Cirrhosis history and symptoms: Difference between revisions
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==History== | ==History== | ||
The diagnosis of liver cirrhosis requires an accurate history of alcohol abuse as to the amount as well as the duration of consumption. Use of illicit drugs and transfusions, family history of liver disease ([[Wilson's disease]], [[hemochromatosis]]), travel, history of infections ([[Hepatitis B]] and [[Hepatitis C|C]]), autoimmune disorders ([[autoimmune hepatitis]], [[Crohn's disease]]) is also helpful in establishing the diagnosis. | The diagnosis of liver cirrhosis requires an accurate history of alcohol abuse as to the amount as well as the duration of consumption. Use of illicit drugs and transfusions, family history of liver disease ([[Wilson's disease]], [[hemochromatosis]]), travel, history of infections ([[Hepatitis B]] and [[Hepatitis C|C]]), autoimmune disorders ([[autoimmune hepatitis]], [[Crohn's disease]]) is also helpful in establishing the diagnosis. | ||
=== Psychosocial history === | |||
*Past history of abuse | |||
=== Past Medical history === | |||
*History of | |||
=== Menstrual history === | |||
*History of | |||
=== Family history === | |||
*[[Family history]] of: | |||
** | |||
=== Medication history === | |||
*History of [[medication]] use should be obtained as many [[:Category:Drugs|drugs]] such as [[Opioid|opioids]] cause [[constipation]] as a side effect. | |||
==Symptoms== | ==Symptoms== | ||
Revision as of 15:40, 6 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]
Overview
The diagnosis of liver cirrhosis requires accurate knowledge of abuse of alcohol by the patient. Other causes of cirrhosis (eg: Hepatitis B and C, metabolic or autoimmune cause) also need to be determined to better understand the prognosis and treatment of the cirrhosis.
History
The diagnosis of liver cirrhosis requires an accurate history of alcohol abuse as to the amount as well as the duration of consumption. Use of illicit drugs and transfusions, family history of liver disease (Wilson's disease, hemochromatosis), travel, history of infections (Hepatitis B and C), autoimmune disorders (autoimmune hepatitis, Crohn's disease) is also helpful in establishing the diagnosis.
Psychosocial history
- Past history of abuse
Past Medical history
- History of
Menstrual history
- History of
Family history
- Family history of:
Medication history
- History of medication use should be obtained as many drugs such as opioids cause constipation as a side effect.
Symptoms
- Initially, the symptoms of liver cirrhosis are very non-specific:
- Right upper quadrant abdominal pain
- Fever
- Anorexia
- Fatigue and weakness
- Nausea and vomiting
- Weight loss
- Abdominal pain and bloating
- Menstrual irregularities
- Symptoms of hypogonadism:
- Impotence
- Infertility
- Testicular atrophy
- Loss of libido
- Easy bruisability
- Decompensated cirrhosis may present with
- Jaundice
- Increase in abdominal girth due to ascites
- Pruritus
- Signs of upper gastrointestinal bleeding:
- Hematemesis
- Hematochezia
- Melena
- Symptoms due to hepatic encephalopathy:
- Altered mental status
- Confusion
- Sleep disturbances
- Muscle cramps due to reduction in effective circulating plasma volume
- Lower extremity edema
- Symptoms may vary depending on the underlying cause of cirrhosis:
- Primary biliary cirrhosis presents with the following symptoms:
- Fatigue out of proportion to the severity of the disease
- Pruritis
- May be intermittent
- Increases in the evening
- May present in the last trimester of pregnancy and may be mis-diagnosed as cholestasis of pregnancy
- Primary sclerosing cholangitis may present with the following in addition to the above symptoms of cirrhosis:
- Cardiac cirrhosis presents with symptoms of congestive cardiac failure along with a sensation of fullness and tenderness in the right upper quadrant of the abdomen.