Fatty liver disease (or stetohepatosis in other words) is a chronic disease of this organ, which is most common. It is characterized by fatty infiltration (that is, the accumulation of lipids) of the liver tissues. According to statistics, about twenty-five percent of the population of developed countries suffer from this pathology. It is most commonly seen in people with obesity and type 2 diabetes. According to the International Classification of Diseases (ICD), fatty liver disease corresponds to the code K76.0.
Causes of occurrence
The main cause of this liver disease, researchers call the so-called insulin resistance, which consists in reducing the sensitivity of white adipose tissue and muscles to insulin. This increases the amount of glucose in the blood serum (hyperglycemia) and increases insulin, that is, hyperinsulinemia develops.
The causes of fatty degeneration of the liver must be determined by a doctor.
Hyperinsulinemia increases the breakdown of lipids (that is, fats) in the connective tissues, a large amount of free acids is released, and the rate of their oxidation in the glands decreases. The liver excessively accumulates triglycerides, and lipoproteins, which are protein lipid complexes of extremely low density, are overproduced. The balance between utilization and production of cells is disturbed. Launched chain reactions of the disorder are accompanied by the death of hepatocytes, the onset of inflammation, and the growth of connective tissues.
The main reason for the progression of fatty degeneration of the liver is called violations occurring in the intestinal microflora. Bacterial overgrowth in the small intestine leads to the entry of some types of bacteria into the portal vein, and in addition, into its tributaries. This activates the body's immune response, inflammation develops, and the production of fibrous tissue is stimulated.
Fatty liver degeneration (according to the ICD-10 code above) develops against the background of an increase in the amount of lipids in the blood, with diabetes and excess body fat. Doctors also call the metabolic syndrome, which consists of a number of metabolic, clinical and hormonal disorders, a common cause of the disease. Thus, the disease is a widespread pathology of a chronic nature. An increase in this incidence is also observed at an early age, as the number of children who are overweight is only increasing. Now let's talk about the symptoms of this disease.
Symptoms
Detecting fatty liver disease is very difficult becauseit is completely asymptomatic. In medical practice, there have been only isolated cases of treatment of patients complaining of unexpressed pain in the right hypochondrium, a feeling of discomfort and weakness. A liver with signs of fatty degeneration is found incidentally. More often, patients turn to the stage of formation of cirrhosis after a long course of the disease. Therefore, to diagnose a deviation, the following symptoms of fatty liver degeneration come to the fore:
- Weight gain in visceral fat. In this case, we mean excess fat deposits that are observed on the internal organs.
- Disturbance in lipid metabolism.
- Increased blood pressure.
- Decreased sensitivity of tissues to insulin along with an increase in the level of this hormone in the blood, symptoms of glucose metabolism disorders and so on.
As part of an external examination by a doctor, an unexpressed enlargement of the liver is detected, although the identification of this sign can be difficult due to obesity in the patient. Liver signs indicate the symptoms of cirrhosis:
- Presence of persistent expansion of small skin vessels in the form of stars and grids.
- Presence of reddening of the palms.
- Breast enlargement in men.
Cirrhosis can be indicated by an increase in the volume of the spleen along with abdominal dropsy, when there is an accumulation of free fluid in the abdomen. Next, let's talk about diagnostic methods.
Diagnosis
Basican instrumental method for diagnosing fatty degeneration of the liver is an ultrasound examination. Computed tomography and magnetic resonance practice are also used. The progression of the disease threatens patients with the formation of cirrhosis. Therefore, in recent years, biological signs have been actively developed in the field of medical research practice, which make it possible to assess the severity of inflammatory processes in the liver along with the growth of connective tissues:
- Analysis of the serum level of adiponectin, that is, a hormone that is produced by adipose tissue in patients with insulin resistance, obesity, type 2 diabetes.
- Method of enzyme immunoassay with numerical determination of M30 antibodies, which selectively recognize cytokeratin-18, which is an intracellular filamentous formation that can be cleaved during cell death due to the development of fatty liver disease. The volume of split fragments makes it possible to assume the progression of the pathology.
- A serum hyaluronic acid value greater than 2,100 nanograms per milliliter is indicative of fibrosis formation.
Biological markers are promising methods for diagnosing fatty liver degeneration (ICD-10 K76.0) in the case of degeneration progression, but their confirmation in a more reliable study is needed. To date, commercial biochemical complex panels for diagnostics called "FibroTest" and its analogues are available. In diseases of the liverdemonstrates a moderate diagnostic accuracy of seventy-five to ninety percent. Now let's move on to the question of treatment methods.
Treatment
Changes in the liver according to the type of hepatosis are associated with a whole range of disorders and abnormalities in metabolic processes, so the treatment involves many therapeutic techniques aimed at restoring the links that were involved in the pathological process.
You can not eat high-calorie foods high in cholesterol and fat, it is necessary to limit fructose in the diet along with red meat. It is best to adhere to fatty liver degeneration with a Mediterranean-type diet, that is, eat more fish, vegetables, and fruits, given their calorie content. Among other things, products with polyunsaturated fatty acids, antioxidant vitamins C, E and fibers are suitable.
