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Decompensated Cirrhosis

marijuana and decompensated cirrhosis

Medical Marijuana and Decompensated Cirrhosis

Every year in America, approximately 31,000 people die from cirrhosis, according to Johns Hopkins Medicine. Many of these cases are due to chronic hepatitis C or liver disease from alcoholism. For the most part, cirrhosis of the liver is not curable. However, some patients receive a liver transplant.

For the majority of patients suffering from cirrhosis, life is full of pain, fatigue, and depression. Conventional medicine doesn’t always help, due to some harmful side effects associated with it.

The benefits of medical marijuana keep growing for many people suffering from chronic diseases. The good news is, medical marijuana and decompensated cirrhosis can help reduce many of these unwanted side effects and symptoms.

What Is Decompensated Cirrhosis?

The two stages of liver cirrhosis are compensated and decompensated.

  1. Compensated cirrhosis means the liver can retain enough of its function to perform vital processes. In this early stage, there are not too many symptoms.
  2. Decompensated cirrhosis means the liver can’t perform normal functions, and you are usually symptomatic. Decompensated cirrhosis happens when 75 percent of the liver is destroyed. This is the later stages of the disease and is life-threatening.

The last stages of liver cirrhosis usually take some years to present. Unfortunately, decompensated cirrhosis eventually happens, and it can be fatal. However, acute liver failure can occur at any stage of the disease.

If your doctor diagnoses cirrhosis in its early stages, they can treat it, and potentially prevent additional damage.

What the Liver Does

The liver is a vital organ that removes harmful substances from the body through a detoxifying process. It cleanses the blood and produces crucial nutrients necessary for the body to function.

Liver cirrhosis is a debilitating and fatal disease that severely damages the liver. There can be many reasons one gets liver disease, but the main reasons are hepatitis and chronic alcoholism.

liver cirrhosis

Although the liver tries hard to repair itself, too much injury can cause irreversible damage. Each time the liver tries to recover itself, scar tissue forms. The more scar tissue, the more difficult it is for the liver to function properly. The further cirrhosis progresses, the less likely the liver can repair itself from damage.

Causes of Decompensated Cirrhosis

The following is a list of the different diseases or causes potentially leading to cirrhosis of the liver.

  • Chronic viral hepatitis
  • Chronic alcohol abuse
  • Accumulating fat in the liver

Other possible causes include:

  • Cystic fibrosis
  • Hemochromatosis
  • Autoimmune hepatitis
  • Biliary atresia
  • Primary sclerosing cholangitis
  • Wilson’s disease
  • Alagille syndrome
  • Syphilis or schistosomiasis

Symptoms of Decompensated Cirrhosis

The following symptoms can occur when the disease progresses from compensated to decompensated.

  • Fatigue
  • Quick bruising and bleeding
  • Itchy skin
  • Jaundice of the skin and eyes
  • Ascites, or buildup of fluid in the abdomen
  • Edema, or fluid buildup in the legs and ankles
  • Pain in the abdomen
  • Nausea
  • Fever
  • Brownish or orange urine
  • A decrease in appetite accompanied by loss of weight
  • Hepatic encephalopathy

Due to the liver breaking down and severe damage occurring, there can be many more symptoms involved.

Physical Effects of Decompensated Cirrhosis

Listed below are some complications affecting the liver and circulatory system.

cirrhosis effects

  • Portal hypertension: This condition happens when the cirrhosis causes the flow of blood to slow down through the liver, which increases the blood pressure in the veins carrying blood from the intestines and spleen to the liver.
  • Edema: Swelling in the legs and abdomen occur when portal hypertension causes fluid to build up in the legs and the abdomen. This can also occur when the liver can’t produce enough albumin, or blood proteins.
  • Splenomegaly: This problem is an enlargement of the spleen. A restriction in blood flow and pressure in the veins can produce changes to the spleen. Symptoms such as a decrease in white blood cells and platelets can occur.
  • Bleeding: When portal hypertension occurs, this can cause blood to flow or get redirected to smaller veins, which enlarges their size and causes what’s known as varicose veins. The strain from the increase to these smaller veins can cause them to burst and bleed severely. Although this may not be life-threatening, smaller veins in the lower esophagus and stomach can rupture, which can be fatal. Of course, this can cause a worse situation if the liver has already sustained damaged and become unable to produce blood-clotting factors. Internal bleeding can occur, as well as bacterial infections from the bleeding.

Other complications include the following.

