siroza

Siroza, or cirrhosis, is the late stage of chronic liver disease in which healthy liver tissue is replaced by scar tissue and nodules, leading to progressive loss of liver function.

Common causes include chronic hepatitis B or C, long-term heavy alcohol use, and non-alcoholic fatty liver disease. Other causes are cholestatic diseases such as primary biliary cholangitis and primary sclerosing cholangitis, genetic disorders like hemochromatosis and Wilson disease, and certain drugs.

In cirrhosis, scar tissue distorts liver architecture and blood flow, causing portal hypertension and reduced liver synthesis and detoxification.

Symptoms may be subtle at first. As damage progresses, fatigue, weight loss, jaundice, itching, easy bruising, edema, and abdominal fluid accumulation (ascites) can occur; later, hepatic encephalopathy may develop.

Common complications include variceal bleeding from portal hypertension, ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, and an increased risk of liver cancer (hepatocellular carcinoma).

Diagnosis relies on history, examination, and blood tests showing impaired liver function; imaging (ultrasound, CT, MRI) reveals a nodular liver. Transient elastography estimates fibrosis; liver biopsy may be used in uncertain cases. Severity is scored with Child-Pugh or MELD.

There is no cure. Treatment aims to slow progression and manage complications: treat the underlying cause, stop alcohol, antiviral therapy for hepatitis, nutrition optimization, and vaccines. Manage ascites with diuretics and salt restriction; treat varices and encephalopathy; liver transplantation may be needed for decompensated disease.

Prognosis depends on stage and response to treatment; decompensated cirrhosis carries higher mortality. Scoring systems such as MELD and Child-Pugh help guide prognosis and transplant decisions.