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What Does Dupuytren's Contracture Have to do with Liver Disease?

December 13, 2020

While here has been a great deal of research invested into the causes of Dupuytren’s Contracture, doctors are still unsure of the exact reason why the condition first begins to appear in a patient.

However, theDupuytren Research Group has confirmed that there is a definite link between Dupuytren’s Contracture and liver disease.

In this article, we’ll dig a little deeper into what causes Dupuytren's Contracture in liver disease patients and why there’s a link between the two.

What is Dupuytren’s Contracture?

Dupuytren’s occurs in the hands and even occasionally in the feet of patients who begin to initially notice a thickening of the fascia in the palm of their hands, before a hard nodule develops underneath their ring finger.

In time, the thickening of the tissue pulls down the pinkie and ring fingers of the hand. It usually occurs in one hand as opposed to two, although bilateral Dupuytren’s Contracture does occasionally occur.

The name was given to the condition by Baron Guillaume Dupuytren, who first began to conduct surgeries on patients whose fingers were being pulled down toward their palms.

Why do People Suffer from Dupuytren’s?

Scientists have not yet been able to pinpoint exactly why a person begins to develop Dupuytren’s Contracture. However, there are links between this condition and others.

TheBritish Dupuytren’s Society lists several conditions that may be related to a person developing Dupuytren’s, including, but not restricted to:

  • Having a family member who already suffers with the disease,
  • Having had a frozen shoulder or suffered trauma to the fingers or hand
  •  Are or have been employed in a job working heavily with vibrating machinery or tools

There are also links to high cholesterol, HIV and, as we’ve read, liver disease. Even patients without an official diagnosis of liver disease but who drink large amounts of alcohol are at increased risk of the development of Dupuytren’s Contracture.

Which Demographic is More at Risk?

Dupuytren’s is more common in men than it is in women and features more predominantly in white communities than in black or Asian groups.

The link between white men and Dupuytren’s goes back hundreds of years, as male Viking skeletons have been unearthed and shown to have the disease, leading scientists to believe that the disease originally began in Scandinavia.

This doesn’t mean that women or black patients won’t develop the Dupuytren's. However, men over 50 are seen as being more likely to develop the disease than other groups.

Not just that, but the risk is increased when a person is a heavy smoker, heavy drinker, suffers with diabetes and even perhaps epilepsy, as studies have suggested.

The Link Between Liver Disease and Dupuytren’s Contracture

It would appear that the main factor in determining the risk of a person contracted Dupuytren’s at some point is genetics. Studies have shown that there is anincomplete penetrance in the gene pattern, meaning that while all with a certain genotype may carry the disease, only some of them will develop the disease, and others won’t.

 

 

For those who do have a genetic predisposition, they are more likely to develop the condition if they have a liver disease.

It’s thought that certain conditions have an impact on the Basal Metabolic Rate, or BMR, which in turn increases the likelihood of Dupuytren’s development.

Liver disease, including fatty liver disease and cirrhosis, affects the body’s ability to regulate chemicals in the blood. When the blood contains certain levels of chemicals or cells are damaged as a result of liver disease, they can go on to affect other areas of the body.

A liver that is damaged or diseased constantly affects the quality of the cells carried around the rest of the body. It can mean that in an already sensitive area of the body becomes inflamed; in the case of Dupuytren’s, this sensitive area is in the palm of the hand.

Other Effects of Liver Disease

It’s not just Dupuytren’s that can be caused or exacerbated by liver disease. The liver is an essential organ and despite its ability to regrow, when a liver is diseased it can greatly shorten a person’s life span.

Malnutrition, weight loss, and decreased cognitive function are all symptoms of liver disease; Dupuytren’s Contracture is not one of the more serious ones by any means.

What Causes Liver Disease?

Some people are genetically disposed to liver disease, which even if they take extra-special care of their body in general, can still become diseased from a build-up of certain substances their liver cannot flush out.

Other causes include viruses and infections, such as hepatitis A, B or C, which are specifically liver infections, or other illnesses which affect the liver as a secondary symptom.

Certain medications that people take can also damage the liver. The link between epilepsy and Dupuytren’s is because of the ingredients in some medications that can cause liver disease.

The most common cause of liver disease, however, is alcohol abuse.

The Link Between Alcohol and Dupuytren’s Contracture

It was found in many studies that while it’s mostly men over 50 who approached their doctor showing symptoms of Dupuytren’s, one thing many of them had in common was their lifestyle.

Alcohol in moderation was not found to have a direct impact on Dupuytren’s. The disease of the hand is neither made worse nor eased if, say, someone has a glass of wine or doesn’t.

What doctors and scientists have discovered is that heavy drinkers are more likely to develop Dupuytren’s as asymptom of other things going on inside the body due to alcohol. As we have seen, it’s a result of liver disease.

The link between liver disease and Dupuytren’s has been established for many years, so much so that many doctors who notice that their patient has Dupuytren’s will automatically be prepared for them to explain that they have alcohol issues.

Can Liver Disease be Cured?

The liver, despite being so vital to the human body, is incredibly resilient and is the only organ, other than skin, that can regenerate itself and even regrow when part of it has been removed.

Some diseases of the liver can be cured; for example, hepatitis A and C are both diseases of the liver that a patient can recover fully from. However, most diseases that affect the liver are chronic and while they can be managed, they can never be fully cured.

Without careful management, therefore, a diseased liver can develop cirrhosis, which is when the liver becomes severely scarred, and therefore damaged beyond repair.

Cirrhosis scarring is known asfibrosis and Dupuytren’s is also a fibrosing disease. Therefore, doctors associate long-term drinking with Dupuytren’s as it appears to be another symptom of fibrosing tissue brought on by alcohol.

Lifestyle Changes Could Slow Down Dupuytren’s Contracture

Cirrhosis scarring is known asfibrosis and Dupuytren’s is also a fibrosing disease. Therefore, doctors associate long-term drinking with Dupuytren’s as it appears to be another symptom of fibrosing tissue brought on by alcohol.

The first thing a doctor will recommend if you are a drinker who is showing signs of Dupuytren’s is that you cut down your alcohol intake, quitting completely if possible.

This isn’t just so it can alleviate the progression of Dupuytren’s, but that it’s better for your whole body if you cut back on drinking, especially if you drink more than the equivalent of one bottle of wine per day.

Heavy smoking, obesity and poor nutrition are all other factors that doctors have long known will exacerbate the symptoms of Dupuytren’s. Smoking and obesity in particular narrow the body’s blood vessels, restricting circulation of oxygen and leading to the death of tissue cells.

Positive lifestyle changes can have a drastic impact on the whole body, and not just on a patient’s Dupuytren’s.

There are, of course, those patients who will develop Dupuytren’s Contracture despite not drinking or smoking. They may eat well, exercise and be of a healthy weight and still begin with the condition.

In this case, it’s more likely that their condition is genetic as opposed to be caused by lifestyle factors, but even now, doctors are still not sure as to the aetiology of Dupuytren’s, or what exactly triggers is.

See Your Doctor if You Have Symptoms of Dupuytren’s Contracture

If you’re developing Dupuytren’s symptoms, it’s best to see a doctor at your earliest convenience. While the syndrome isn’t an emergency, early intervention can lead to the best care and management of the condition.

Be prepared for the doctor to ask you about your lifestyle and habits. As this article has explained, there is a great link between liver disease and Dupuytren’s, and your doctor will know that addressing any liver issues early will result in a much greater chance at treatment and the avoidance of many different health conditions as a result, not just Dupuytren’s.


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