Many of us have heard of autoimmune hepatitis. What is this pathology? This is a chronic disease, which is an unresolved inflammatory phenomenon in such an important organ for our existence as the liver. This pathology has no established nature.
What happens?
If diagnosed with autoimmune hepatitis, what does it mean? This serious pathology, for completely incomprehensible reasons, gradually destroys liver cells. Moreover, the body's own immune system helps in this process. At the first stage of the disease, inflammation of the parenchyma, that is, the main part of the organ, occurs. This process progresses rapidly and can lead to cirrhosis of the liver.
In this case, the cells of such an important organ for us, hepatocytes, die off. Their place is immediately filled with rough and inelastic connective tissue. As a result, the liver is simply not able to perform its functions efficiently.
Can be founddifferent names for this disease. However, most often in the medical literature, the pathology is referred to as active chronic autoimmune hepatitis. It is a rare condition that occurs most often in girls over the age of 10 and in women under the age of 30.
Symptoms
Clinical manifestations of pathology are different. Thus, a quarter of all patients have no symptoms of autoimmune hepatitis. And this continues until the person has any complications. In such cases, the disease overtakes people suddenly or they show all the symptoms of viral hepatitis or other signs indicating liver damage. In the first scenario, a person begins to be disturbed by weakness. His bodily fluids take on a dark color. The skin, as well as mucous membranes, turn yellow, appetite disappears. In the second case, extrahepatic symptoms occur. That is why doctors often assume the presence in the body of various systemic diseases, such as rheumatoid arthritis, lupus erythematosus, etc.
But in general, the manifestations of the pathology are excessive fatigue, fever, fever up to 39 degrees, swollen lymph nodes, acne, abdominal pain, especially in the right hypochondrium, disruption of the joints, as well as active growth hair on all parts of the body. If the disease begins to provoke the synthesis of adrenal hormones, which are produced in excess, then the patient may experience a decreasemuscle tissue on the legs and arms, rapid weight gain, stretch marks on the thighs and a bright blush on the cheeks.
Sometimes in patients the disease comes on suddenly, is acute and very difficult. All this is accompanied by the occurrence of fulminant hepatitis, which provokes the rapid death of most of the liver cells. This, in turn, leads to the rapid formation of toxins that negatively affect, and then affect the brain. It will be very difficult if autoimmune hepatitis (symptoms) has already appeared, treatment. The prognosis in such cases, doctors give an extremely unfavorable for the patient.
Types of disease
Treatment of autoimmune hepatitis will directly depend on its variety. One or another type of pathology is determined by the presence of a certain kind of antibodies in the blood serum. At the same time, three types of autoimmune chronic hepatitis are distinguished:
1. In the first type of the disease, proteins-antibodies to actin-protein, smooth muscle cells, antinuclear antibodies are detected.
2. The second type of disease is characterized by the presence of antibodies to microsomes, to kidney and liver cells.
3. The third type of pathology is diagnosed in cases of detecting antibodies to a substance that is responsible for protein synthesis, that is, to a liver soluble antigen.
Causes of pathology
Autoimmune hepatitis is a disease in which a person's immunity begins an active struggle with its own absolutely he althy tissues and cells. What are the reasons for this phenomenon? Modern medicine has yet to answer this question.maybe. However, scientists have an assumption that a similar failure in the work of the body's defenses is caused by various previously transferred viral diseases, in particular, hepatitis A, as well as B and C, herpes, Epstein-Barr virus.
Some researchers are also of the opinion that a certain gene plays a major role in the development of various autoimmune diseases. However, it is worth noting that the disease in children under 10 years of age is almost never detected.
Diagnosis
Treatment of autoimmune hepatitis will be much more effective if the disease is detected early in its development. However, the diagnosis of pathology is extremely difficult. As a rule, doctors make such a diagnosis only with the gradual exclusion of the presence of other diseases. To do this, the doctor analyzes the patient's complaints and anamnesis of his life. All this happens during the conversation. At the same time, the specialist finds out what worries the person, and how long it all lasts.
Next, a physical examination is performed, during which the doctor examines the mucous membranes and skin, measures the patient's body temperature, taps and feels the liver, finding out its soreness and increase in size. If there is a suspicion of the presence of pathology, laboratory tests are carried out. They are designed to detect the level of globulin and the activity of the AST enzyme. A referral is also given for an immunological blood test. They also examine it for the presence of the hepatitis A virus, as well as B and C. The doctor gives a referral for a coprogram. During this studythe feces are checked for the presence of undigested food particles in it.
