- GYNECOMASTIA (enlarged breasts) in men and
AMENORRHEA(absence of menstrual periods) in
women due to the diminished ability of the
liver to metabolize ESTROGENS
The liver may feel enlarged or irregular when
the gastroenterologist palpates the abdomen. By
this stage, numerous blood chemistry tests show
abnormal results. PERCUTANEOUS LIVER BIOPSYcon-
firms the presence of fibrous tissue and the diag-
nosis of cirrhosis.
Treatment Options and OutlookTreatment attempts to manage symptoms, address
consequential health problems, and slow the pro-
gression of any underlying health conditions.
Eliminating ALCOHOL consumption, medications,
and environmental exposures that damage liver
cells are among the measures essential to preserve
remaining liver function. Numerous clinical stud-
ies show the ability of the herbal product MILK
THISTLEor silymarin, its active ingredient, to help
protect the liver from further damage. When cir-
rhosis progresses despite these interventions, liver
transplantation becomes the treatment of final
resort. Without liver transplantation, progressive
cirrhosis is fatal. Liver transplantation perma-
nently resolves cirrhosis, though at present there
are far fewer donor livers available than people
who need them. Live donor liver segment dona-
tion, in which a living person donates a portion of
his or her healthy liver, is an option to full liver
transplantation when a donor is available.
Risk Factors and Preventive MeasuresCirrhosis results from chronic, long-term damage
to the liver. People who are at risk for developing
cirrhosis have longstanding liver disease, such as
chronic hepatitis, hepatitis of ALCOHOLISM,
HEMOCHROMATOSIS, PRIMARY BILIARY CIRRHOSIS, PRI-
MARY SCLEROSING CHOLANGITIS, and WILSON’S DISEASE.
Preventive measures include vaccination against
hepatitis INFECTION (hepatitis A and hepatitis B)
and minimizing behaviors that allow exposure to
hepatitis. Consistent PERSONAL HYGIENE practices,
such as HAND WASHINGbefore handling food and
after going to the bathroom, help control the
spread of the hepatitis VIRUS.
See also HEPATITIS PREVENTION; LIFESTYLE AND
HEALTH; ORGAN TRANSPLANTATION.
colitis INFLAMMATIONof theCOLON. Colitis can be
acute (sudden) or chronic (long-term). Various cir-
cumstances can cause acute colitis. Among them
are INFECTION, radiation, and ischemia. Chronic coli-
tis is usually a form of INFLAMMATORY BOWEL DISEASE
(IBD), an autoimmune disorder. The symptoms of
colitis are abdominal discomfort, cramping, and
DIARRHEA. The doctor makes the diagnosis primarily
on the basis of symptoms; BLOODtests often can
confirm the presence of pathogens. Treatment may
include medications that target the underlying
cause of the inflammation or infection as well as
antidiarrheal medications.Infectious Colitis
Bacterial and protozoan infections of the colon are
common. People who are already debilitated—
such as the very old, the very young, and those
with compromised immune function—face
increased risk for complications, such as DEHYDRA-
TION, that can be fatal. Fecal cultures can identify
the causative agent, which then determines the
appropriate treatment.
Bacterial colitis Numerous BACTERIAcause bac-
terial infections of the colon, which often are FOOD-
BORNE ILLNESSES. Those most frequently detected
include Salmonella, Shigella, Campylobacter jejuni,
and Listeria monocytogenes. Treatment for bacterial
colitis is the appropriate antibiotic medication,
which helps contain symptoms within 48 to 72
hours and eliminate the infection in about 10 to 14
days. Bacterial infections, notably LISTERIOSIS, can be
especially dangerous for pregnant women.
Parasites Parasitic infections can occur from
drinking contaminated water, eating contaminated
foods, and through contact with someone who has
such an infection. It is possible to have a protozoan
or parasitic infection and show no symptoms. The
most common infective protozoan is Entamoeba
histolytica, which causes AMEBIASIS (also called
amoebic dysentery). Treatment is a course of
antiparasitic medication such as metronidazole.
Recovery is usually complete with appropriate
treatment. Other protozoan infections include
GIARDIASIS, CYCLOSPORIASIS, and CRYPTOSPORIDIASIS.Radiation Colitis
RADIATION THERAPY to treat cancers, such as
PROSTATE CANCER, in the lower abdominal regioncolitis 25