Currently, the problem of chronic hepatitis is extremely relevant. According to statistics, 5% of the world's population suffer from the disease. This diagnosis combines a group of liver pathologies, each of which has different causes and symptoms. The diagnosis of chronic hepatitis is made if the disease has not been eliminated for at least 6 months.
Concept
The mechanism of development of pathology is the death of liver cells, which occurs under the influence of various adverse factors. In this case, the process is irreversible. The natural result is a significant increase in the load on the remaining parenchymal cells that form the main structure of the organ.
The disease, as a rule, is preceded by acute hepatitis, the treatment of which was not carried out properly, or there was no positive dynamics during therapy due to a pronounced weakening of the body's defenses or excessive activity of the factor that causes the disease(for example, a virus).
In addition, in some cases, the transition to the chronic form occurs due to the absence of symptoms. A person may not suspect that he has been developing a dangerous disease for several months or years, until the regenerating function of a vital organ has exhausted itself.
In the International Classification of Diseases (ICD), chronic hepatitis has code B18.0 and means an inflammatory process that develops in the liver, the duration of which is at least six months.
Reasons
Disease never occurs on its own. The launch of its development occurs only under the influence of certain provoking factors.
According to the etiology, chronic hepatitis is classified into the following types:
- Infectious. The causative agents are viruses whose vital activity leads to hepatitis B, C and D. Infection can occur with the parenteral route of administration of drugs (when they bypass the gastrointestinal tract and enter the bloodstream immediately), during childbearing (from mother to fetus), during lactation, with unprotected sexual contact. In most cases, the infection enters the human body during the implementation of medical procedures, accompanied by a violation of the integrity of the skin. This situation occurs when instruments are not thoroughly sterilized and when disposable needles are reused. In addition, other people's manicure tools, razors and other personal items also representdanger. According to statistics, during the transfusion of blood and its components, infection with hepatitis B most often occurs. The chronic form may not manifest itself for a long time. Left untreated, liver failure or cirrhosis develops.
- Toxic. It develops as a result of the negative impact on the liver cells of all kinds of toxic substances. It most often occurs with excessive consumption of alcoholic beverages, uncontrolled intake of medications and prolonged exposure to adverse conditions (for example, when human activity is associated with hazardous production). The risk of developing chronic hepatitis increases with self-medication with the following types of pharmacological drugs: antipyretics, antibiotics, cytostatics, anti-tuberculosis, antiarrhythmics.
- Autoimmune. It occurs as a result of damage to parenchyma cells by the body's own defenses. In other words, the immune system mistakes them for foreign ones. A feature of the disease is that young people usually suffer from it. Often, pathology develops simultaneously with other autoimmune ailments.
- Ischemic. Circulatory failure leads to hypoxia, due to which the liver does not receive enough oxygen and nutrients. As a result, harmful compounds that are products of metabolic processes begin to accumulate in the body. Most often, fatty degeneration of the organ occurs - a reversible condition that precedes cirrhosis.
- Cryptogenic. Reasons for itoccurrence of medicine are unknown, but they differ from the above. Accurate diagnosis requires careful differential diagnosis. In the ICD, this type of hepatitis has a separate code - B19.0.
Thus, the risk group includes people suffering from severe pathologies of an infectious nature, intestinal and cardiovascular diseases, ignoring the principles of a he althy diet, taking medicines uncontrollably, as well as people whose daily activities are associated with harmful production.
Symptoms
Chronic hepatitis is an ailment, the clinical picture of which is quite extensive. However, many patients may not feel any warning signs for a long time.
The symptoms of chronic hepatitis and their severity depend on the form of the disease:
- Inactive (another name is persistent). In most cases, the course of the pathology is not accompanied by any signs. In some people, they are present, but their severity is so weak that they do not pay any attention to the symptoms. At the same time, the organ increases in size slightly, the indicators of the general blood test are normal, in the biochemical one, the level of liver enzymes is slightly increased. Under the influence of negative factors (alcohol, food poisoning, etc.), an exacerbation occurs, in which the patient complains of severe pain in the right hypochondrium. During palpation, the doctor notes a moderate increase in the size of the organ. As a rule, after removing the startingfactor and diet, the patient's well-being is normalized.