If necessary, instrumental diagnostics are carried out. It includes ultrasound, examination of the stomach, esophagus and duodenum using endoscopic equipment. This study is designed to exclude the presence of tumors of various etiologies. The patient is sent for a liver biopsy, during which a small tissue sample of this organ is taken for the purpose of histological examination.
After autoimmune hepatitis has been diagnosed and the doctor has prescribed treatment, all the recommendations received should be strictly followed. Only in this case can we talk about favorable forecasts for the development of the disease.
Ways to eliminate pathology
After autoimmune hepatitis (symptoms) is identified, and treatment for this disease has become vital, the doctor can apply several methods. They are as follows:
- in following a strict diet;
- in drug therapy;
- in surgical intervention.
Let's take a closer look at all these methods.
Diet
Treatment of chronic autoimmune hepatitis, which is in the acute stage, is carried out with strict observance of bed rest. When the remission phase begins, it is enough for the patient to properly organize his work and rest regimen, while avoiding all sorts of (emotional and physical) overwork. In addition, it is important to exclude the impact on the liver of various toxicsubstances, including alcohol and drugs, excreted by this body. During the period of remission, it is also not necessary to carry out physiotherapeutic procedures that affect the liver area. Balneotherapy is also prohibited.
Proper nutrition is of great importance for the normalization of the patient's condition. Carrying out the treatment of chronic autoimmune hepatitis, gastroenterologists recommend the use of a diet (table No. 5). It includes vegetable soups and lean meats (poultry, beef). Baked or boiled fish can be included in the diet of patients. The diet, which is recommended in cases where treatment of chronic autoimmune hepatitis is required, includes foods such as low-fat cottage cheese and cheese, and if there is no intolerance, then dairy, as well as sour-milk products. When preparing meals for people suffering from autoimmune hepatitis, it is important to use butter and vegetable oil only in small quantities. The consumption of eggs should also be limited. They can be included in the diet only 2 or 3 times a week, 1-2 eggs per day.
The diet does not consider any restrictions in relation to vegetables and non-acidic fruits. However, their consumption, like any other permitted food, must be within reasonable limits.
The diet recommended for a person being treated for autoimmune hepatitis excludes fried foods, fatty meats, s alty and spicy snacks, sorrel and spinach, cocoa and strong coffee,alcohol and canned goods. Meals must be fractional. It is important to eat at least four times a day, and it is better if the meal is made six times. It is also important to maintain a balanced diet so that the body receives all the substances it needs.
Medication use
If treatment of autoimmune hepatitis is required, the algorithm of the doctor's actions will depend on the stage and course of the pathology. But in any case, in addition to using the diet, the patient is prescribed the necessary medications. Depending on what kind of clinic is observed in a patient diagnosed with autoimmune hepatitis, treatment by a specialist can be prescribed using various drugs.
Given the fact that the main cause of this pathology is hyperactivation and malfunction of the body's defenses, which begin to intensively destroy he althy liver cells, the doctor must include drugs in the course of therapy, the action of which is aimed at suppressing the immune system. These are immunosuppressive drugs that are hormonal and anti-inflammatory. These primarily include such medicines as "Prednisolone" and "Azathioprine". It is these two drugs that are used in cases where autoimmune hepatitis is treated. In the course of therapy, they can be prescribed both separately and together.
As for "Prednisolone", this drug has a wide spectrum of action. It has a positive effect on all typesmetabolic process, and also allows you to get a fairly good anti-inflammatory effect. Under the influence of this medication, the activity of the pathological process decreases. And this is due to both the direct immunosuppressive effect of the drug on K-cells, and its inducing effect on the suppressor function of T-lymphocytes.
Only high doses of this drug can provide effective treatment if autoimmune hepatitis (symptoms) is detected. The prognosis for the course of the disease in such cases is quite favorable. So, when conducting clinical studies during the appointment of a course using the drug "Prednisolone", there was a decrease in the intensity and frequency of immunopathological reactions observed in the liver tissue.
Another autoimmune hepatitis drug is Azathioprine. It affects the immune response through the mechanism of suppression of an actively developing clone of immune cells, as well as the elimination of the elimination of inflammatory cells.
