In the article we will consider the prevention, diagnosis and treatment of liver diseases.
She is one of the vital organs, responsible for neutralizing and destroying various poisonous and toxic substances, and cleansing the blood from impurities harmful to the body. The liver produces bile, which is involved in the stimulation of the intestines and the breakdown of fats. Liver cells store vitamins and minerals that are necessary for normal life.
The main difference of this organ from others and the uniqueness of the liver is that it lacks nerve endings, as a result of which the first symptoms of pathology in the form of pain do not occur in its diseases. By the time when the main hepatic syndromes accompanying the main diseases develop, the liver tissues in most cases are already seriously affected, as a result of which the pathology withdifficult to treat. That is why it is extremely important to know what are the symptoms of liver diseases and which ones occur first.
How is liver disease diagnosed? Let's figure it out.
Types of liver diseases
According to statistics, more than 200 million inhabitants of the planet have one or another pathology of the liver. Diseases of this organ as a factor in mortality are among the top 10 causes of death, and hepatitis is comparable in mortality to AIDS and tuberculosis. In most cases, such pathologies develop when infected with viral infections or poisoning with some toxic substances, in the list of which ethyl alcohol is in the lead. Chronic diseases of the organ most often provoke the occurrence of cirrhosis of the liver and complete degeneration of the liver tissue.
That is why timely diagnosis of diseases of the liver and gallbladder is so important.
Main types of liver pathologies
- Hepatitis of various etiologies: toxic, viral (including alcohol and drugs), ischemic. Hepatitis is divided into acute and chronic inflammation of the liver tissues.
- Cirrhosis provoked by systematic or significant exposure to organ tissues of toxic substances, as well as cirrhosis as a result of a necrotic process, hereditary pathologies or blood diseases.
- Development of pathological neoplasms in the liver tissues: oncological tumors of liver cells or those that have metastasized into it from other organs, various cystic formations, abscessfabrics.
- Infiltrates of liver tissues as a result of glycogenosis, amyloidosis, fatty degeneration, formation of lymphomas, granulomatosis.
- Functional disorders that in most cases are accompanied by jaundice: Gilbert's syndrome, gestational cholestasis, Dubin-Johnson and Crigler-Najjar syndromes.
Pathologies that occur when the biliary tract is damaged inside the liver tissue: cholangitis, inflammatory processes in the bile ducts, complete or partial obstruction of the ducts in the event of cholelithiasis, with scar tissue changes.
Pathologies of the vascular system: thrombosis of the veins of this organ, congestion and cirrhosis that develops with heart failure, the formation of arteriovenous fistulas.
Signs of liver disease in women and men are shown below.
General symptoms and signs of liver disease
Violation of the functions of this internal organ causes the presence of similar symptoms in various diseases, since in one way or another there is a lack of production of cholesterol and bile, a decrease in the efficiency of removing toxic substances from the body, and difficulties in digestion processes. Similar problems with the liver have similar symptoms, common signs of reduced functioning of this organ. Main symptoms of liver disease:
- Deterioration of general well-being and asthenia. Substances that are released as a result of nitrogen metabolism are quite toxic to the body and can only be neutralized inliver tissues. A decrease in the ability to neutralize like this causes a general malaise in the patient, a deterioration in well-being for no apparent reason, a decrease in efficiency, excessive drowsiness, a feeling of weakness, increased fatigue and excessive irritability. These are common signs of liver disease in women.
- Dyspeptic symptoms. Dyspepsia is a violation of the functioning of the digestive tract. With certain diseases of the digestive system, dyspeptic symptoms differ in characteristic phenomena (the color of feces, the severity of vomiting and nausea, etc.), however, with hepatic pathologies, general symptoms are observed. Dyspeptic symptoms can be expressed in stool disorders, alternating diarrhea and constipation, bouts of vomiting and nausea, taste distortions, changes in appetite, as well as a bitter taste in the mouth in the morning or after eating.
- Pain in the right hypochondrium. The occurrence of pain under the right rib, a general feeling of heaviness in the abdomen and discomfort are characteristic of edematous and inflammatory edematous processes occurring in the liver. The pain syndrome can radiate to the back, right shoulder blade, lower back, collarbone, and the pain can be pulling or acute, depending on the etiology and nature of the pathological process. Hepatic colic is often accompanied by sharp stabbing pains in the right side of the abdomen, and occurs against the background of complete or partial blockage of the intrahepatic bile ducts.
- Jaundice. What the skin looks like with liver disease can be seen in the photo. This phenomenon is notan independent disease, but is a symptom of acute liver damage, which is characterized by a violation of the transport of bile or changes in bilirubin metabolism. Jaundice is of mechanical, infectious origin, and can also be associated with hereditary pathologies, syndromes or acquired diseases, injuries and neoplasms in the liver tissue and in the biliary tract. This symptom manifests itself in the form of staining of the skin and sclera of the eyes in a green-yellow hue. When diagnosing liver diseases (liver test), that is, in laboratory blood tests, an increase in the level of bilirubin fractions is observed.
