrosis;
Stage 2 indicates fibrosis extending out from the portal areas with rare bridges between portal areas;
Stage 3 indicates many bridges of fibrosis that link up portal and central areas of the liver;
Stage 4 indicates cirrhosis.
The degree of fibrosis can be assessed as none, minimal, mild, moderate or severe.
Cirrhosis When fibrosis becomes widespread and has progressed to the point where the internal structure of the liver has become abnormal, fibrosis has progressed to cirrhosis. Cirrhosis is the result of long-term liver damage caused by chronic inflammation and liver cell death.
Cirrhosis is accompanied by a reduction in blood supply to the liver. The loss of healthy liver tissue and the reduced blood supply can lead to abnormalities in liver function. Even when liver disease has progressed to cirrhosis, it may still be possible for the damage to be at least partially reversed if the underlying cause can be eliminated. Cirrhosis progression can often be slowed or even stopped with treatment. The onset of cirrhosis is usually silent, with few specific symptoms to identify this development in the liver. A large number of people live many, many years with cirrhosis without any decompensation or symptoms.
Cirrhosis stage usually is a pathology term and does not always correlate well with symptoms, laboratory abnormalities or complications of cirrhosis. Many patients with advanced fibrosis/cirrhosis remain asymptomatic and live a normal life expectancy. However, cirrhosis can be a serious disease associated with complications leading to death. The prognosis is best made based on liver function. There are 3 stages of cirrhosis:
Stage A - "compensated"; not too sick Stage B - beginning to decompensate; complications beginning to appear Stage C - "decompensated"; end stage
It is important to know that once cirrhosis develops, it is critical to avoid further progression of the disease. The consumption of alcohol in any form, including such things as certain mouthwashes and cough medicines, must be completely avoided by people with cirrhosis.
Liver Failure Liver failure occurs when large parts of the liver become damaged beyond repair and the liver is no longer able to function. Liver failure is a life-threatening condition that demands urgent medical care. Most often liver failure occurs gradually and over many years. However, a more rare condition known as acute liver failure occurs rapidly (in as little as 48 hours) and can be difficult to detect initially.