- Active (other names - aggressive, progressive). The course of this form of chronic hepatitis is always accompanied by pronounced symptoms. At the same time, visible changes occur both in general and in the biochemical blood test. The clinical picture is quite multifaceted, but doctors distinguish the following main signs of chronic hepatitis in an active form: nausea, belching, flatulence, diarrhea, bloating, loss of appetite, constant feeling of weakness, decreased performance, fatigue, weight loss, fever, bleeding gums, the skin becomes yellowish, dark urine, pain in the right hypochondrium, itching all over the body, spider veins.
The severity of symptoms directly depends on how severely the liver is affected. In addition, due to the accumulation of harmful compounds in the body, patients may complain of sleep disturbances and instability of the psycho-emotional state. Also, signs of other autoimmune diseases can be added to the above symptoms if the cause of liver damage is an attack by antibodies that are produced by the body's own defense system.
Manifestations of chronic hepatitis in children are the same as in adults. But because their immune systems are not fully developed, they are more likely to have an active form of the disease.
Diagnosis
If there are alarming symptoms, you need to contactto a therapist. If he suspects liver disease, he will refer you to either a gastroenterologist or a hepatologist.
During the reception, the specialist conducts primary diagnostics, including:
- Collecting an anamnesis. The doctor needs to provide information on what medicines the patient has taken recently, whether he has had any injections, whether he has visited beauty salons, whether he has ever had unprotected sexual contact and how long ago, whether he had a transfusion of blood and its components. In addition, it is important for a specialist to know what diseases a person and his immediate family suffer from.
- Inspection. To determine the size of the liver, the doctor performs palpation. In addition, he performs percussion (tapping the desired zones) to assess the resulting sound phenomena, which also allows you to understand whether the organ is enlarged or not.
A thorough examination is essential for an accurate diagnosis.
Laboratory diagnosis of chronic hepatitis involves the following tests:
- Biochemical. The patient is taking blood, in which the level of protein, bilirubin, aminotransferase, alkaline phosphatase is determined. A thymol test is also carried out.
- Immunological. The biomaterial is also blood. The study is necessary to identify and determine the concentration in the liquid connective tissue of immunoglobulins G and M to viral hepatitis. Based on the results of the analysis, one can judge at what stage of development the disease is.
It is important to know that whenin the presence of chronic hepatitis, the results of laboratory tests may be within the normal range. For an accurate diagnosis, the doctor prescribes an ultrasound of the abdominal organs. In addition, according to indications, the following can be additionally performed: computed tomography, MRI or liver biopsy.
Drug therapy
The tactics of treating chronic hepatitis depends on its form and type. If the disease is in the acute stage, the patient is admitted to a hospital in the gastroenterology department.
With the viral nature of the pathology, the doctor prescribes glucocorticosteroids, antivirals and interferon alfa. To eliminate intoxication, enterosorbents are indicated. The course of treatment of chronic hepatitis is carried out until the blood counts are normal.
If the disease is autoimmune, the doctor prescribes glucocorticosteroids and cytostatics. If chronic hepatitis is extremely severe, an organ transplant may be necessary.
In case of toxic damage, it is necessary to eliminate the provoking factor. After that, the doctor prescribes hepaprotectors.
The treatment regimen is compiled on an individual basis, taking into account the characteristics of the patient's state of he alth and based on the results of all tests. Chronic hepatitis is a disease in which it is unacceptable to self-prescribe medications. In most cases, these situations lead to cirrhosis.
Diet
To support liver function and improvewell-being, it is necessary to adjust the diet.
