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Charles Saul Lieber (February 13, 1931 – March 1, 2009) was a Belgian-American clinical nutritionist who established that excess alcohol consumption can cause cirrhosis of the liver even in subjects who have an adequate diet, contradicting then-current scientific opinion. [1]
Generally, liver damage from cirrhosis cannot be reversed, but treatment can stop or delay further progression and reduce complications. A healthy diet is encouraged, as cirrhosis may be an energy-consuming process. A recommended diet consists of high-protein, high-fiber diet plus supplementation with branched-chain amino acids. [111]
Cirrhosis is a late stage of serious liver disease marked by inflammation (swelling), fibrosis (cellular hardening) and damaged membranes preventing detoxification of chemicals in the body, ending in scarring and necrosis (cell death). [11] Between 10% and 20% of heavy drinkers will develop cirrhosis of the liver (NIAAA, 1993).
Extensive damage and scarring of the liver over time defines cirrhosis, a condition in which the liver's ability to function is permanently impeded. [19] This results in jaundice, weight loss, coagulopathy, ascites (abdominal fluid collection), and peripheral edema (leg swelling). [20]
Chronic liver disease takes several years to develop and the condition may not be recognised unless there is clinical awareness of subtle signs and investigation of abnormal liver function tests. Testing for chronic liver disease involves blood tests, imaging including ultrasound, and a biopsy of the liver. The liver biopsy is a simple ...
Liver failure is the inability of the liver to perform its normal synthetic and metabolic functions as part of normal physiology. Two forms are recognised, acute and chronic (cirrhosis). [ 1 ] Recently, a third form of liver failure known as acute-on-chronic liver failure ( ACLF ) is increasingly being recognized.
MASLD constitutes the third most common risk factor for liver cancer. [130] Cirrhosis is found in only about 50% of people with MASLD and with liver cancer, so liver cancer may occur without cirrhosis being present. [14] MASLD is a precursor of metabolic syndrome, although a bidirectional influence is possible.
Both may progress to cirrhosis of the liver, but the risk is much greater with MASH as opposed to MASLD. At 15 years, 11% of people with MASH develop cirrhosis as opposed to less than 1% with MASLD. [3] All cause mortality in MASH is 25.5 per 1000 person years with a liver specific mortality of 11.7 per 1000 person years.
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