Abstract

Autonomic dysfunction is an dysfunction of the normal functioning of the autonomic nervous system that adversely affect health. Few studies suggest that autonomic dysfunction is common in liver cirrhosis, both in alcoholics and non alcoholics. Autonomic neuropathy in liver cirrhosis is characterized by predominant vagal impairment. Autonomic dysfunction accounts for a significant proportion of symptoms, which can be common, non specific and challenging to treat. Autonomic dysfunction contribute to the impaired quality of life in chronic liver disease. Hence the present study is undertaken to estimate the presence of autonomic dysfunction in patients of alcoholic cirrhosis and to determine the association between severity of of liver damage and extent of autonomic function impairment.

This hospital based cross sectional study includes 60 cases of alcoholic cirrhosis. Various tests for the cardiovascular autonomic dysfunction were done on all cases. Severity of liver damage was determined by Child-pugh class of liver cirrhosis. The data was collected and analysed at the end of study.

Autonomic dysfunction was seen in 55(94%) cases of alcoholic cirrhotics. Only parasympathetic dysfunction was observed in 44(73.3%) cases while only sympathetic dysfunction was seen in 2(3.3%) cases. Combined, i.e.both sympathetic and parasympathetic dysfunction was seen in 9(15%) cases. According to Ewings criteria, maximum cases (31) had early autonomic dysfunction while only 3(5%) cases had severe autonomic dysfunction. There were 30(50%) cases of Childs class B followed by 20(33%)in Childs class C. Only 10(11.7%) were included in Childs class A. There was no statistical significant association between Child-Pugh class of liver cirrhosis and autonomic dysfunction. But there was statistical significant association (P<0.05) between severity of autonomic dysfunction and higher Child Pugh class of liver cirrhosis.

Autonomic dysfunction is common in alcoholic cirrhosis of liver. The severity of autonomic dysfunction increases with increase in the extent of the liver damage.

Keywords-Autonomic  dysfunction,Cirrhosis of liver.

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