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"Does liver cirrhosis mean the liver has hardened? Then what about weight loss and jaundice?"
"Yellow eyes, yellow skin, yellow urine, liver cirrhosis has turned me into a little yellow person!"
"Doctor, I eat well and sleep soundly, how could a health check reveal liver cirrhosis?"
Understanding the disease is the beginning of accepting and facing it. To clarify how the liver functions and what liver cirrhosis is, I will take you through the past and present of liver cirrhosis.
1. Structure of the Liver
In adults in our country, the weight of the liver is 1.4 to 1.8 kg for males and 1.2 to 1.4 kg for females, accounting for about 1/30 to 1/50 of body weight. The liver is heaviest between the ages of 26 and 40, and then gradually decreases in weight. The liver is located in the upper right part of the abdominal cavity, occupying most of the upper right abdomen and part of the upper left abdomen. Its upper edge is at the level of the fifth intercostal space along the right clavicular line, and its lower edge reaches the costal margin, which can extend below the costal margin in children.
The liver is the largest solid glandular organ in the human body and serves as the 'chemical factory' for material metabolism. The liver is 'suspended' in the abdominal cavity by ligaments, which have a certain degree of elasticity, allowing the liver's position to change with variations in abdominal pressure and volume. For example, during deep breathing, the liver can move down or up, and in pregnant women or those with ascites, the liver can move upward.
The surface of the liver is covered by a thin layer of dense connective tissue called the capsule. The capsule extends into the liver to form a network-like framework, dividing the liver parenchyma into many basic units with similar shapes and functions, known asliver lobules.The liver is composed of countless liver lobules that are structurally identical and similar in size and shape. Each liver lobule consists of liver cells, their capillary bile ducts, and blood vessels.
In simple terms, the liver is made up of small prism-like blocks, and these blocks are the liver lobules. The liver cells within the lobules work together to achieve functions such asdetoxification, metabolism, digestion, and hormone inactivation.Thus, it is the basic unit of liver structure and function. Under a magnifying glass, you can see that the liver lobule mainly consists of liver cells, blood vessels, and blood sinusoids.
If the liver is a city, then the liver lobules are the villages within the city, liver cells are individual households, blood vessels are like rivers, and blood sinusoids are like small ponds. The main business of the liver lobules is blood-related, with blood as the raw material, and after a series of chemical processes such as oxidation, reduction, decomposition, and combination, the final product is still blood. To transport and store this blood, the village's rivers must be clear and the ponds must be full.
2. Changes in the Liver After Cirrhosis
Portal cirrhosis can be caused by various factors, but it is most commonly seen in long-term alcoholics in Europe and America (alcoholic cirrhosis), while in China and Japan, viral hepatitis is the main cause (post-hepatitis cirrhosis).In the early to mid-stages, the liver volume is normal or slightly enlarged,with normal or slightly hard texture. In the later stages, the liver volume decreases and weight reduces, dropping from a normal 1500g to below 1000g. Liver stiffness increases, and the surface appears granular or nodular, with sizes relatively uniform, and the maximum diameter does not exceed 1 cm.
Necrotic cirrhosis corresponds to large nodular cirrhosis and mixed small and large nodular cirrhosis, formed on the basis of extensive necrosis of the liver parenchyma.The liver volume decreases, weight reduces, and texture becomes hard.The difference from portal cirrhosis is that the liver deformation is significant, with obvious atrophy of the left lobe and varying sizes of nodules.
Biliary cirrhosis, caused by bile duct obstruction and bile accumulation, is less common and is divided into primary and secondary types. Primary biliary cirrhosis is
(1) Secondary Biliary Cirrhosis
The common causes are obstruction of the bile duct system, such as gallstones, tumors, etc., causing direct obstruction or external compression of the extrahepatic bile duct, leading to bile duct narrowing or closure. In children, it is often due to congenital biliary atresia or cysts of the common bile duct. In the early stages, the liver volume is often slightly enlarged, with a smooth or finely granular surface and moderate hardness, corresponding to incomplete septal type. The liver often appears deep green or green-brown due to bile staining.
(2) Primary Biliary Cirrhosis
Also known as chronic non-suppurative destructive cholangitis, the cause is unknown but may be related to autoimmunity. It is rare in our country and mostly occurs in middle-aged and older women. Clinical manifestations include chronic obstructive jaundice, liver enlargement, and skin itching due to bile irritation. Patients often have hyperlipidemia and yellow tumors on the skin.
In summary, once cirrhosis occurs, everything changes! Liver cells die in large numbers under the dual assault of viruses and white blood cells. Around the dead liver cells, a lot of fibrous tissue will grow, wrapping them in circles, which is fibrosis.
As more liver cells die, fibrosis becomes more severe, and the river channels in the liver lobule village are increasingly occupied by fibers, becoming narrower, with some already blocked. The ponds are also occupied by fibers, with decreasing water storage capacity, and some are nearly dried up due to being filled with fibrous tissue.
Returning to the liver, fibrosis of the liver lobule occurs, with some blood vessels in the liver blocked, and some liver sinusoids completely devoid of blood. This is no longer a city of blood; blood can hardly even enter. This is the scene of liver cirrhosis.
3. Daily Care for the Liver
Going to bed early and getting up early, avoiding staying up late is key to nourishing liver blood and is of utmost importance. "When a person lies down, blood returns to the liver." We should sleep before 11 PM. At midnight, when water and fire are in harmony, the yin energy is at its peak, and the body's self-repair is also most vigorous. If one stays up late during this time, it can lead to insufficient liver blood and excessive liver fire, resulting in problems such as dry eyes, fatigue, dizziness, and irritability.
Moderate exercise, such as jogging and swimming, can promote blood circulation in the body and maintain our vitality. Avoid intense exercise, as "the liver governs the tendons"; excessive movement of the limbs can easily injure the tendons and even affect the liver. Human movement relies on muscle strength. The nourishment of the fascia comes from liver blood; sufficient liver blood leads to strong muscle strength and agile limbs.
3. Massage Liver Acupoints
During leisure time, one can frequently press the Dadu and Taichong acupoints, as well as the Xingjian, Taixi, and Ganyu acupoints. Since the liver meridian runs along the ribs, one can also rub the sides frequently to soothe the liver and relieve depression.
4. Strengthen the Spleen and Protect the Liver
The liver stores blood, not only can it store blood but also regulate blood throughout the body; the spleen governs blood and is the source of qi and blood generation. Therefore, improving the digestive function of the spleen and stomach can increase qi and blood, allowing the liver to have blood to store. Foods that strengthen the spleen and stimulate appetite, such as pumpkin, coix seed, millet, yam, and lentils, can be consumed more often.
5. Close Your Eyes and Nourish Your Spirit
Furthermore, "the liver opens to the eyes," and "the eyes receive blood to see." If liver blood is insufficient, the eyes will lose nourishment, leading to dryness and discomfort, and even dizziness and blurred vision; conversely, if one overuses their eyes for a long time, it can easily lead to the depletion of liver blood, thereby affecting the normal function of the liver.
