Fibrosis

 

Detailed view of Fibrosis

Introduction

Fibrosis is the formation of excess fibrous connective tissue in an organ or tissue in a reparative or reactive process. This can be a reactive, benign or pathological state. In response to injury, this is called scarring and if fibrosis arises from a single cell line, this is called a fibroma. Physiologically, fibrosis acts to deposit connective tissue which can destroy the architecture and function of the underlying organ or tissue. Fibrosis can be used to describe the pathological state of excess deposition of fibrous tissue, as well as the process of connective tissue deposition in healing. Defined by the pathological accumulation of extracellular matrix (ECM) proteins, fibrosis results in scarring and thickening of the affected tissue, it is in essence an exaggerated wound healing response that interferes with normal organ function.


The other name of Fibrosis is Fibrotic scarring. It is an uncontrolled wound healing in which connective tissue replaces normal parenchymal tissue to the extent that it goes unchecked, leading to considerable tissue re-modelling and the formation of permanent scar tissue.  So, when fibrosis occurs in response to injury, the term “scarring” is used.

Types

There are mainly three types of fibrosis that occur in our body: Pulmonary fibrosis, Liver cirrhosis and Cardiac fibrosis.

1.    Pulmonary fibrosis: it refers to a number of conditions that causes interstitial lung damage followed by fibrosis and ultimately loss of lung elasticity. This type of fibrosis produces further problems such as persistent cough, chest pain, difficulty in breathing and fatigue or weight loss, aching muscles and joints. But these conditions vary from person to person. Some people become ill very quickly but some others take much time as over months or years. It may occur as a secondary condition in various other diseases but in some conditions, the underlying cause is not clear so in such situations idiopathic pulmonary fibrosis is used. This type of condition may occur in the later stage approximately between 50 to 70 years. This condition appears in male and female equally. A high resolution CT scan shortly known as HRCT shows how much scarring is in the lungs. Some of the risk factors of pulmonary fibrosis are:

1.  The situations that increase the risk of damage of lung

2.  Smoking

3.  Gastroesophageal reflux disease          

4.  Tuberculosis and/or pneumonia

It is true in many cases that pulmonary fibrosis can be managed with a condition of preventive measures and medications but in some cases patient may require lung transplantation.

2.     Liver cirrhosis: Cirrhosis refers to the scar tissue and swellings that replace liver tissue and disrupt liver function. The condition is usually caused by alcoholism, fatty liver disease, hepatitis B or hepatitis C. Every time the liver undergoes stress or injury, it tries to regenerate and produces scar tissue in the process. As the scar tissue builds up, the liver function gets worse in condition and when cirrhosis is advanced, the liver no longer works properly. Cirrhosis does not give rise to symptoms until the damage has become extensive, at which point it may cause a wide range of symptoms. It also does not give rise to symptoms until the damage has become large. If liver cirrhosis is detected and diagnosed during the early stages of the disease, any further damage to the liver may be prevented. Treatment depends on the stage of the disease and the underlying cause of the cirrhosis but the overall goal is to slow development of the disease and relieve symptoms. If liver cirrhosis is advanced, a liver transplant may be the only option for some patients. But before transplantation, it is necessary to ensure that they are healthy enough to undergo the procedure. 

Each time your liver is injured due to any disease, alcohol consumption or maybe other cause, it tries to repair itself. During the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function which may be called decompensated cirrhosis. It is Advanced Cirrhosis that may be life-threatening.

The liver damage done by cirrhosis generally cannot be undone but if liver cirrhosis diagnosed at the appropriate time and the cause is treated, further damage can be avoided and sometimes reversed. Unfortunately, the signs and symptoms do not appear until liver damage is on a large scale. But when the symptoms appear, the most common symptoms are Fatigue, bleeding even on a mild scar or bruising, loss of appetite, nausea, swelling in legs, weight loss etc. But these conditions also vary from person to person.  

3.    Cardiac fibrosis: The heart that becomes damaged due to myocardial infarction may undergo fibrosis.  Cardiac fibrosis can affect the valves in the heart as well as the muscle which becomes stiff and less compliant and sometimes cause heart failure. This can increase the risk of heart failure. Fibrocytes usually secrete collagen and are therefore essential for structural support of the heart. However, when these cells are over-activated, fibrosis and thickening of the tricuspid valve and pulmonary valve can occur. This loss of flexibility in the valves can eventually cause valvular dysfunction and heart failure. This term may also refer to an abnormal thickening of the heart valves.

