Jnma 61 258 115
Jnma 61 258 115
Jnma 61 258 115
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doi: 10.31729/jnma.8016
ABSTRACT
Introduction: Cirrhosis in young adults is an important health problem worldwide and is a common
disease. Patients usually present late in a decompensated state with varied complications. However,
national data on the exact burden of the disease is lacking. The aim of this study was to find out the
prevalence of liver cirrhosis among young adults admitted to the Department of Gastroenterology
in a tertiary care centre.
Methods: A descriptive cross-sectional study was done among patients admitted to the Department
of Gastroenterology in a tertiary care centre between 25 November 2021 to 30 November 2022 after
receiving ethical approval from the Institutional Review Committee [Reference number: 227(6-11)
E2-078/079]. Convenience sampling was done. Point estimate and 95% Confidence Interval were
calculated.
Results: Among 989 patients, liver cirrhosis in young adults was seen in 200 (20.22%) (18.12-22.32,
95% Confidence Interval). Chronic alcohol use was the primary cause of cirrhosis seen in 164 (82%)
cases. The most typical presenting symptom was abdominal distension seen in 187 (93.50%) patients.
The most frequent complication was ascites seen in 184 (92%) patients. The most frequent endoscopic
finding was gastro-oesophagal varices seen in 180 (90%) patients. There were 145 (72.50%) men and
55 (27.50%) women.
Conclusions: The prevalence of liver cirrhosis in young adults was found to be lower than the other
studies done in similar settings.
INTRODUCTION
Liver cirrhosis refers to a disorder that alters the unknown.3 Early interventions and preventions are
overall typical architecture of the liver. Globally, the required to stabilize disease progression and to avoid
majority of instances are ascribed to non-alcoholic or delay clinical decompensation and the need for liver
fatty liver disease, viral hepatitis, or excessive alcohol transplantation.4
usage.1 Depending on the aetiology and whether portal
hypertension or hepatocellular damage predominates, The aim of this study was to find out the prevalence
the clinical appearance of cirrhosis differs. However, of liver cirrhosis among young adults admitted to
even in the absence of any clear clinical symptoms, the Department of Gastroenterology in a tertiary care
substantial liver damage may be present.2 centre.
______________________________________
Various causes of cirrhosis in adults have been studied
but the aetiology of cirrhosis in young adults less Correspondence: Dr Rahul Pathak, Department of
Gastroenterology, Tribhuwan University Teaching Hospital,
than or equal to 40 years has not been well studied, Maharajgunj, Kathmandu, Nepal. Email: dr.rahuliom@gmail.
and the incidence of cryptogenic cirrhosis remains com, Phone: +977-9851113793.
edema, and hair loss over the body (Table 1). DISCUSSION
Table 1. Symptomatology at presentation (n= 200). The prevalence of liver cirrhosis among young adults
Signs and symptoms n (%) was 20.22% which was high when compared to a
Abdominal distension 187 (93.50) similar study done in other tertiary care centres of
Anorexia 140 (70) Nepal,6 but lower to the similar studies done in Nepal.7,8
Fatigue 120 (60)
In the current investigation, alcoholic liver disease
Vomiting 104 (52)
was the most prevalent aetiology of cirrhosis and was
Dizziness 64 (32)
found in 164 (82%) individuals which was similar to
Fever 50 (25)
other studies.4,9,10 The most prevalent cause of cirrhosis
Altered sensorium 36 (18)
in Nepal is chronic alcohol use. Therefore, cirrhosis
Oliguria 12 (6)
cases are increasingly being detected in young
Ascites 184 (92)
people, as was shown in the current research, which
UGI bleed 108 (54)
may be related to early alcohol consumption and
Icterus 148 (74)
dependency. The prevalence of alcohol use, misuse,
Pallor 144 (72)
and dependency among the younger population is
Pedal oedema 120 (60)
increasing, which may be the cause of this condition.
Loss of body hair 118 (59)
Spider naevi 86 (43) In this study, 184 (92%) individuals had ascites
Palmar erythema 48 (24) followed by pallor in 144 (72%) and pedal edema in 120
Parotid enlargement 52 (26) (60%), icterus was seen in 148 (74%) patients. In this
Dyspnea 40 (20) research, 108 (54%) patients had upper gastrointestinal
bleeding. These results were similar to other studies.4,9
There were 108 (54%) individuals who had UGI
In the current study, the most frequent finding on UGI
bleeding. The most frequent endoscopic finding was
endoscopy was gastro-oesophageal varices, which
gastro-oesophagal varices, which were discovered in
were observed in 180 (90%) patients, followed by
180 (90%)patients, followed by portal gastropathy in
portal gastropathy in 150 (75%) patients which was
150 (75%) patients, peptic ulcers in 15 (7.50%) patients,
similar to other studies.9
gastro-duodenitis in 4 (2%) patients, Mallory Weiss
tears in 20 (10%) patients and GI malignancies in 2 The mean age of the patients from our study was
(1%) patients. similar to these studies.9 With regards to the gender-
wise distribution of the patients, our study showed
The participants were divided into groups based on
that ALD was more predominant in males which is
their CTP classifications. Most cases belong to CTP C
similar to other studies.4,9,10 The increased prevalence
120 (60%) patients (Figure 2).
of ethanol use among males compared to women
is most likely the cause of the male preponderance
over female in all investigations. Additionally, there
may be disparities in how the two sexes seek medical
attention.
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