Cirrhosis Center - Bethesda, MDBethesda Gastroenterologist Doctors for CirrhosisType of Physician: Gastroenterologist What is a Gastroenterologist? A subspecialty certification by the Board of Internal Medicine; practitioners focus on the stomach, intestines, colon, liver, and gallbladder (digestive organs). The gastroenterologist treats conditions such as abdominal pain, ulcers, diarrhea, cancer, and jaundice and they consult with surgeons when abdominal operations are indicated. Specialty: Gastroenterology Common Name: GI Doctor Gastroenterologist Doctors in Bethesda * Metropolitan Gastroenterology Group  Metropolitan Gastroenterology Group  T Jake Liang MD  Metropolitan Gastroenterology Group  Metropolitan Gastroenterology Group  Metropolitan Gastroenterology Group  Digestive Disease Branch  Metropolitan Gastroenterology Group  Washington Gastroenterology  Robynne K Chutkan MD  Washington Gastroenterology  Washington Gastroenterology  Washington Gastroenterology  Washington Gastroenterology  Ajay Bakshi MD  Gary M Roggin MD  Digestive Disease Clinic  V P Chandar MD PA  Steven A Burger MD  Sanford Richman MD  Montgomery Gastroenterology  Montgomery Gastroenterology  Montgomery Gastroenterology  Bernard A Heckman MD  MONTROSE PEDIATRIC GI  Maryland Digestive Disease Center  Maryland Digestive Disease Center  Maryland Digestive Disease Center  Maryland Digestive Disease Center  Maryland Digestive Disease Center  Kempanna Sudhakar MD  Rockville Internal Medical Group  S Grace Woo MD LLC  Capital Gastroenterology Consultants PA  Capital Gastroenterology Consultants PA  Capital Gastroenterology Consultants PA  Capital Gastroenterology Consultants PA  Capital Gastroenterology Consultants PA  Capital Gastroenterology Consultants PA  Capital Gastroenterology Consultants PA  Capital Gastroenterology Consultants PA  Capital Gastroenterology Consultants PA  Capital Gastroenterology Consultants PA  Capital Gastroenterology Consultants PA  Jatinder Sekhon MD  Digestive Disease Consultants PA  Digestive Disease Consultants PA  Drs Stern & Gantt  Digestive Disease Consultants PA  Digestive Disease Consultants PA  Digestive Disease Consultants PA  Digestive Disease Consultants PA  Drs Stern & Gantt  Neil L Julie MD  Birns Gloger & Witten MD PC  Birns Gloger & Witten MD PC  Ghanshyam Gupta MD  Arthur Schoengold MD  Birns Gloger & Witten MD PC  Boo K Kim MD  T Ann Tonnu MD  Montgomery Internal Medicine Associates PA  Marc Kozam MD  Ghulam Mohiuddin MD  Ghulam Mohiuddin MD  Asghar Shaigany MD  James S Chesley Jr. MD  Cohen & Epstein MDs  Cohen & Epstein MDs  Healthcare of Greater Washington  McCone Endoscopy Centers  A O Moshyedi MD  A O Moshyedi MD  Mushtaq A Shah MD  Maximo Singer MD  Redjaee & Taleghani MDs  Maryland Digestive Disease Center  Maryland Digestive Disease Center  Elizabeth R Myles MD  Vincent Sutliff MD  GI Associates of Maryland  GI Associates of Maryland  John Bedeau MD & David Gorray MD  Kaiser Permanente Medical Center Largo  Kaiser Permanente Medical Center Largo  Kaiser Permanente Medical Center Largo  Kaiser Permanente Medical Center Largo  Aly Sabet MD  Sam Tellawi MD  Chandrakant K Bhatia MD  Digestive Disease Associates  Digestive Disease Associates  Megan Willard MD  Digestive Disease Associates  Digestive Disease Associates  Digestive Disease Associates  Digestive Disease Associates  Digestive Disease Associates  Gastro Center of Maryland  Wondwosen Abdi MD Bethesda, MarylandUpcoming Local Events2012-06-02
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Cirrhosis (Liver)Read the Cirrhosis (Liver) article » What is cirrhosis?
Cirrhosis is a complication of many liver diseases that is characterized by abnormal structure and function of the liver. The diseases that lead to cirrhosis do so because they injure and kill liver cells, and the inflammation and repair that is associated with the dying liver cells causes scar tissue to form. The liver cells that do not die multiply in an attempt to replace the cells that have died. This results in clusters of newly-formed liver cells (regenerative nodules) within the scar tissue. There are many causes of cirrhosis; they include chemicals (such as alcohol, fat, and certain medications), viruses, toxic metals (such as iron and copper that accumulate in the liver as a result of genetic diseases), and autoimmune liver disease in which the body's immune system attacks the liver.