Diagnosis

To diagnose, the doctor may review your medical and family history, discuss your signs and symptoms and conduct a physical examination. The doctor may also use stethoscope to listen to your lungs while you breathe. Some tests may also be suggested by your doctor as Chest X-ray, CT scan and Echocardiogram. These all are related to your chest, if still he or she may doubt then he or she suggests you for lung tests as Pulmonary functioning testing, Pulse oximetry, Exercise stress test and Arterial blood gas test.

If other tests have not diagnosed the condition, the doctor may remove a small portion of lung tissue (biopsy). The biopsy may further examined in the laboratory to diagnose pulmonary fibrosis. There are mainly two ways Bronchoscopy and Surgical biopsy.

In Bronchoscopy, doctors use a small, flexible tube known as bronchoscope that passes through the mouth or nose into the lungs. The other method is Surgical biopsy. In this doctors use Video-Assisted Thoracoscopic Surgery (VATS) or open surgery (thoracotomy). In a VATS, doctors insert surgical instruments and a small camera through two or three small incisions between ribs. Through the camera, the doctor can see lungs on a video monitor while removing tissue samples from lungs. All the procedures are performed after given general anaesthesia to a patient. The other method under Surgical biopsy is open surgery or thoracotomy. In this, the surgeon removes a lung sample through an incision in the chest between ribs. These procedures also performed after given general anaesthesia.

The last test that your doctor suggests you may be the blood test. Through blood test doctor evaluates your liver and kidney function.

Treatment

Due to the involvement of multiple organ systems, fibrosis can be a complex disease to manage. Patients need immediate attention to respiratory implications such as lung infection, thick sticky mucus and intestinal implications such as intestinal blockage, nutrition and dehydration. Though treatment depends on a multitude factors like the severity of the disease and the overall health of the patient, some of the commonly used are:  

Medications

Airway clearance: To remove the plugged mucous

Pulmonology rehabilitation: To improve lung function and health including activities like physical exercise, breathing techniques and nutritional counselling. Rehabilitation may involve chest physical therapy, energy-conserving techniques and psychological counselling.

Lung transplant is suggested in severe cases, if required. 

Home remedies

Cod Liver Oil

Cod liver oil contains fatty acids called omega-3 so it is helpful for the smooth functioning for the processing of the body. It is good for the lungs, heart, depression and arthritis but there is no scientific evidence. Its fatty acids are helpful to prevent blood clotting, pain and swelling. It contains vitamin A and vitamin D so it alleviates the inflammation of the lungs. It helps to minimize the symptoms of pulmonary fibroids. Taking cod liver oil from the mouth is effective for High and Lower blood pressure. It is also helpful for kidney disease and type 2 diabetes. It is effective for Osteoarthritis.

Smoking

Smoking is one of the main causes of the development of fibrosis. It is widely known that smoking significantly causes extreme damage to the lungs. Therefore, it is important to quit inhaling smoke in every possible form. Reducing smoking can majorly reduce the risk of developing the condition of fibrosis. Smoking causes a major problem known as Human Immunodeficiency Virus generally known as HIV. In a year the death rate due to smoking is also mainly from Chronic Obstructive Pulmonary Disease also known as COPD. A new study tells us that smoking increases the risk of coronary heart disease, stroke, lung cancer both in men and women. It also affects the heart as well as blood vessels also known as cardiovascular disease. The reason for that the smoking damages blood vessels and can make them thicken and grow narrower. This makes your heart beat faster and your blood pressure go up. A stroke occurs when the clot blocks the blood flow to your brain and a blood vessel in or around your brain burst.

Baking soda

Baking soda is an effective home remedy to relieve discomfort caused due to fibrosis. For this remedy, you need to mix one tablespoon of baking soda powder with a glass of water and drink it before every meal. Due to overeating sometimes there is a problem of heartburn or acid reflux or simply call acidity. Baking soda treats acidity by making the body alkaline. Baking soda water promotes digestion and eliminates toxins from the body. It stops heartburn also known as acid reflux. It is a painful, burning sensation that arises in the upper region of the stomach and can reach up to the esophagus. A few common causes of reflux are overeating, eating with stress and eating greasy or spicy foods. Baking soda is the solution to all these problems.

Water

It is important to stay hydrated. Proper hydration can protect your body from the risk of developing various diseases along with fibrosis. Consumption of water eliminates toxins from the body. A toxin-free body is at a lower risk of developing fibrosis. You can also drink other healthy fluids such as fruit juices to clean the organs of your body. A lack of water can cause blood to become thicker that increase blood pressure.

Self-Care

·         Avoid drinking alcohol.

·         Quit smoking.

·         Practice deep breathing exercises.

·         Exercise regularly.

Summary

Fibrosis is a life-threatening condition and must not be taken lightly. While it may be difficult to resolve this condition, you can slow down its movement and reduce the severity of its symptoms by following the tips and natural remedies.

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