In weight loss programs, "Mukofalk" is used as a fibrous food modifier. This drug is almost calorie-free, it consists of dietary soft fibers. Diet therapy can be done with the following options:
- Eating a low-fat diet is less than thirty percent of total calories.
- Following a low-carb diet - less than 60 grams per day.
- Low-calorie diet, i.e. 800 to 1500 calories per day.
It is worth noting that the use of a very low-calorie diet (less than 500 kilocalories) is very dangerous, as this provokesinflammation of the liver along with proliferation of connective tissues.
Increase physical activity
Patients suffering from fatty degeneration are recommended to exercise and walk in the fresh air. For example, we are talking about walking at a moderate pace, swimming with cycling would be useful. The duration of training should be two to three hours a week. To achieve weight loss and improvement in the structure of the liver, strength exercises allow. Constant physical activity reduces obesity of all internal organs, reduces insulin resistance along with the accumulation of free fatty acids in the bloodstream.
Treatment will be much more effective if you combine physical activity with a low-calorie diet. Dieting combined with three times a week one hour of exercise has been proven to improve liver he alth by reducing intra-abdominal obesity along with fat cell count. Achieve regular weight loss of at least one kilogram per week.
Let's look at the cures for fatty liver below.
Medication use
There are no effective medications for the treatment of the disease in question. As part of the treatment of hepatosis and fatty degeneration of the liver, drugs are prescribed that reduce the degree of obesity, reduce damage to the gland and help restore insulin resistance:
- For example, patients may beprescribed a weight loss drug called Orlistat.
- Correction of insulin resistance is carried out with the help of "Metformin" for patients with type 2 diabetes. The drug "Pioglitazone" is suitable for patients with non-alcoholic steatohepatitis.
- Medicines are also prescribed to lower blood pressure.
The key problem of the course of this disease is that the disease increases the risk of progression of certain abnormalities in the cardiovascular system. Next, find out why a phospholipid deficiency is dangerous.
Phospholipid deficiency in fatty liver disease
In the event that the human body experiences an excess or deficiency of a certain trace element, mineral or vitamin, it will definitely report this. Phospholipid deficiency is dangerous with serious consequences. The fact is that an insufficient amount of such lipids can affect the functioning of almost all cells. As a result, a fat deficiency can cause problems in the brain (such as impaired memory) and digestive organs.
Deficiency of these substances will certainly lead to a weakening of the immune system, disrupt the integrity of the mucous membranes. The lack of phospholipids can also affect the quality of bone tissue, which ultimately leads to arthrosis or arthritis. In addition, dull hair along with dry skin and brittle nails are a signal of a lack of phospholipids in the body.
How to recover from fatty liver degeneration from alcohol? More on that below.
From alcoholism
Alcoholic liver degeneration is the accumulation of fat droplets inside and between special hepatocyte cells under the influence of alcoholic beverages. This is the initial, and at the same time, the most common form of alcoholic disease of the organ. Thus, people have various disorders in the structure and functions of the liver, which develop as a result of prolonged alcohol intake. The toxic effect does not depend on the type of drinks taken and is determined by the amount of ethanol (that is, pure alcohol) in them.
Symptoms of alcohol degeneration
The disease can develop gradually and imperceptibly for a person. In most situations, it is detected on the basis of laboratory and instrumental research methods when the patient contacts the doctor for some other reason. As the general condition deteriorates, the number and severity of symptoms increase in the liver. With prolonged alcoholic liver degeneration, the following symptoms may appear, combined into several different syndromes (a stable set of symptoms united by one development):
- Hepatic cell failure syndrome.
- Development of telangiectasia (appearance of spider veins on the face and body).
- Palmar or plantar erythema in the form of reddening of the skin.
Among other things, a general feminization of appearance for men is possible, when they take on part of the outlines and appearance of women:
- The appearance of fat deposits on the thighs, thin limbs andstomach.
- Presence of scant pubic and axillary hair.
- Development of gynecomastia (that is, the formation and enlargement of the mammary glands).
- The appearance of testicular atrophy (we are talking about a decrease in the volume of the tissues of this organ, a disorder of their functions).
- The appearance of impotence (a disorder of erectile and sexual function among men, when there is an inability to perform a normal sexual intercourse).
In addition, the following symptoms may also occur:
- Occurrence of hypertrophy (enlargement) of the salivary parotid glands (the so-called hamster symptom).
- Presence of dilated capillaries on the face (dollar bill symptom and red face).
- Having a tendency to bruise.
- The occurrence of Dupuytren's contracture (the appearance of a painless subcutaneous cord in the form of a tissue compaction in the form of a tourniquet). This is a curvature and shortening of the tendons of the palm, leading to limited function and deformity.
- The presence of icteric coloration of the skin, mucous membranes of the mouth and sclera (white shells of the eyeballs).
- Occurrence of dyspeptic disorders in the form of indigestion, such as loss of appetite in combination with rumbling in the abdomen and frequent stools.
