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As Dry January progresses and many Brits consider reevaluating their relationship with alcohol, it’s crucial to be aware of potential long-term consequences, such as liver cirrhosis. Also known as end-stage liver disease, cirrhosis is characterized by significant damage, including inflammation (hepatitis), fatty deposits (steatosis), increased liver stiffness, and mild scarring (fibrosis).

Major causes of cirrhosis include prolonged alcohol abuse, chronic infections like hepatitis B or C, and a severe form of non-alcoholic fatty liver disease (NAFLD) known as non-alcoholic steatohepatitis. Other contributors include bile duct issues, immune system problems, hereditary conditions, and extended use of certain medications.

Cirrhosis is classified as compensated or decompensated:

  1. Compensated cirrhosis implies the liver can cope with damage and maintain vital functions.
  2. Decompensated cirrhosis indicates the liver cannot perform all functions adequately, leading to serious symptoms and complications.

British Liver Trust notes that around 4,000 people in the UK die from cirrhosis annually, and 700 require liver transplants to survive. Symptoms vary across stages:

Early symptoms:

  • General fatigue
  • Loss of appetite
  • Weight loss and muscle wasting
  • Nausea and vomiting
  • Liver tenderness/pain
  • Spider-like blood capillaries on the skin
  • Blotchy red palms
  • Disturbed sleep pattern

Later symptoms:

  • Intensely itchy skin
  • Jaundice (yellowing of eyes and skin)
  • White nails
  • Clubbed fingers
  • Hair loss
  • Swelling of legs, ankles, feet (edema)
  • Abdominal swelling (ascites)
  • Dark urine
  • Pale or dark/black stools
  • Frequent nosebleeds and bleeding gums
  • Bruising and difficulty stopping bleeds
  • Vomiting blood
  • Muscle cramps
  • Shoulder pain
  • Enlarged breasts and shrunken testes (in men)
  • Irregular or absent menstrual periods (in women)
  • Impotence and loss of sexual desire
  • Dizziness, extreme fatigue, and shortness of breath
  • Rapid heartbeat (tachycardia)
  • Fever, shivers, forgetfulness, confusion, drowsiness
  • Changes in personality, trembling hands, difficulty writing
  • Staggering gait, increased sensitivity to drugs and alcohol

Certain “red flag” symptoms necessitate immediate medical attention, especially if cirrhosis has been diagnosed:

  • Fever with high temperatures and shivers (possibly due to infection)
  • Shortness of breath
  • Vomiting blood
  • Very dark or black tarry stools (feces)
  • Periods of mental confusion or drowsiness

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