Why does cirrhosis cause problems?The liver is an important organ in the body. It performs many critical functions, two of which are producing substances required by the body, for example, clotting proteins that are necessary in order for blood to clot, and removing toxic substances that can be harmful to the body, for example, drugs. The liver also has an important role in regulating the supply to the body of glucose (sugar) and lipids (fat) that the body uses as fuel. In order to perform these critical functions, the liver cells must be working normally, and they must have an intimate relationship with the blood since the substances that are added or removed by the liver are transported to and from the liver by the blood. The relationship of the liver to the blood is unique. Unlike most organs in the body, only a small amount of blood is supplied to the liver by arteries. Most of the liver's supply of blood comes from the intestinal veins as the blood returns to the heart. The main vein that returns blood from the intestines is called the port... Recommended Reading Related to Cirrhosis (Liver)Alpha-Fetoprotein Blood Test » What is alpha-fetoprotein (AFP) blood test?The most widely used biochemical blood test is alpha-fetoprotein (AFP), which is a protein normally made by the immature liver cells in the fetus. At birth, infants have relatively high levels of AFP, which fall to normal adult levels by the first year of life. Also, pregnant women carrying babies with neural tube defects may have high levels of AFP. (A neural tube defect is an abnormal fetal brain or spinal cord that is caused by folic acid deficiency during pregnancy.) In which situations are high blood levels of AFP seen?In adults, high blood levels (over 500 nanograms/milliliter) of AFP are seen in only three situations:
What tests are available for measuring AFP?Several a... Other Related Cirrhosis ArticlesEmergency Contact for Bethesda
Nearby Bethesda Hospitals *National Institutes of Health Suburban Hospital Psychiatric Institute of Washington Sibley Memorial Hospital Holy Cross Hospital Walter Reed Army Medical Center Georgetown University Hospital Washington Adventist Hospital National Rehabilitation Hospital Washington Hospital Center Washington DC VA Medical Center Children's National Medical Center Howard University Hospital The George Washington University Hospital Providence Hospital The HSC Pediatric Center Virginia Hospital Center The Specialty Hospital of Washington Dominion Hospital Shady Grove Adventist Hospital Adventist Rehabilitation Hospital of Maryland Potomac Ridge Behavioral Health Adventist HealthCare Gladys Spellman Specialty Hospital Prince George's Hospital Center Saint Elizabeth's Hospital Inova Alexandria Hospital Inova Fairfax Hospital Inova Fairfax Hospital for Children Northern Virginia Mental Health Institute Montgomery General Hospital United Medical Center The Specialty Hospital of Washington-Hadley Doctors Community Hospital Laurel Regional Hospital Reston Hospital Center Inova Fair Oaks Hospital Inova Mount Vernon Hospital Fort Washington Hospital Howard County General Hospital Southern Maryland Hospital Center Inova Loudoun Hospital Center Sheppard Pratt at Ellicott City Prince William Hospital Potomac Hospital North Spring Behavioral Healthcare Baltimore Washington Medical Center Graydon Manor Behavioral Health Spring Grove Hospital Center Springfield Hospital Center Anne Arundel Medical Center Saint Agnes Hospital Kernan Hospital Northwest Hospital Harbor Hospital Center Bon Secours Baltimore Health System Civista Medical Center University of Maryland Medical Center Baltimore VA Medical Center University Specialty Hospital Maryland General Hospital Mercy Medical Center Levindale Hebrew Geriatric Center & Hospital Kennedy Krieger Institute Sinai Hospital of Baltimore Frederick Memorial Hospital Johns Hopkins Hospital Featured Articles*Provider Directory Terms of Use: The WebMD 'Provider Directory' is provided by WebMD for use by the general public as a quick reference of information about Providers. The Provider Directory is not intended as a tool for verifying the credentials, qualifications, or abilities of any Provider contained therein. Inclusion in the Provider Directory does not imply recommendation or endorsement nor does omission in the Provider Directory imply WebMD disapproval. |
Suggested Reading on Cirrhosis (Liver) by Our Doctors
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Related Diseases & Conditions
34 articles-
Liver Disease
- Liver disease can be cause by a variety of things including infection (hepatitis), diseases such as gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause; however, common symptoms may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
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Gallstones
- Gallstones are stones that form when substances in the bile harden. Gallstones (formed in the gallbladder) can be as small as a grain of sand or as large as a golf ball. There can be just one large stone, hundreds of tiny stones, or any combination. The majority of gallstones do not cause symptoms.