  • Infections: As just mentioned regarding bleeding internally, cirrhosis makes it hard for your body to fight off infections. Ascites can produce spontaneous bacterial peritonitis, which is a serious infection.
  • Malnutrition: Due to your body’s inability to process nutrients, weight loss accompanied by weakness can occur.
  • Hepatic encephalopathy: Since cirrhosis prevents the liver from removing toxins from the body, these toxins can build up in the brain and cause symptoms ranging from mental confusion, cognitive impairment, difficulty concentrating and coma.
  • Jaundice: This condition is one of the more common symptoms of the disease. Jaundice occurs when the liver can’t release enough bilirubin, which is a blood waste product, from the blood, resulting in a yellowing of the skin and eyes, as well as dark urine.
  • Bone disease: Due to the liver’s inability to process nutrients, the muscles and bones can become weak and fragile, resulting in a greater risk of fractures.
  • Increased risk of liver cancer: This risk is a concern for most people suffering from liver cirrhosis. The unhealthy environment, bacterial infection, and breakdown of the liver’s ability to remove toxins is fertile ground for abnormal cell growth.
  • Acute-on-chronic liver failure: As with many diseases occurring in some of the larger organs, liver cirrhosis can cause multiple organ failure, due to many serious complications, though researchers don’t quite understand how it happens.

Mental Effects of Decompensated Cirrhosis

Due to the ongoing complications and multiple symptoms, it’s no wonder some patients suffer from mental disorders such as anxiety and depression. But various MRI studies have shown these symptoms, including a change in the default-mode network in previous resting-state studies.

Cirrhosis Statistics

According to the National Institutes of Health, facts about cirrhosis include:

  • Just over 31,000 deaths occurred from it in 2010.
  • Cirrhosis is a leading cause of mortality and morbidity in America.
  • Variceal bleeding occurs in 25 to 40 percent of patients with cirrhosis of the liver.
  • Variceal bleeding has a 10 to 30 percent mortality rate.
  • One of the main symptoms of decompensated cirrhosis is ascites. In the past 10 years, 60 percent of all people with cirrhosis have experienced it.

In 2013, the number of deaths from cirrhosis rose to nearly 38,000, making it the 12th most common cause of death in the U.S.

Decompensated Cirrhosis History

Changes in assumptions about alcohol use and its major cause of liver cirrhosis have occurred since the turn of the century. Social and political views have determined the temperance movement, which has had a profound effect on medical and public health discussions and implementations of the role of alcohol use in liver disease.

During the 19th century, many clinical and epidemiological approaches emphasized the importance and the direct correlation between liver cirrhosis and alcoholism. However, during the turn of the century and the temperance movements, ideas changed about alcohol.

Both of these eras saw changes in alcoholism and liver cirrhosis based on the liberalization and changes in drinking norms in American society. Due to these changes, cirrhosis and the correlation between it and alcoholism became minimized. People blamed the disease on industrial toxins and air pollution. However, in recent years, research has shown heavy drinking and alcoholism is a direct cause of liver cirrhosis.

Current Treatments Available for Decompensated Cirrhosis and Their Side Effects

As with any disease, your physician will assist with any medical treatment, which includes:

Removing Excess Body Fluid

To prevent excess water weight or fluid buildup, a low-sodium diet will prevent, or at least reduce, ascites and edema. Medications can control severe fluid buildup, and certain procedures can drain the fluid and relieve tension and pressure. Doctors can insert a small tube — known as a transjugular intrahepatic portosystemic shunt, or TIPS — into a vein in the liver to reduce blood pressure in the liver and release fluid buildup.

Treating Portal Hypertension

One way to treat the increased blood pressure in the veins is with blood pressure medication your doctor can prescribe, which will also prevent severe bleeding. Your doctor can also perform an upper endoscopy to check for enlarged veins in the esophagus and stomach possibly causing bleeding.

If you’re having a moderate case of bleeding and develop varices, your doctor can prescribe medication to reduce the bleeding. Some patients who can’t handle the medication for whatever reason may consider having a band ligation procedure to stop or reduce the bleeding. In severe cases, your doctor may decide to insert a TIPS in the vein of your liver to reduce blood pressure and prevent further bleeding.

Combatting Infections

To reduce the likelihood of infections, your doctor can prescribe antibiotics and may recommend you getting certain vaccinations for hepatitis, pneumonia and the flu.

Checking for Liver Cancer

To reduce the chances of liver cancer, your doctor will suggest a regular checkup, blood tests, and ultrasounds every six months.

Preventing Hepatic Encephalopathy

To avoid the buildup of toxins in your blood, your doctor may prescribe certain medications to address this brain disorder issue effectively.

Getting a Liver Transplant

Often, medical professionals suggest a liver transplant with advanced cases of liver cirrhosis or when the liver stops functioning. Some signs that show advanced cases of cirrhosis of the liver are:

  • Jaundice
  • Ascites
  • Bleeding varices
  • Hepatic encephalopathy
  • Kidney dysfunction
  • Liver cancer

Cirrhosis of the liver is the most common reason for a liver transplant. Most liver transplants are from a deceased donor. In rare cases, part of a liver will come from a living donor.

Recent Developments in Decompensated Cirrhosis

Advanced strategies for treating decompensated cirrhosis aim at preventing multiorgan failure and complications to prolong a patient’s survival and improve their quality of life.

Additionally, there are two present clinical trials.

