Grandma Yan has always been depressed these days, and her wife and daughter were very unhappy when they saw her. After further questioning, she found out that after she went to the hospital for an examination last week, the doctor told her that her liver had fibrosis, although the doctor explained that it should not have developed cirrhosis. However, she was very worried about whether she would be like her mother and died of liver cirrhosis and liver cancer before she could hold her grandson.

The abdominal ultrasonography report found that the liver has fibrosis or liver parenchyma lesions. Many people who are diagnosed with this for the first time will be as uneasy as Grandma Yan, worrying that their liver will harden sooner or later, and eventually will be like many patients with advanced liver disease. The face is full of sickness, ascites appears, and even liver coma or hematemesis died.

Why do good people suddenly develop fibrosis? In fact, liver fibrosis is found during the examination, which means that the liver may have some fibrosis or cirrhosis, and this change is definitely not caused overnight.

Liver fibrosis due to persistent inflammation of the liver

Liver fibrosis is the state before cirrhosis. When the skin of the human body is seriously injured, it will repair the wound by scarring. Similarly, if the liver cells are severely damaged due to long-term inflammation, the liver will also be stimulated. Fibroblasts, which make collagen, are deposited in the liver to fill the spaces left by the necrosis of liver cells, forming so-called fibrotic tissue.

If the liver is already fibrotic and continues to inflame, the fibrous tissue accumulates and progresses toward irreversible cirrhosis.

For example, a healthy liver is like a newly grown loofah, which is tender and elastic; while liver fibrosis is like an old loofah, with more and more fiber in it; as for severe liver cirrhosis, it is like a loofah. The whole melon flesh is gradually replaced by hard fiber.

Chronic viral hepatitis patients are at high risk

Most liver fibrosis is caused by chronic hepatitis that damages the liver for a long time, including viral hepatitis such as chronic hepatitis B and hepatitis C, as well as alcoholic hepatitis, drug-induced hepatitis, and autoimmune liver diseases (such as biliary cirrhosis) or genetic and metabolic diseases such as Wilson’s disease.

In acute hepatitis, liver inflammation is more severe, a large number of liver cells are necrotic, and even fulminant hepatitis may occur, which may leave the sequelae of liver fibrosis after recovery.

After liver fibrosis, the overall structure of the liver tissue changes, the operation of liver cells and blood flow are not smooth, and it is easy to cause the pressure of the hepatic portal vein to be too high, resulting in further damage to the liver function.

Ultrasound examination can make preliminary judgment

Ultrasound is a convenient and non-invasive test that can observe the texture of the surface and interior of the liver, and then determine whether the liver has fibrosis or even cirrhosis. However, it is far less accurate than liver biopsy in the differentiation of various stages of liver fibrosis and the determination of liver cirrhosis.

A normal liver shows a fine and uniform texture under ultrasound, and the results shown on the examination report are normal.

hepatic fibrosis

If the texture of the liver looks uneven, it is diagnosed as parenchymal disease or diffuse liver disease, which refers to liver fibrosis. Diffuse liver disease is not only used to refer to liver fibrosis, some comprehensive liver diseases, such as fatty liver, are also collectively referred to as diffuse liver disease.

When explaining the ultrasound results to the patient, the doctor may tell the patient “a little fibrosis”, “a little scarring”, etc. If the patient’s blood test results also show abnormal liver function, they may tell the liver inflammation and many more. However, the diagnosis of liver fibrosis by ultrasound is related to the doctor’s experience and judgment, so there may be some test errors.

Liver cirrhosis liver surface bumps like bitter gourd

If the liver is not only thick in texture, but even has uneven surface, like bitter gourd, it can be diagnosed as liver cirrhosis at this time.

However, because ultrasound examination cannot directly observe the tissue like pathological sections, some people who are diagnosed as normal may also have early liver fibrosis, and those who are judged to have liver parenchymal lesions may also have mechanical The imaging error, in fact, the liver tissue is still normal.

Similarly, the difference between liver fibrosis and liver cirrhosis on ultrasound is also somewhat vague. It must be comprehensively evaluated based on the experience of the doctor, as well as the results of the patient’s clinical symptoms and biochemical examinations.

Liver biopsy required for diagnosis

At this stage, the most accurate method for diagnosing liver fibrosis is liver biopsy. A little liver tissue can be removed under a microscope to clearly see whether there is fibrosis or to determine the degree of fibrosis.

Liver tissue from normal to cirrhosis, some medical institutions are divided into 5 stages pathologically, namely: F0 no fibrosis; F1 mild fibrosis; F2 moderate fibrosis; F3 severe fibrosis; F4 liver cirrhosis.

Liver fibrosis is often asymptomatic

The average person’s liver only needs 20% to 30% of normal tissue, which is enough to meet the body’s needs. In addition, the liver has no pain nerves, so even if it has been damaged or even fibrosis is progressing step by step, the patient usually has no obvious symptoms. .

If it is not detected in time, the fibrosis will continue to deteriorate until the body shows signs such as spider naevi, palmar erythema, varicose veins on the abdominal surface, or complications such as vomiting blood, ascites, hepatic coma, and jaundice. The function of the liver is often very poor. You may even be in danger of liver failure.