- The appearance of pain or heaviness in the right hypochondrium, characterized by a slight intensity. This discomfort is usually intermittent and does not cause serious discomfort to the patient.
It is worth noting that the condition of patients with fatty liver degeneration improves significantly immediately after discontinuationalcoholic drinks. Periods of severe deterioration are directly related to continued alcohol consumption, which leads to the development of alcoholic acute hepatitis (i.e. inflammation of the liver).
Drug "Siofor"
Means "Siofor" belongs to the group of modern biguanides. It is indicated for effective regulation of concentrated glucose volume among insulin dependent patients. This tool is indispensable in the case when proper nutrition combined with regular exercise does not help in the fight against weight-increasing glycemia. An equally important advantage of the drug in question is its ability to effectively reduce the amount of cholesterol, in addition, they are provided with unique assistance in the process of combating excess weight. Siofor is indispensable for fatty liver degeneration.
The drug is one of the most popular hypoglycemic drugs. Its main active ingredient is metformin. The main ingredient of the product does not have any effect on the functioning of beta cells in the human body. Due to this, people do not produce excessive amounts of insulin, respectively, hypoglycemia does not form. Thanks to the reception of the described drug, it is possible to achieve the following effects:
- Slowing down the absorption of active glucose within the digestive organs.
- Decrease in the rate of hepatic glucose production.
- Significant improvement in overall tissue sensitivity to sugar-containing hormones.
Diffuse liver hepatosis
Tissues of a he althy liver are usually homogeneous, with multiple blood vessels passing through them along with bile ducts. Diffuse changes in the liver are characterized by the fact that excess fat can settle and accumulate in the cells of this organ, namely in hepatocytes. Normal he althy cells then die gradually. The liver acquires heterogeneity, and most often, against the background of diffuse infiltration, almost all of it undergoes various changes. There are three types of diffuse hepatosis in fatty liver degeneration:
- Focal (when only a small part of the organ is affected).
- Local (for example, in one of the beats).
- Total (in this case, the entire organ is usually affected).
Causes of disease
Provoke diffuse changes in the liver and hepatosis can:
- The impact of malnutrition (when fatty foods and fast food predominate).
- The presence of metabolic disorders in the human body.
- The appearance of diabetes along with the disruption of the thyroid gland.
- The emergence of obesity and the impact of alcoholism.
- Prolonged use of certain medications, such as antibiotics.
Unfortunately, diffuse hepatosis of this organ is not always possible to distinguish from chronic inflammatory processes, the more difficult it is to determine its cause in order to prescribe the correct treatment. Therefore, together with laboratory tests and ultrasound examinations, a biopsy and computed tomography are prescribed.
How to treat hepatosis of the liver?
Symptomatology and treatment of the disease
Diffuse hepatosis is accompanied by symptoms characteristic of almost any disease of the organ in question, namely:
- The presence of heaviness and pain in the region of the right hypochondrium.
- Appearance of nausea and vomiting.
- The liver may be enlarged.
Sometimes this disease occurs without any pronounced signs, aggravated by increased physical activity, overeating, and in addition, as a result of alcohol abuse. Its treatment will require an integrated approach, since it is very important to achieve the elimination of the causes of cell destruction. Medical treatment is necessary along with long-term adherence (for at least several months) to the diet prescribed by the doctor. Recovery of liver cells is impossible if you continue to drink alcohol, smoke, eat fatty foods.
Treatment of fatty liver should be comprehensive and timely.
In order to restore hepatocytes, hepatoprotectors are used. Sometimes the doctor, in addition to the diet, prescribes additionally all kinds of biologically active additives to the main diet. In the process of recovery and immediately after it, you need to constantly monitor your weight, giving up alcohol and smoking, continuing to adhere to a strict diet. It is important to achieve the normalization of the normal functioning of the nervous system, and at the same time improve immunity. All this will certainly help to avoidpossible relapses of the disease in the future.
Possible complications of this disease
It is worth noting that such a pathology as fatty degeneration can be complicated by the addition of additional inflammatory processes. For example, the occurrence of steatohepatitis, fibrosis or cirrhosis of the liver, cholestasis (bile stasis) is often observed along with the development of organ failure. That is why it is very important to undergo regular medical examination of your body, and in addition, to follow certain preventive measures, which we will discuss below.
Prevention of this pathology
The main prevention of this disease consists, first of all, in the complete refusal of the patient to drink alcoholic beverages. In addition, strict adherence to a diet, maintaining an optimal weight along with maintaining a he althy lifestyle and eliminating bad habits is no less important.
In cases where such a disease was detected in a person at an early stage, there is a fairly high probability that a complete cure can be achieved. In more severe cases, treatment must begin with the fight against the underlying disease, which caused the development of fatty degeneration of this organ.
Thus, patients in any case need a diet with the obligatory exclusion of alcohol. Obese patients need to lose all excess weight. In the course of drug treatment, it is advisable to prescribe hepatoprotectors along with vitamin therapy, lipotropic drugmeans, preparations of ursodeoxycholic acid, etc.
We looked at how fatty liver is treated.