The following products must be included in it:
- bread (wheat or rye);
- tea;
- whole milk;
- kefir;
- low-fat cottage cheese;
- cheese (hard, not spicy);
- butter and vegetable oils;
- chicken egg white;
- soups without frying;
- cereals;
- lean meat, steamed, boiled or baked (excluding chicken and veal);
- vegetables (from legumes only green peas are allowed);
- fish lean;
- compote;
- sweet fruits and berries;
- honey;
- jam.
The following foods should be completely eliminated from the diet:
- mushrooms;
- legumes;
- vinegar;
- garlic;
- sorrel;
- spinach;
- cocoa;
- marinades;
- canned food;
- pepper;
- radish;
- radish.
All meals must be baked, boiled or steamed. Fatty and fried foods should be completely excluded. Before use, the products are crushed. It is forbidden to eat hot and cold food, it must be warm.
Thus, the diet involves eating medium-calorie foods with a high protein content. Do not forget about the water balance. Drink up to 2 liters of pure non-carbonated liquid daily.
Lifestyle
In order to improve the effectiveness of medicalinterventions and minimize the likelihood of frequent exacerbations, the following rules must be observed:
- Avoid strenuous exercise. When anxiety symptoms appear, bed rest is indicated. The work schedule should be gentle, and it is also forbidden to work at night.
- If possible, spend holidays in sanatoriums or cities and countries with familiar climatic conditions.
- Sleep at least 7 hours a night. Good rest has a positive effect on the state of the body's immune system.
- Maintain normal bowel function. Constipation must be excluded. If necessary, it is recommended that you consult your doctor who will prescribe safe, mild laxatives.
- Do not smoke, do not use drugs or alcohol.
- Regular check-ups with a specialist. Compliance with medical recommendations for chronic hepatitis is the only way to improve the course of the disease.
It is important to understand that the treatment of pathology in most cases is carried out for the rest of life. The above rules must be followed at all times, and not only during exacerbations.
Forecast
Chronic hepatitis is a disease that threatens not only the he alth but also the life of the patient. If you have any warning signs, you should consult a doctor who will conduct a thorough diagnosis. Unfortunately, many patients ignore the first symptoms, seeking medical help at the stage of development of liver cirrhosis and other dangerous complications (for example, withgastrointestinal bleeding).
Currently, modern drugs are used to treat chronic hepatitis, which not only improve the course of the disease, but also prevent further destruction of liver cells. In this regard, with a timely visit to the doctor, the prognosis is favorable in most cases, but it also depends on the form of the pathology, the patient's diet and the principles of a he althy lifestyle.
Prevention
In order to prevent the development of the disease, you must:
- timely treat hepatitis in acute form, preventing their transition to chronic;
- use only your beauty tools and personal hygiene items;
- when visiting tattoo parlors and before any injections, make sure that the needles are disposable;
- restrict alcohol consumption;
- take all precautions when coming into contact with toxic substances;
- take medicines according to the scheme developed by the attending physician, do not increase their dosage on their own;
- parents should take responsibility for vaccinating their children against hepatitis and other dangerous diseases;
- wash hands after going to the toilet and before every meal;
- avoid casual sex;
- drink only boiled or bottled water.
Compliance with these recommendations significantly reduces the risk of infection with hepatitis of any kind, as well as if it becomes chronic.
In closing
Currently, liver diseases are diagnosed as often as pathologies of the cardiovascular system. In most cases, the destruction of the parenchymal cells of the organ occurs asymptomatically, and therefore patients seek medical help at the stage of development of complications. To prevent this, it is necessary to visit a doctor with regular, even mild ailments. He will conduct a primary diagnosis, if chronic hepatitis is suspected, he will also prescribe a number of studies. When the diagnosis is confirmed on an individual basis, he will draw up a treatment regimen that includes medication, lifestyle changes and diet. In most cases, the prognosis is favorable, since modern drugs not only improve the course of the pathology, but are also able to stop the process of liver cell death. Ignoring medical recommendations, on the contrary, in a short time leads to cirrhosis and other complications that can be fatal.
