01/01/2019
The end stage of any chronic liver diseases is cirrhosis and this stage is irreversible. Liver diseases like alcohol liver disease, fatty liver disease, excess deposition in the liver of iron, copper as well as other metabolic causes just to mention a few.
In cirrhosis, the liver is like a scar tissue. It is shrunken and smaller in size. A good analogue; healthy liver is smooth and fresh like that sold in the market. Cirrhotic liver is like cooked liver - hard and shrunken. Cirrhosis is the usual pathway to liver cancer except for Hepatitis B and cancers from other organs which have sent cancer cells (metastasized) to the liver.
Hepatitis B is a special entity in Africa because the infection usually occurs during child birth from the infected mother. So even by age 20-30 years, the person would have had chronic hepatitis for about 20-30 years. The liver continuously repairs itself leaving behind scar tissue until eventually the whole liver is scarred up into cirrhosis. Hepatitis B can develop into liver cancer even before the stage of cirrhosis.
Cirrhosis comes in 2 types;
A. Compensated - life goes on but the median expected survival is 12 years. So a hepatitis B patient with cirrhosis at age 25 can easily die at age 35-40.
Compensated cirrhosis will eventually transition to decompensated because of development of complications;
B. Decompensated - cirrhosis complicated by the presence of ascites, esophageal varices bleeding, altered mental status (encephalopathy) and or jaundice . The median survival here is about 1.5 years.
Please get tested for hepatitis b surface antigen and surface antibody. If you already have positive hepatitis b surface antibody you are safe. You developed the antibody because you received hepatitis b immunization or you got infected with hepatitis b but you have overcome the infection.
If you have hepatitis b surface antigen it is not good. Further workup is need to address the degree of inflammation in the liver (hepatitis) and ultrasound of the liver is needed to rule out cirrhosis and liver cancer.
Starting Gastroenterology Practice in Accra Ghana in 2019.
Interested persons can contact me via WhatsApp at Digestive & Diagnostic Medical Services # 0017402438446 for further information.
Laurence Entsuah M.D.
Board Certified and Practicing Gastroenterologist - U.S.A.
