What are the 4 Stages and Symptoms of Cirrhosis
If you are like me, you did not know diddley squat about the stages of cirrhosis when you were diagnosed. I understood what End Stage meant. The End is pretty easy to figure out. But how in the heck did I get to the end, or stage 4, or End Stage or whatever they called it? What happened before, during and after? If you have even read one of my blogs, you know that I have questions. There is no stopping until I get some answers.
Cirrhosis is basically talked about in 4 stages. There are many different ways that a doctor can assess what stage you are in. You will have blood tests, maybe an MRI, a FibroSURE scan, liver biopsy or perhaps other procedures performed. Your doctor does all of these tests in an attempt to see the liver itself and to see how your body is function in relationship to the liver. I have come to believe that the whole body is run by the liver. Which is true in a way. The liver performs tasks that are amazing! The part that makes me the happiest is that it is the only organ that actually tries to heal itself.
I think of it this way: When you cut your finger, the skin knits itself together to close up the wound. This knitting is what causes scars. Like the ones on your knees and elbows. Each scar represents a story of a bike wreck, a scrape from the sidewalk, or a cut from a tree branch. You can probably remember how you got every scar.
Your bones also tell a story about any breaks that you have had. Calcium and other minerals leave deposits as they repair the damaged bone. They can be seen on X Ray years later.
Your liver tells the story of your life also. If it has been bombarded by the Hepatitis C Virus, overloaded by fatty liver disease, or attacked by your own immune system, it shows up as scars. Drugs and alcohol also put a heavy burden on the liver and damages cells. The scars show up on the various tests that give an actual picture. They also show up in your blood work and in your other organs. Your liver enzymes are raised as they race to fix the damaged cells.
Scarring in the liver is called fibrosis. That is because when the liver is healing itself, it forms collagen bands. Remember how your skin and bones heal? Same thing, different material. In a nutshell, collagen grows and connects and wraps itself around the liver. It also wraps around the portal vein and smaller veins too. Your poor liver does not consider what the scarring will eventually do, it just tries to heal itself.
Stage 1 of Cirrhosis is when your liver is actively inflamed and trying to heal.
What your liver is going through: Basically the liver is destroying itself in its attempt to heal. It begins to show signs of swelling. Some connective tissue may be found the portal vein area. That is also where your main arteries supply blood and where the bile ducts are. There is not a lot of connective tissue at this stage of Cirrhosis. Very little damage has been done, but your liver is definitely feeling some pain from the Hepatitis C Virus or from whatever is attacking it.
What you are going through: This stage usually has no symptoms. You do not even have a clue that something is wrong. IDK how many times I have wished that Hepatitis C testing were done routinely. But, no use crying over spilled milk. sigh
Stage 2 shows the inflammation, but not a lot of damage.
What the liver is going through: There is a red alert going off in your body telling the liver to work harder. The liver begins to start putting out collagen to try and stop the swelling. It is still working really well. Most of the liver is healthy and normal, and the fibrous bands are mainly around the portal vein area. Your other organs are probably not even affected yet.
What you are going through: At this time, you may have slightly higher liver enzymes in your blood work. I know that mine elevated about 12 years ago and then went back down. It should have been a red flag. Most of us do NOT have any symptoms at this point.
Stage 3 is where the damage is really showing up more.
What the liver is going through: The fibrous bands send out runners that are trying to grab onto or connect with who knows what trying to heal. You may hear the term “bridging” used. I picture it just like a bridge made of white collagen fibers bound up trying to help. The problem is that it does NOT help. The connections are not useful. They can wrap around the arteries and veins. Then the blood supply begins to be shut down. The arteries are pinched off in a way. The liver feels the pressure. It’s job is to filter the blood. What? No blood coming through? Major problems occur and begin to affect other organs. Again, any healthy piece of liver that is left will keep doing it’s job. It compensates for the mess that is being made.
What you are going through: By this time you are feeling it. You may have itchy skin or eczema, hair loss, mental confusion, high and low blood sugar swings, food coma after heavy protein meal, and some swelling.
Stage 4 is considered the last stage.
What the liver is going through: By the time this happens, scar tissue of fibrous bands have zig zagged all through the portal vein system. Even the healthier portions of the liver cannot compensate very well any more. The spleen, gall bladder, and gastrointestinal tract are all feeling the impact. Your liver has passed it’s pain onto the rest of your body. You may hear the term decompensation.
What you are going through: This is where it begins to fall apart for you. You many have mental confusion, brain fog, or hepatitic encephalopathy, yellowing of the eyes and skin called jaundice, reverse sleep pattern, swelling from fluid build-up called ascites, portal hypertension creating varices, and other symptoms.
End Stage Liver Disease deserves it’s own blog. And it shall have one eventually. We know what it means. The liver is no longer able to carry out the functions that you need to keep going. You are going through a very hard time mentally, physically, and emotionally. I had that label the minute I was diagnosed with Hepatitis C.
End Stage does not have to mean the end of your life. Saying those words to you is the whole purpose of why I blog. At one time, liver fibrosis reversal was not considered possible. At one time they thought the earth was flat.
Let’s hang in there together as best friends. I am out to prove that there is life with Stage 4 Cirrhosis. You can’t get rid of me that easy. Stick with me. Practice lifestyle and diet changes. We’re going to figure this thing out together. xoxo Karen:)
For more links to Cirrhosis and Hepatitis C articles click here.
Do you really believe that the liver can heal itself? Are you willing to make changes so that it can?
pics via nlm.nih.gov, livedesignonline.com, weightlossdetective.com