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Liver Cancer
- Liver cancer is the fifth most common cancer in the world and the majority of patients with liver cancer will die within one year as a result. Patients with associated cirrhosis caused by chronic hepatitis B or C infections, alcohol, and hemochromatosis are at the greatest risk of developing liver cancer. Many patients with liver cancer do not develop symptoms until the advanced stages of the tumor which usually makes prognosis poor. The combination of an imaging study (ultrasound, CT, or MRI scans) and an elevated blood level of alpha-fetoprotein will most effectively diagnose liver cancer, while a liver biopsy can make a definitive diagnosis. Medical treatments, including chemotherapy, chemoembolization, ablation, and proton beam therapy, are not very effective. Surgical removal of the tumor or a liver transplant may be most effective in certain cases.
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Hepatitis C
- Hepatitis C is an inflammation of the liver due to the hepatitis C virus (HCV), which is usually spread by blood transfusion, hemodialysis, and needle sticks, especially with intravenous drug abuse. Chronic hepatitis C may be treated with interferon, usually in combination with anti-virals.
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Alcoholism
- Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
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Hepatitis B
- The hepatitis B virus is a unique, coated DNA virus belonging to the Hepadnaviridae family of viruses. The course of the virus is determined primarily by the age at which the infection is acquired and the interaction between the virus and the body's immune system. Successful treatment is associated with a reduction in liver injury and fibrosis (scarring), a decreased likelihood of developing cirrhosis and its complications, including liver cancer, and a prolonged survival.
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Ascites
- Ascites, the accumulation of fluid in the abdominal cavity is most commonly caused by cirrhosis of the liver. Some of the other causes of ascites include portal hypertension, congestive heart failure, blood clots, and pancreatitis. The most common symptoms include increased abdominal girth and size, abdominal bloating, and abdominal pain. Treatment depends on the cause of ascites.
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Internal Bleeding
- Internal bleeding occurs when an artery or vein is damaged and blood to escapes the circulatory system and collects inside the body. Internal bleeding can be caused by a variety of situations such as blunt trauma, deceleration trauma, medications, fractures, and spontaneous bleeding. Treatment of internal bleeding depends on the cause of the bleeding.
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Enlarged Spleen (Splenomegaly)
- The spleen enlarges if it is asked to do excessive work in filtering or manufacturing blood cells, if there is abnormal blood flow to it, or if it is invaded with abnormal cells or deposits. Symptoms of an enlarged spleen may include weakness and fatigue, easy bleeding, and poor white blood cell function. Treatment of an enlarged spleen is focused toward the cause of the splenomegaly. Surgery may be required to remove the spleen.
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Jaundice
- Jaundice is a yellowish staining of the skin and whites of the eyes (sclerae) with bilirubin, the pigment found in bile. Jaundice can be an indicator of liver or gallbladder disease, or it may result from the rupture of red blood cells (hemolysis).
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Hyponatremia (Low Blood Sodium)
- Hyponatremia is a condition where the level of sodium in the blood is low. Causes of hyponatremia can occur from excess fluid in the body, or a loss of sodium in body fluid. Some of the symptoms of hyponatremia include headache, muscle cramps or spasm, seizures, weakness and confusion. Treatment of hyponatremia depends on the cause.
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Thrombocytopenia (Low Platelet Count)
- Thrombocytopenia refers to a decreased number of platelets in the blood. There are many causes of thrombocytopenia such as decreased platelet production (viral infections for example rubella, mumps, chickenpox, hepatitis C, and HIV); increased platelet destruction or consumption (for example sulfonamide antibiotics, heparin, blood transfusions, and lupus); or increased splenic sequestration (enlarged spleen due to conditions for example liver disease, blood cancers, and more). Treatment of thrombocytopenia depends on the cause.
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Fatty Liver
- Nonalcoholic fatty liver disease (NAFLD) refers to a wide spectrum of liver disease ranging from simple fatty liver (steatosis), to nonalcoholic steatohepatitis (NASH), to cirrhosis (irreversible, advanced scarring of the liver). All of the stages of NAFLD have in common the accumulation of fat (fatty infiltration) in the liver cells (hepatocytes).
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Insulin Resistance
- Insulin resistance is the diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues. Causes of insulin can include conditions such as stress, obesity, metabolic syndrome, and steroid use. Some of the risk factors for insulin resistance include fatty liver, heart disease, strokes, peripheral vascular disease, high cholesterol, and smoking. Treatment for insulin resistance are lifestyle changes and if necessary, medication.
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Cystic Fibrosis
- Cystic fibrosis is a disease of the mucus and sweat glands. Cystic fibrosis is an inherited disease. The outcome of the disease leaves the body malnourished, bulky and fouls smelling stools, vitamin insufficiency, gas, painful or swollen abdomen, infertility, susceptible to heat emergencies, and respiratory failure. There is no cure for cystic fibrosis, treatment of symptoms is used to manage the disease.
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Hemochromatosis (Iron Overload)
- Hereditary hemochromatosis (iron overload) is an inherited disorder in which there is excessive accumulation of iron in the body. Individuals may have no symptoms or signs, or they can have severe symptoms and signs of iron overload. The most effective treatment for hemochromatosis is therapeutic phlebotomy.
