Hello and welcome to the zero to finals podcast.

My name is Tom and in this episode I'm going to be talking you through liver cirrhosis.

If you want to follow along with written notes on this topic, you can follow along at seridifinals.com

slash cirrhosis or in the gastroenterology section of the zero to finals medicine book.

Let's get straight into it.

Liver cirrhosis is the result of chronic inflammation and damage to liver cells.

But when the liver cells are damaged, they're replaced with scar tissue,

and the scar tissue is called fibrosis.

And this scar tissue tends to form nodules within the liver. The fibrosis affects the structure and the blood flow through the liver,

and causes increased resistance in the vessels that are leading into the liver.

These vessels that have increased resistance in them are from the portal

system or the portal vein, and this increased resistance is called portal hypertension. It's worth

remembering the four common causes of liver cirrhosis. Firstly, alcoholic liver disease, secondly, non-alcoholic fatty liver disease. Thirdly,

hepatitis B and fourth, hepatitis C. Cirrhosis also has a large number of rarer causes of liver

damage that you should also consider because they might potentially be reversible.

And we're going to go through all of these at different times, but some examples of these are

autoimmune hepatitis, primary biliris, haemochromatosis, Wilson's disease, alpha-1 antitripsin deficiency,

cystic fibrosis, and medications such as amyodorone,

methotroxate, and sodium valproate. So what sort of signs might you find on examination if you've got a patient with liver cirrhosis? Firstly, jaundice, which is the yellow discoloration of the skin,

and this is caused by a raised bilirubin level. You might find hepatomegaly, however,

later on in the disease, as the liver becomes more serotic, it tends to shrink.

Spleenomegaly, which is caused by portal hypertension that causes back pressure into the spleen, so it swells up.

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