The improvement method should control the inflammatory response as soon as possible

After learning that they have liver fibrosis, many patients fear that it will not be long before they will develop cirrhosis. Is there no way to improve liver fibrosis? Will there be a road of no return for cirrhosis of the liver?

In the early stage of liver fibrosis, as long as the cause of fibrosis, that is, the inflammation of the liver, can be improved, the liver with a little fibrous tissue still has the opportunity to repair itself by the human body, and then return to the original soft liver, or stagnate in the early stage. The state of fibrosis will not continue to deteriorate. In the middle and late stages of liver fibrosis, as long as the risk factors for continued inflammation of the liver are removed, the state of liver fibrosis may be terminated, and even return to the F1 or F2 stage, and it will not deteriorate to liver cirrhosis.

Although there is no specific drug that can directly soften liver fibrous tissue, there are several oral antiviral drugs and interferon that can be used for chronic hepatitis B or C, the most common cause of liver fibrosis, as long as chronic hepatitis With successful treatment, the problem of liver inflammation is removed, and the condition of liver fibrosis or cirrhosis can be controlled.

Protect the liver and quit drinking in time, and refuse to make medicine jars

As for patients with hepatic fibrosis caused by alcoholic hepatitis or drug-induced hepatitis, they must stop drinking alcohol as soon as possible, and stop taking unnecessary drugs, home remedies or health food.

Alcohol itself will directly or indirectly damage liver cells and inhibit the synthesis of albumin in liver cells, which will not only cause alcoholic hepatitis, but also lead to liver cell fibrosis, and even liver cirrhosis or liver cancer over time, so you must not drink too much.

The interaction between drugs and the liver is also very close. Whether the drugs we take are in the form of food, paint or injections, their metabolism is almost all related to the liver and kidneys. Use any drug must be checked by a doctor. Use it just right. Improper medication can damage the liver and cause hepatitis.

Regular checkups are essential for people at high risk of liver disease

In the face of liver disease, regular check-ups are very important. Chronic hepatitis virus carriers are potentially high-risk groups of liver cirrhosis and liver cancer. It is recommended to follow the doctor’s instructions to regularly draw blood and do liver ultrasound examinations.

If the liver function test is normal every year, will there be no liver fibrosis?

uncertain. The blood test for liver function is normal. It only means that the liver is not inflamed at the moment when the blood is drawn. It does not mean that there was no inflammation in the past. Maybe the liver was inflamed earlier and formed fibrous tissue, so it is impossible to test from blood alone. The results rule out whether there is liver fibrosis.

Is it easier for people who develop chronic hepatitis B earlier to have liver fibrosis and cirrhosis?

The chance of chronic hepatitis B progressing to cirrhosis is about 1% to 2.4% per year, so theoretically, the earlier a person develops chronic hepatitis B, the more likely they are to progress to liver fibrosis or cirrhosis in the future; especially those with the condition People with poor control, that is, the indicators of liver function continue to rise, or those who are hepatitis B e antigen positive and have a particularly high amount of virus in the blood, these potential high-risk groups of liver fibrosis, if necessary, should undergo liver biopsy to check. Confirm diagnosis. In addition, if patients with chronic hepatitis B also have HIV infection, the progression of hepatitis B disease will be faster.

Generally, it takes 40 to 50 years for hepatitis B carriers to start cirrhosis on average, and this group of people will face liver fibrosis and cirrhosis earlier.

Is fatty liver related to liver fibrosis? Why do doctors keep advising everyone to control their diet and weight when they help to check the liver?

Generally speaking, fatty liver caused by obesity and excess nutrition can be controlled by diet and weight loss, but if it is caused by alcoholism, it may evolve from alcoholic hepatitis to liver fibrosis, liver cirrhosis, and even liver cancer. Therefore, you should first check whether you have the problem of excessive drinking, which will cause fatty liver. If there is such a situation, you must quit as soon as possible.

The liver has been slightly fibrotic, how many years can it be protected at most?

The liver that has been fibrotic is not easy to continue to deteriorate as long as it does not continue to be injured and inflamed. In some patients with liver fibrosis, the liver function indexes of alanine aminotransferase and aspartate aminotransferase have remained normal, and the progress of liver fibrosis is slow or has stopped. Such people may stay in liver fibrosis for a lifetime, or fibrosis The level will improve slightly over time.

However, some people’s liver tissue is still inflamed, and the liver function index is still high in blood tests. The liver cells of these patients are still damaged, and fibrosis is still in progress, so it is easier to continue to progress, and even evolve into cirrhosis of the liver. Therefore, how many years the liver can last depends on the degree and duration of liver inflammation in the patient.

Can fibrotic or hardened liver tissue be surgically removed?

The lesions of liver fibrosis and cirrhosis are diffuse, that is to say, every part of the liver has changes to a similar degree, and it is not limited to a certain part of the liver, so there is no way to treat liver fibrosis or liver disease with local excision. hardening.