Other signs of liver pathologies
Other signs of diseases of this internal organ are associated with a violation of its functionality and insufficient neutralization of toxic substances. The following symptoms may develop:
- skin itching, moderate to severe;
- small hemorrhages under the skin, which are expressed in the form of spider veins, minor bruises that occur with little or no exposure as a result of changes in blood clotting;
- formation of fatty subcutaneous plaques ("wen");
- reddening of the surface of the skin on the palms;
- changing the shade of the tongue to shiny, raspberry, etc.
These are the main signs of liver disease.
Treatment of the disease is important to start in a timely manner.
Liver disease syndromes
Syndrome isa set of symptoms characteristic of a particular pathology. Sometimes it completely corresponds to it, but in most cases the clinical picture is represented by several syndromes in varying degrees of intensity. With regard to liver diseases, several syndromes can be distinguished here:
- Mesenchymal-inflammatory, the symptoms of which include hyperthermia, tenderness of the lymph nodes and their swelling, joint pain, vascular lesions of the skin and lungs, swelling of the spleen.
- Cytolytic syndrome. Cytolysis is the process of death of liver cells under the influence of damage to their membranes during viral infectious pathologies, toxic effects, starvation, etc. In this case, the patient has a pattern of cytolytic syndrome, which is determined in laboratory tests based on the levels of transaminase, bilirubin, iron, relationship between ASAT and ALT. This syndrome has a predictive and diagnostic value in cirrhosis, hepatitis, oncological formations.
- Cholestasis. This phenomenon is observed in violation of the outflow of bile from the hepatic or biliary tract. Stagnation of bile in these pathways is expressed in a change in the color of the skin (jaundice), itching, the formation of plaques on the surface of the upper eyelids, severe pigmentation, lightening of feces and darkening of urine.
- Portal hypertension. The development of this syndrome leads to a change in blood flow in the hepatic veins, as a result of which the process of blood outflow is disturbed and pressure inside the liver increases. This phenomenon may be due to mechanicallesions, tumors, cirrhosis, vascular pathologies, chronic forms of hepatitis, toxic damage, parasitic invasion of the liver tissue.
- Hepatocellular failure. Replacement of hepatocytes with connective tissue or their dystrophy are expressed by this syndrome. The clinical picture in this case consists of weight loss, hyperthermia, jaundice, redness of the palms, subcutaneous hemorrhages.
We continue to consider the symptoms, diagnosis and treatment of liver diseases.
Hepatitis
This category of liver pathologies is an inflammation of the organ in acute or chronic form.
Among hepatitis, various forms are distinguished, both according to the type of pathological process and its etiology.
According to the form of the clinical course, they are distinguished:
- Acute hepatitis, usually of viral or toxic origin (in case of poisoning). The onset of the disease is similar to the flu, but there are characteristic changes in the blood picture and yellowness of the skin. Such hepatitis can become chronic or cause complications.
- Chronic hepatitis, which develops as a result of prolonged exposure to toxic substances (alcohol, drugs) on the liver, and may also be a consequence of an acute form of pathology. For a long period, it proceeds without pronounced symptoms, if left untreated, it can end with a transition to cancer or cirrhosis of the liver.
For etiological reasons, they stand out:
- infectious(viral) hepatitis;
- secondary hepatitis due to herpes infection, mumps, rubella, etc.;
- hepatitis of parasitic or bacterial etiology, as well as autoimmune and toxic varieties of the disease.
Cirrhosis of the liver
This pathology is chronic and is characterized by a radical restructuring of the tissue structures of this organ and the vascular bed, a decrease in the number of hepatocytes, excessive growth of connective tissues and the subsequent development of liver failure.
This disease does not show any symptoms for a long time, or has minimal atypical manifestations in the form of excessive fatigue, mood swings. Often there are digestive disorders in the form of dyspeptic disorders, intolerance to fatty foods and alcoholic beverages. Severe stages of this disease occur with serious changes in liver function and life-threatening complications. This is, first of all, portal hypertension, which leads to the expansion of the vessels of the esophagus.
Cirrhosis of the liver in most cases is the result of untreated hepatitis, hereditary pathologies and severe toxic poisoning.
Liver fibrosis
This pathology is an excessive growth of the connective liver tissue, which occurs as a result of damage to hepatocytes when exposed to toxic substances, the development of viral hepatitis and other adverse factors.
Initial pathologicalchanges are asymptomatic, but are often determined during laboratory tests that show increased activity of liver enzymes. At this stage, the liver increases in size, the level of various blood cells decreases, which causes the development of anemia and thrombocytopenia.
Gradually, this pathological disorder in the liver tissues passes to the next stage - the development of cirrhosis, as evidenced by an increase in the size of the spleen, hemorrhage from the veins of the esophagus.
How is liver and gallbladder disease treated?
