Cirrhosis history and symptoms: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
Liver cirrhosis may present with non specific constitutional symptoms such as fever, anorexia, fatigue, nausea, [[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. | Liver [[cirrhosis]] may present with non specific constitutional [[Symptom|symptoms]] such as [[fever]], [[anorexia]], [[fatigue]], [[Nausea and vomiting|nausea]], [[vomiting]], [[Menstrual disorder|menstrual irregularities]] and [[testicular atrophy]]. Patients with decompensated [[cirrhosis]] may develop complications and present with [[jaundice]], increase in abdominal girth due to [[ascites]], [[Itch|pruritus]], [[hematochezia]], [[melena]] and [[confusion]] due to [[hepatic encephalopathy]]. [[Symptom|Symptoms]] may also vary depending upon the underlying cause of [[cirrhosis]]. A detailed history of [[alcohol]] use, [[Blood transfusion|blood transfusions]], history of [[Hepatitis|viral hepatitis]] and family history of [[Hepato-biliary diseases|liver disease]] must be taken in all [[Patient|patients]]. | ||
==History== | ==History== | ||
=== Social history === | === Social history === | ||
*History of alcohol use: | *History of [[alcohol]] use: | ||
**Amount | **Amount | ||
**Duration | **Duration | ||
*History of illicit drug use | *History of illicit [[:Category:Drugs|drug]] use | ||
*History of unprotected sexual intercourse | *History of unprotected sexual intercourse | ||
=== Past Medical history === | === Past Medical history === | ||
*History of | *History of [[Infection|infections]]: | ||
**[[Hepatitis B]] | **[[Hepatitis B]] | ||
**Hepatitis [[Hepatitis C|C]] | **Hepatitis [[Hepatitis C|C]] | ||
*History of autoimmune disorders: | *History of [[Autoimmunity|autoimmune disorders]]: | ||
**[[autoimmune hepatitis]] | **[[autoimmune hepatitis]] | ||
**[[Crohn's disease]] | **[[Crohn's disease]] | ||
*History of blood transfusions | *History of [[Blood transfusion|blood transfusions]] | ||
=== Menstrual history === | === Menstrual history === | ||
*History of menstrual irregularities | *History of [[Menstrual disorder|menstrual irregularities]] | ||
=== Family history === | === Family history === | ||
| Line 33: | Line 33: | ||
=== Medication history === | === Medication history === | ||
*History of use of any hepatotoxic drugs | *History of use of any [[Hepatotoxicity|hepatotoxic]] drugs | ||
==Symptoms== | ==Symptoms== | ||
* Initially, the symptoms of liver cirrhosis are very non-specific: | * Initially, the [[Symptom|symptoms]] of [[liver]] [[cirrhosis]] are very non-specific: | ||
** Right upper quadrant [[abdominal pain]] | ** Right upper quadrant [[abdominal pain]] | ||
** [[Fever]] | ** [[Fever]] | ||
** Anorexia | ** [[Anorexia]] | ||
** [[Fatigue]] and [[weakness]] | ** [[Fatigue]] and [[weakness]] | ||
** [[Nausea]] and [[vomiting]] | ** [[Nausea]] and [[vomiting]] | ||
** [[Weight loss]] | ** [[Weight loss]] | ||
** [[Abdominal pain]] and bloating | ** [[Abdominal pain]] and bloating | ||
** Menstrual irregularities | ** [[Menstrual disorder|Menstrual irregularities]] | ||
** Symptoms of hypogonadism: | ** Symptoms of [[hypogonadism]]: | ||
*** Impotence | *** [[Erectile dysfunction|Impotence]] | ||
*** Infertility | *** [[Infertility]] | ||
*** Testicular atrophy | *** [[Testicular atrophy]] | ||
*** Loss of libido | *** Loss of [[libido]] | ||
** Easy bruisability | ** Easy bruisability | ||
*Decompensated cirrhosis may present with | *Decompensated [[cirrhosis]] may present with | ||
**Jaundice | **[[Jaundice]] | ||
**Increase in abdominal girth due to ascites | **Increase in abdominal girth due to [[ascites]] | ||
**Pruritus | **[[Itch|Pruritus]] | ||
**Signs of upper gastrointestinal bleeding: | **Signs of [[upper gastrointestinal bleeding]]: | ||
***Hematemesis | ***[[Hematemesis]] | ||
***Hematochezia | ***[[Hematochezia]] | ||
***Melena | ***[[Melena]] | ||
**Symptoms due to hepatic encephalopathy: | **Symptoms due to [[hepatic encephalopathy]]: | ||
***Altered mental status | ***[[Altered mental status]] | ||
***Confusion | ***[[Confusion]] | ||
***Sleep disturbances | ***Sleep disturbances | ||
**Muscle cramps due to reduction in effective circulating plasma volume | **Muscle cramps due to reduction in effective circulating plasma volume | ||
**Lower extremity edema | **Lower extremity [[edema]] | ||
* Symptoms may vary depending on the underlying cause of cirrhosis: | * Symptoms may vary depending on the underlying cause of [[cirrhosis]]: | ||
* '''[[Primary biliary cirrhosis]]''' presents with the following symptoms: | * '''[[Primary biliary cirrhosis]]''' presents with the following symptoms: | ||
** [[Fatigue]] out of proportion to the severity of the disease | ** [[Fatigue]] out of proportion to the severity of the [[disease]] | ||
** [[Pruritis]] | ** [[Pruritis]] | ||
*** May be intermittent | *** May be intermittent | ||
*** Increases in the evening | *** Increases in the evening | ||
*** May present in the last trimester of pregnancy and may be mis-diagnosed as | *** 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: | * '''[[Primary sclerosing cholangitis]]''' may present with the following in addition to the above symptoms of [[cirrhosis]]: | ||
** [[Fatigue]] | ** [[Fatigue]] | ||
** [[Pruritis]] | ** [[Pruritis]] | ||
** [[Steatorrhea]] | ** [[Steatorrhea]] | ||
* '''[[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 [[RUQ|right upper quadrant]] of the [[abdomen]]. | ||
* Features of hemochromatosis: | * Features of [[hemochromatosis]]: | ||
**[[Arthritis]] | **[[Arthritis]] | ||
**Abdominal pain | **[[Abdominal pain]] | ||
**Severe fatigue | **Severe [[fatigue]] | ||
**[[Heart failure]] symptoms | **[[Heart failure]] symptoms | ||
**Bronze-colored skin | **Bronze-colored [[skin]] | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 17:06, 6 December 2017
|
Cirrhosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case studies |
|
Cirrhosis history and symptoms On the Web |
|
American Roentgen Ray Society Images of Cirrhosis history and symptoms |
|
Risk calculators and risk factors for Cirrhosis history and symptoms |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]
Overview
Liver cirrhosis may present with non specific constitutional symptoms such as fever, anorexia, fatigue, nausea, 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:
- 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:
- 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.
- Features of hemochromatosis:
- Arthritis
- Abdominal pain
- Severe fatigue
- Heart failure symptoms
- Bronze-colored skin