  1. G-CSF in decompensated cirrhosis: This clinical trial is evaluating whether multiple cycles of G-CSF (granulocyte-colony stimulating factor) may result in better outcomes by causing more sustained and prolonged stem cell migration to the liver.
  2. Rifaximin reduces the complications of decompensated cirrhosis: This clinical trial is studying the drug Rifaximin’s ability to reduce the complications of decompensated cirrhosis, and is currently in phase four.

How and Why Marijuana Can Be an Effective Treatment for Decompensated Cirrhosis

currhosis marijuana treatment

Research has shown some improvement in treating cirrhosis with cannabis. The impact of medical cannabis for decompensated cirrhosis is complicated, but cannabinoids from cannabis had some positive impact on the body’s endocannabinoid system, which directly affects cirrhosis, fibrosis and other liver diseases.

There have been some beneficial effects of CB2 receptor activation on an alcoholic fatty liver, fibrosis, injury to the liver, hepatic inflammation, and regeneration. Studies have shown using the CB2 receptor found in cannabis may provide therapeutic relief for patients suffering from cirrhosis of the liver and other liver diseases.

One independent study showed some alcohol users who used cannabis had a lower risk of developing the following conditions:

  • Alcoholic steatosis
  • Steatohepatitis
  • Fibrosis cirrhosis
  • Hepatocellular carcinoma

What Side Effects and Symptoms of Decompensated Cirrhosis Can Medical Marijuana Treat?

Some symptoms cannabis and decompensated cirrhosis help treat include:

Pain

Pain relief is one major benefit of using cannabis for those suffering from cirrhosis of the liver. More states are allowing patients with cirrhosis of the liver to seek pain treatment with medical marijuana and hopefully enjoy less pain and a better life. It is a safer option since addiction to prescription opioids is on the rise.

Nausea

Medical marijuana, including cannabinoids and THC, have shown to be more effective at treating nausea than many medications.

Insomnia

Research has revealed medical marijuana is effective when it comes to improving sleep and helping one stay asleep. It also doesn’t have the side effects other medications have when treating insomnia.

Anxiety

Early research studies show medical marijuana can effectively treat anxiety. It has some of the same ingredients over-the-counter medications contain.

One of the most popular anxiety medications is benzodiazepines. It has a neurotransmitter called GABA working to balance anxiety levels quickly. The problem with this medication is that it is very addictive. Patients quickly build up a tolerance to it, and it causes thousands of overdose deaths every year.

Medical marijuana can also manage the levels of GABA in your brain, according to early research studies, due to the cannabidiol it contains.

Depression

Recent surveys conducted at the University of Southern California show interesting results regarding marijuana and depression with those who use marijuana and those who do not. Out of the 4,400 surveyed, those who used marijuana had fewer signs of depression than those who do not use marijuana.

Best Strains of Marijuana to Use for Symptoms of Decompensated Cirrhosis

Here is a list of good marijuana for decompensated cirrhosis strains to use.

Strains for Depression

  • Jack Herer (Sativa)
  • Pineapple Express (hybrid)
  • Harlequin (hybrid)

Strains for Anxiety

  • Granddaddy Purple (Indica-dominant)
  • Girl Scout Cookies (hybrid)
  • Amnesia Haze (hybrid)

Strains for Pain

  • Afghan Kush (Indica)
  • ACDC (Sativa-dominant)
  • Blue Dream (Sativa-dominant)

Strains for Nausea

  • Death Star (Indica-dominant)
  • Chocolope (Sativa)
  • Sunset Sherbet (hybrid)

Best Methods of Marijuana Treatment to Use to Treat Side Effects and Symptoms of Cirrhosis

You can ingest cannabis in several ways to help you benefit from the drug. The methods you can use marijuana and decompensated cirrhosis treatment include:

  • Smoking
  • Edibles
  • Patches
  • Tinctures
  • Topicals
  • Vaporizers
  • Oils
  • Dabbing

Finding the best method for you can take trial and error and work with your physician and budtender. Smoking weed, however, may not be the optimal method, as it can impact respiratory function in the same way tobacco can.

Take the Next Step in Obtaining Medical Marijuana for Decompensated Cirrhosis

marijuana for cirrhosis

If you’re suffering from cirrhosis and its many symptoms and are ready to begin looking into how cannabis for decompensated cirrhosis may help make your quality of life better, feel free to start your search here at MarijuanaDoctors.com.

Be sure to write down the questions you want to discuss with the doctor during your online consultation. You can also search for a medical marijuana doctor to provide you with the recommendation you need for medical cannabis. Once you have your medical marijuana product in hand, you can locate a cannabis dispensary to purchase your products.

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Resources:

  1. https://www.hopkinsmedicine.org/healthlibrary/conditions/liver_biliary_and_pancreatic_disorders/liver_disease_statistics_85,P00686
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508079/
  3. https://pubs.niaaa.nih.gov/publications/surveillance105/Cirr13.pdf
  4. https://onlinelibrary.wiley.com/doi/abs/10.1111/liv.13696

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