• Friday July 10,2020

Fibrosis (sclerosis)

Fibrosis, often referred to as sclerosis, is a hardening of tissue and organs due to the overproduction of collagen fibers. Frequently affected by fibrosis are the lungs, liver, kidney, heart or skin. Fibrosis is not a disease in itself, but rather a symptom underlying various underlying diseases.

What is fibrosis?

A fibrosis can occur in different regions of the body and thus leads to different complaints.
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The term fibrosis comes from the Latin "fibra" which translates in German as "fiber". The term refers to a pathological proliferation of the tissue fibers of the body, which may affect the function of the fibrosis-affected organ.

For example, respiratory distress may manifest fibrosis in the lungs, while liver fibrosis may manifest in hypertension and impaired brain function, including coma. The easiest way to imagine fibrosis is as scarring. In a healthy person, after wound healing, more and more connective tissue is formed at the injured site, which becomes visible as a scar.

Even with fibrosis there is damage to the affected organ, which can have a variety of causes and on which the body reacts with scarring.

causes

The causes of the onset of fibrosis are extremely diverse. They range from normal aging processes and long-term medication intake, circulatory disorders, infections and alcohol abuse to chronic inflammations such as hepatitis.

But also harmful environmental influences such as gases, vapors and organic dusts, for example of molds or house dust mites, can cause long-term allergic fibrosis. Autoimmune diseases can also lead to fibrosis. The starting point of fibrosis is always damage to the organ, whether through wear and tear, inflammatory reactions or an excessive lifestyle, to which the body must respond with progressive scarring.

If the underlying disease is not treated appropriately, the organ tissue is increasingly penetrated by scar tissue, which can not take over the function of the healthy tissue cells.

Symptoms, complaints & signs

Fibrosis can occur in different regions of the body and usually leads to different complaints. If the fibrosis occurs directly on the skin, the skin is usually thick and shriveled. This also results in a reduced aesthetics, so that most patients feel uncomfortable with these symptoms and suffer from inferiority complexes or a significantly reduced self-esteem.

Furthermore, there are also restrictions on movement and inflammation of the joints. These can continue to spread to the internal organs if they are not treated properly. Patients also often experience difficulty in swallowing fibrosis of the skin. In the liver, fibrosis can in the worst case lead to inflammation and cirrhosis of the liver.

If this is not treated, then the person dies due to the complaints. Furthermore, it comes to hypertension. Fibrosis may also develop in the lungs, with patients suffering from pneumonia and severe breathing difficulties.

The life expectancy of the patient is thereby extremely limited and the quality of life is significantly reduced. As the disease spreads to neighboring areas of the body, it requires immediate medical attention.

Symptoms of liver fibrosis (scleroderma):

  • cirrhosis
  • hepatitis
  • high blood pressure

Symptoms of fibrosis of the lung (pulmonary fibrosis):

  • see the article ⇒ Pulmonary fibrosis

Diagnosis & History

Existing fibrosis is diagnosed by means of a tissue sample, which the doctor can examine under the microscope for fibrosis-typical changes. Imaging techniques such as X-ray, ultrasound and computed tomography can also be used.

An X-ray examination is a commonly used method, especially in suspected lung fibrosis, while the liver can be better examined with the ultrasound machine. A fibrosis of the liver, also called liver cirrhosis, can also be detected by palpation of the organ. Important for a comprehensive diagnosis is also the discussion between doctor and patient in order to be able to connect possible pre-existing conditions with the fibrosis.

The diagnosis also includes functional tests of the corresponding organ. If the hardening of the tissue can be stopped in time, a life without or with little restrictions is possible. If the disease is already so advanced that the affected organ is no longer functional, organ failure occurs.

complications

As a result of fibrosis, a number of complications can occur. Depending on the severity of the disease, the organs and tissue become harder and less elastic as the disease progresses. This can cause discomfort and pain especially on the hands and fingers. Frequently, joint inflammations also form.

There may be difficulty swallowing, as the esophagus loses its elasticity and virtually freezes. In the later stages, the entire gastrointestinal tract may lose its function, leading to shortness of breath and other ailments. Increased lung pressure can increase the size of the right ventricle and cause long-term heart failure.

If the kidneys are affected, chronic deficiency symptoms can lead to hypoxia and hypertension. In advanced stages, fibrosis can cause kidney failure. If the disease is not treated at the latest, the other organs gradually fail and the patient dies.

Treatment may be complicated by the prescribed medication. A possible transplantation involves the risk of the organism rejecting the donor organ and causing life-threatening infections.

When should you go to the doctor?

A doctor's visit should take place as soon as the affected person has the feeling that something is wrong in his body. In case of a feeling of pressure, a diffuse sense of illness or a decrease of the usual efficiency, a doctor should be consulted. If swallowing or pain persists for several days, a doctor should be consulted. If the symptoms increase in size and intensity or if there are other symptoms, it is advisable to have them clarified by a doctor.