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Liver
- The liver is the largest solid organ in the body, and is actually an gland. The liver has a wide variety of critical functions such as manufacturing proteins and metabolizing fats and carbohydrates. The liver also eliminates harmful biochemical waste products from the body (alcohol, drugs, toxins). The liver secretes bile that aids in digestion. Examples of diseases of the liver include cirrhosis, hepatitis, cancer, and fatty liver. Symptoms of liver disease include bleeding, easy bruising, edema, fatigue, and jaundice.
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Pleurisy (Pleuritis)
- Pleurisy, an inflammation of the lining around the lungs, is associated with sharp chest pain upon breathing in. Cough, chest tenderness, and shortness of breath are other symptoms associated with pleurisy. Pleurisy pain can be managed with pain medication and by external splinting of the chest wall.
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Gynecomastia
- Gynecomastia, an enlargement of the gland tissue in the male breast is the caused by an imbalance of hormones. Certain medical conditions may also lead to gynecomastia such as cirrhosis, malnutrition, disorders of the male sex organs, kidney failure, thyroid disorders, and medications. Gynecomastia is generally treated with medication, and if necessary surgery.
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Encephalopathy
- Encephalopathy means brain disease, damage, or malfunction. Causes of encephalopathy are varied and numerous. The main symptom of encephalopathy is an altered mental state. Other symptoms include lethargy, dementia, seizures, tremors, and coma. Treatment of encephalopathy depends on the type of encephalopathy (anoxia, diabetic, Hashimoto's, hepatic, hyper - hypotensive, infectious, metabolic, infections, uremic, or Wernicke's) are examples of types of encephalopathy.
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Pleural Effusion
- Pleural effusion is an excess fluid between the two membranes that envelop the lungs. There are two classifications of causes of pleural effusion; transudate and exudate. The treatment of pleural effusion depends on the cause.
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Viral Hepatitis
- Hepatitis is most often viral, due to infection with one of the hepatitis viruses (A, B, C, D, E, F (not confirmed), and G) or another virus (such as those that cause infectious mononucleosis, cytomegalovirus disease). The main nonviral causes of hepatitis are alcohol and drugs. Many patients infected with hepatitis A, B, and C have few or no symptoms of illness. For those who do develop symptoms of viral hepatitis, the most common are flu- like symptoms including: loss of appetite, nausea, vomiting, fever, weakness, tiredness, and aching in the abdomen. Treatment of viral hepatitis is dependant on the type of hepatitis.
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Metabolic Syndrome
- The main features of metabolic syndrome include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for clotting. Patients are most often overweight or obese. Lifestyle modification such as the Mediterranean diet, exercise, and quitting smoking are the preferred treatment of metabolic syndrome.
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Primary Biliary Cirrhosis
- Primary Biliary Cirrhosis is a chronic disease characterized by progressive inflammation and destruction of small bile ducts within the liver. The bile ducts transport bile from the liver to the intestine for the absorption of fat and elimination of waste products. The causes of Primary Biliary Cirrhosis may involve autoimmunity, infection, or genetic predisposition, acting alone or in combination. There are many medications and treatment options available for those with this and other associated diseases of Primary Biliary Cirrhosis.
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Male Breast Cancer
- Male breast cancer accounts for 1% of all breast cancers, and most cases are found in men between the ages of 60 and 70. A man's risk of developing breast cancer is one in 1,000. Signs and symptoms include a firm mass located below the nipple and skin changes around the nipple, including puckering, redness or scaling, retraction and ulceration of the nipple. Treatment depends upon staging and the health of the patient.
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Portal Hypertension
- Portal hypertension is most commonly caused by cirrhosis, a disease in which results from scarring of a liver injury. Other causes of portal hypertension include blood clots in the portal vein, blockages of the veins that carry the blood from teh liver to the heart, and a parasitic infection called schistosomiasis.
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Coma
- Coma is the inability to waken or react to the surrounding environment. The Glasgow Coma Scale is frequently used to measure the depth of coma. Causes of coma include trauma, bleeding, edema, lack of oxygen, poisoning, or hypoglycemia. Prognosis for a patient in a coma depends on the cause of the coma.
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Primary Sclerosing Cholangitis (PSC)
- Primary sclerosing cholangitis (PSC) is a chronic, progressive disease of the bile ducts that channel bile from the liver into the intestines. There is an association between primary sclerosing cholangitis and ulcerative colitis and Crohn's disease. Symptoms of primary sclerosing cholangitis include abnormal liver blood tests, itching, fatigue, and jaundice. Primary sclerosing cholangitis is treated with medications and in some cases, liver transplant.
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The Digestive System
- Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
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