The drug "Azathioprine" affects both the primary and secondary immune response. However, in the treatment of this drug, many experts note its insufficient effect. This is due to a violation of the activation of the drug, as well as an acceleration of the process of its destruction in cases of liver disease. To eliminate this problem, another hormonal drug, Prednisolone, is simultaneously prescribed in the course of therapy. He is able to activate the action of "Azathioprine". In addition, side effects after the treatment of autoimmune hepatitis with the complex use of two drugs are four times less.compared with those observed with the use of only one "Prednisolone". This clearly indicates the need for this approach to treatment.
The use of two drugs at the same time inhibits the development of the inflammatory process and allows the body's defenses to independently eliminate existing failures. Unfortunately, patients are forced to take these medicines from six months to 4 years. At the same time, doctors do not give any guarantees that this course will be the only one. Many patients have to repeat it more than once during their lives.
A similar therapy algorithm is also used in cases where autoimmune hepatitis is being treated in children.
Coenzymatic and metabolic drugs can be used to eliminate the pathology. They are such vitamin and multivitamin complexes as "Cocarboxylase", "Riboxin" and many others. In complex therapy, hepatoprotectors, which contain phospholipids, are also used. These are drugs such as Livolin, Essentiale, Heptral and many others. According to experts, the appointment of such funds should be made only in the stage of remission, when there is no pronounced inflammatory process.
In order to remove from the body those toxic metabolic products that the liver cannot handle, doctors prescribe intravenous infusion therapy. As a rule, in such cases, the drug "Rheosorbilact" or saline is used. The procedure is performed under constant control of blood pressure and excretion.urine.
Alternative regimen
Treatment using a combination of drugs such as Prednisolone and Azathioprine has been used effectively in medical practice for almost five decades. Such therapy has significantly increased the life expectancy of patients with autoimmune hepatitis.
However, there is now a growing debate about the use of other regimens that would be shorter for patients and would cause fewer side effects. For example, specialists are considering the possibility that the treatment of autoimmune hepatitis "Budenofalk" can be carried out. This is a drug belonging to the group of glucocorticosteroids of the 2nd generation. In addition, it has a minimum number of side effects and is ninety percent metabolized by the liver during its first passage through it. This contributes to the restoration of he alth in patients suffering from autoimmune hepatitis.
The results of ongoing clinical studies convincingly proved the fact that Budenofalk, when used in combination with Azathioprine, induced and maintained remission in those people with autoimmune hepatitis who did not yet have signs of developing liver cirrhosis. At the same time, the therapy ended with the occurrence of less side effects than after the use of Prednisolone.
According to researchers, this drug has the potential to become the new standard of clinical therapy used in the treatment of autoimmune hepatitis.
Surgical treatment
In cases where the use of drug therapy for four years does not improve the patient's condition and does not normalize his blood biochemical parameters, the patient undergoes surgery.
It is a transplant operation of a donor organ. As a rule, for this, a part of the liver of a person’s blood is taken.
Folk remedies
The use of products, the formulation of which was created by healers based on natural ingredients, allows you to evacuate bile, eliminate nausea and intoxication, and also relieve pain.
It should be borne in mind that if a person has autoimmune hepatitis, treatment with folk remedies will only alleviate the symptoms of the disease, but will not completely get rid of it. Such methods are quite effective only for those pathologies that are easily treatable. This refers to hepatitis A or its toxic type.
Various herbs with a choleretic effect have proven themselves well in the fight against inflammation in the liver. They prepare infusions and decoctions. These healing herbs include:
- nettle roots and leaves;
- mint and anise;
- yarrow;
- dill seeds;
- St. John's wort; - birch leaves.
Charges are made from medicinal herbs, which are taken before meals. Prepared infusion of rose hips replace tea. Drink it through a straw, as this remedy has a negative effecton tooth enamel.
It has a positive effect on the state of the liver and the juice of various vegetables, because it contains a large amount of vitamins and useful elements. Juice can be used to treat hepatitis at home:
- Jerusalem artichoke;
- raw potato;
- carrot diluted with water;
- celery and dandelion leaves;- raw beet diluted with water.
Forecast
Survival of patients suffering from autoimmune hepatitis depends entirely on the intensity of the inflammatory process taking place in the liver. In mild cases, 80% of people have it for more than 15 years. However, in the absence of full-fledged therapy and with a severe course of the disease, only a few manage to live for more than five years.