A medical examination is also necessary as soon as breathlessness sets in. If there is a problem with inhalation or a rapid heartbeat for no apparent reason, this is considered to be worrying. If insomnia sets in, the blood pressure rises and a permanent sensation of warmth can be perceived, a doctor's visit is necessary. In case of persistent functional limitations of different kinds, it is recommended that the person concerned presents to a doctor.

If gastrointestinal disturbances, unwanted weight loss, or irregularities in urination occur, these observations should be further investigated and treated as necessary. This applies in particular as soon as they occur unabated repeatedly. Unusual and sudden changes in the appearance of the skin should also be clarified by a doctor. Thickening of the skin, a dry feeling on the skin and a feeling of tightness should be discussed with a doctor.

Treatment & Therapy

Depending on the cause of the occurring fibrosis, the treatment options are diverse. The treatment of fibrosis depends on the underlying disease. For example, if fibrosis is inflammatory, the ultimate goal is to stop the inflammatory process. This can be done by means of cortisone preparations or immunosuppressants.

If toxins or alcohol abuse are the cause of fibrosis, the avoidance of the causative substances is indispensable. A symptomatic treatment, such as an oxygen supply in a fibrosis of the lungs is conceivable. Fibrosis can not be completely cured, existing damage remains, which is why early treatment is of particular importance.

If fibrosis is already at the terminal stage, there is the option of organ transplantation. If a fibrosis is not treated, it ends fatally.

Outlook & Forecast

Fibrosis is a change in the tissue that often affects the lungs. However, the prognosis for such fibrosis does not look very good and usually can not be cured. In many cases fibrosis leads to death. However, this disease can be delayed with appropriate treatment and the right medication.

Affected individuals with fibrosis can have a positive influence on the outlook and prognosis through coordinated self-management. In addition, the prognosis depends on many different factors that can positively influence the entire course of the disease. The factors mentioned include, for example:

  • the start of treatment (the sooner treatment is given, the better)
  • from the damage already done in the lungs
  • the speed with which the disease progresses
  • the effectiveness with which the treatment strikes the affected person

Fibrosis is a serious condition requiring medical attention. However, in most cases the prognosis is anything but positive. Often, this disease is deadly. Only the delay of this disease is possible. By appropriate treatment severe complications can be avoided.

prevention

Fibrosis can be prevented by a healthy lifestyle, such as moderate alcohol consumption and abstinence from smoking. In addition, a vaccine against the inflammatory disease hepatitis B makes sense. The body should be exposed as little as possible to poison and pollutants. A normal body weight, a healthy diet and sufficient exercise strengthen body and immune system and are not to be underestimated for the prevention of fibrosis.

aftercare

In the case of fibrosis, the person concerned usually has no special measures or options for follow-up care. The affected person is definitely dependent on early diagnosis and detection of this disease, so that further complications or complaints can be avoided. It can not come to an independent healing in this disease.

Furthermore, in the case of fibrosis, the diagnosis of the underlying disease is very important in order to limit it and treat the symptoms causally. The fibrosis may also reduce the life expectancy of the person affected. However, the life expectancy and the further course depend strongly on the underlying disease, so that no general course can be given.

The treatment of fibrosis is usually done by taking medication. The person concerned should pay attention to a regular intake and also to a correct dosage, so that the complaints can be properly alleviated. Without treatment, fibrosis usually leads to the death of the person affected. The patient is also dependent on the help and care of friends and family through this disease.

You can do that yourself

Fibrosis, synonymous with sclerosis, does not create its own clinical picture, but describes a symptom that may be the expression of several different diseases. All causes of fibrosis have in common that functional tissue in certain organs is increasingly being replaced by collagenous connective tissue.

The tissue of the affected organs is thereby harder (sclerotic) and the organ increasingly loses functionality, because the built-in connective tissue, almost as a substitute tissue - can not take on any of the original organ functions.

In many cases, the fibrosis is weak and needs no further treatment, so that an adjustment of the behavior in everyday life and self-help measures omitted. If important organs such as the lungs, liver and others are affected, it is important to find out the cause of sclerotization in order to start fighting the causes.

The fibrosis of the organ in question is irreversible. This means that although fibrosis can be stopped if its causes have been successfully eliminated, the disease can not be reversed.

In some cases, self-help measures are urgently needed. For example, environmental conditions in dusty environments (coal mining, aluminum processing, flour processing plants) can be the cause of pulmonary fibrosis (pneumoconiosis). As a self-help measure comes here a career change, but at least a job change into consideration.

If an incipient cirrhosis of the liver can be attributed to excessive and chronic alcohol consumption, the self-help measure consists in the renunciation of alcohol consumption, which can be achieved if necessary by means of a withdrawal cure.


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