Therapy is often delayed, as symptoms gradually increase and do not cause much concern for a long time. Traditional treatments include medication, physiotherapy, diet, and sometimes surgery.
Drug therapy is carried out strictly under the supervision of a specialist. Depending on the diagnosis, the patient is prescribed hepatoprotectors, antibiotics, antiviral, antimicrobial, anthelmintic drugs, B vitamins and some organic acids.
The most versatile drugs are hepatoprotectors. They cannot eliminate the cause of the pathology, but they are able to restore the functioning of the liver, protect its cells from damage. They are based on either ursodeoxycholic acid ("Ursosan", "Livodexa", "Exhol"), ademetionine ("Heptor", "Heptral"), phospholipids ("Rezalyut pro", "Essentiale forte N"), ornithine ("Hepa- Merz"), as well as natural components("Gepabene", "Sibektan").
Physiotherapy is used to restore an organ after illnesses (greater efficiency in galvanic mud procedures, UHF, microwave, galvanic current on the collar zone).
Surgical treatment is performed for severe liver diseases. They eliminate complex abscesses, cysts, restore tissues after injuries. Partial or complete removal of the liver and transplantation may be necessary for cirrhosis, oncology, blockage of the veins.
Diagnosis of liver diseases
The list of diagnostic measures to determine liver pathologies includes:
- Collection of anamnesis and complaints of the patient.
- Palpation and percussion of the liver area, examination.
- Laboratory study of pigment metabolism.
- Biochemical blood test. Laboratory analysis of blood in the diagnosis of liver disease occupies a leading position.
- Urine bilirubin level determination.
- Determination of the qualities of carbohydrate metabolism.
- Research of the blood coagulation system.
- Research on protein metabolism.
- Determination of the level of bile acids in bile.
- Determination of cholinesterase.
Instrumental methods for diagnosing liver diseases include:
- Ultrasound.
- Computed tomography.
- MRI.
- radioisotope scanning.
- liver biopsy.
How is non-alcoholic fatty liver disease diagnosed?
In general, NAFLD is asymptomatic, so the disease is detected by chance during a biochemical study with cytolysis syndrome. Complaints are usually not made. There may be asthenovegetative syndrome (weakness, fatigue) and discomfort in the right hypochondrium. Skin itching, dyspeptic syndrome, jaundice and portal hypertension are manifested in the advanced stage of NAFLD.
Through laboratory tests, the following changes are revealed:
- activity of alanine (ALT) and aspartic (AST) aminotransferases increased by no more than four to five times, the AST / ALT index is not more than two, more often the activity is higher in ALT;
- alkaline phosphatase (AP) and g-glutamyl transpeptidase (GGTP) activity also increased;
- presence of hypertriglyceridemia, hypercholesterolemia;
- hyperglycemia (IGT or type 2 diabetes);
- Hypoalbuminemia, high bilirubin levels, presence of thrombocytopenia, prothrombin time is increased in patients at an advanced stage of the disease.
What other diagnostics of liver diseases is carried out? A liver test can now be taken at any medical facility.
Differential diagnostics are often carried out - the external manifestations of the disease are determined, the general condition of the patient is assessed, feces and urine are examined. Laparoscopy is also carried out according to strict indications, which are jaundice, ascites, cancer, tuberculous peritonitis, fibrosis.
Consequences of liver diseases and recovery from them
After the liver pathology has been cured, people return to the usual waylife, in particular, to bad habits, poor nutrition, etc. This is very dangerous, because the disease can recur. In most cases, they lead to an exacerbation:
- high physical activity;
- hypothermia;
- emotional turmoil;
- exposure to direct sunlight;
- malnutrition;
- excessive drinking.
The liver is weakened after the disease, so the first six months patients are recommended:
- Continue following the diet prescribed during the illness. During the recovery period, the diet is expanded, but alcohol and certain foods (fatty foods, smoked meats, spicy dishes) remain prohibited.
- Regularly examine the condition of the liver. The patient is instructed to do this every six months.
- Avoid viral and cold diseases.
- Active lifestyle.
- Strengthening immunity.
In addition, a person who has had one of the liver diseases needs to restore its functions. For this purpose, it is recommended to undergo a course of treatment with hepatoprotectors - drugs that restore hepatocytes.
Among them:
- Gepabene;
- "Essentiale";
- Heptor.
Vitamin complexes are also used for these purposes. To date, pharmaceuticals offer medicines that help protect the liver:
- Vita-Spectrum;
- "Gepar";
- "Gepaguard";
- Legalon.
If the rules of therapy are observed, after the disease of this organ is cured, no negative consequences, as a rule, occur. However, you must follow the diet and all the doctor's recommendations.
With untimely diagnosis of liver diseases and the lack of treatment, the consequences can be extremely unfavorable. Pathologies such as hepatitis, fibrosis and cirrhosis of the liver lead to death without adequate therapy.
We looked at the diagnosis and treatment of liver disease.
