Cirrhosis history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
Liver cirrhosis may present with non specific constitutional symptoms such as [[Fever]], anorexia, [[Fatigue]], [[Nausea]] and [[vomiting]], menstrual irregularities and testicular atrophy. Patients with decompensated cirrhosis may develop complications and present with jaundice, increase in abdominal girth due to ascites, pruritus, hematochezia, melena and confusion due to hepatic encephalopathy. Symptoms may also vary depending upon the underlying cause of cirrhosis. A detailed history of alcohol use, blood transfusions, history of viral hepatitis and family history of liver disease must be taken in all patients. | |||
==History== | ==History== | ||
=== | === Social history === | ||
* | *History of alcohol use: | ||
**Amount | |||
**Duration | |||
*History of illicit drug use | |||
*History of unprotected sexual intercourse | |||
=== Past Medical history === | === Past Medical history === | ||
*History of | *History of infections: | ||
**[[Hepatitis B]] | |||
**Hepatitis [[Hepatitis C|C]] | |||
*History of autoimmune disorders: | |||
**[[autoimmune hepatitis]] | |||
**[[Crohn's disease]] | |||
*History of blood transfusions | |||
=== Menstrual history === | === Menstrual history === | ||
*History of | *History of menstrual irregularities | ||
=== Family history === | === Family history === | ||
*[[Family history]] of: | *[[Family history]] of liver disease: | ||
** | **[[Wilson's disease]] | ||
**[[hemochromatosis]] | |||
=== Medication history === | === Medication history === | ||
*History of | *History of use of any hepatotoxic drugs | ||
==Symptoms== | ==Symptoms== | ||
| Line 71: | Line 81: | ||
* '''[[Cardiac cirrhosis]]''' presents with [[Congestive heart failure history and symptoms|symptoms of congestive cardiac failure]] along with a sensation of fullness and tenderness in the right upper quadrant of the abdomen. | * '''[[Cardiac cirrhosis]]''' presents with [[Congestive heart failure history and symptoms|symptoms of congestive cardiac failure]] along with a sensation of fullness and tenderness in the right upper quadrant of the abdomen. | ||
* Hemochromatosis | |||
** Arthropathy | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 15:59, 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
Liver cirrhosis may present with non specific constitutional symptoms such as Fever, anorexia, Fatigue, Nausea and vomiting, menstrual irregularities and testicular atrophy. Patients with decompensated cirrhosis may develop complications and present with jaundice, increase in abdominal girth due to ascites, pruritus, hematochezia, melena and confusion due to hepatic encephalopathy. Symptoms may also vary depending upon the underlying cause of cirrhosis. A detailed history of alcohol use, blood transfusions, history of viral hepatitis and family history of liver disease must be taken in all patients.
History
Social history
- History of alcohol use:
- Amount
- Duration
- History of illicit drug use
- History of unprotected sexual intercourse
Past Medical history
- History of infections:
- Hepatitis B
- Hepatitis C
- History of autoimmune disorders:
- History of blood transfusions
Menstrual history
- History of menstrual irregularities
Family history
- Family history of liver disease:
Medication history
- History of use of any hepatotoxic drugs
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.
- Hemochromatosis
- Arthropathy