Liver Cirrhosis - Serious Progressivedisease. In a healthy state, this organ has a red-brown color. Acquires a yellowish tint during illness. With cirrhosis, the liver is rebuilt. As a result, healthy cells are affected and are replaced with scar tissue. As a result, the work of this organ is disrupted, liver failure and portal hypertension develop.
Types of liver cirrhosis
Classification of cirrhosis occurs according to etiology (causes of disease) and morphology (external signs). Depending on the size of the nodes it is:
- small node (diameter up to 3 mm);
- large node (over 3 mm);
- mixed (with nodes of different diameter).
Depending on the etiology and morphology, cirrhosis is divided into:
- alcoholic;
- biliary (with stagnation in the liver of bile);
- compensated;
- postnecrotic;
- decompensated;
- portal;
- pigmentary.
Common signs of cirrhosis
Симптомы цирроза зависят от стадии заболевания.At the initial (class A) complications yet. This is the perfect time to eliminate the cause of the disease. During this period, you can save the liver and continue to lead a normal life, since this body has great opportunities for regeneration.
При прогрессирующем циррозе начинаются осложнения (classes b and c). The abdomen increases in volume, changes in behavior and consciousness appear. The gums and nose begin to bleed. Symptoms of cirrhosis in women - an increase in the mammary glands (gynoscomas) and the cessation of menstruation.
Появляется повышенная утомляемость, снижение weight, absentmindedness of attention, daytime sleepiness, insomnia. Lost your appetite. A feeling of bloating appears in the stomach. Jaundice develops. Feces and urine change normal color. Lower thighs and stomach pains begin to flow.
Fluid builds up in the abdominal cavity.Bacterial infections appear. They suffer from frequent headaches. Symptoms of cirrhosis in men: partially or completely disappears sexual desire and increase the mammary glands. Begin to fall hair in the armpit and pubic area.
With cirrhosis, the liver increases or, conversely,decreases. In any case, it becomes more dense. The size of the spleen increases. Signs of jaundice and portal hypertension appear. Often there is dull and aching pain in the region of the liver. She becomes stronger after physical work or in violation of the diet.
Skin itching, nausea and vomiting develop. Stool is broken (constipation or diarrhea). External signs are vascular "stars", reddening of the palms. The language takes on a crimson color.
Treatment of cirrhosis
Cirrhosis is completely impossible to cure, butcan slow down in the early stages of the disease. With a progressive and neglected case, the efforts of physicians are aimed at removing unpleasant symptoms and complications.
The basis of the treatment of cirrhosis includes therapeutic measures:
- diet;
- diuretic drugs;
- antiviral therapy;
- glucocorticoid hormones;
- drugs that reduce pressure in the portal area ("Nitrosorbid", "Anaprilin");
- hepatoprotectors that protect the liver cells ("Ademetionin", "Silymarin");
- plasma exchange;
- with exacerbations of cirrhosis, hospitalization is necessary.
During surgical treatment, punctures of the abdominal area are performed to remove accumulated fluid. Shunting operations are being done (creating new paths for blood flow). Or make a liver transplant.
Treatment of cirrhosis of the liver with leeches
Treatment of cirrhosis with leeches is recommended, butapplied only under medical supervision. Since it is necessary to constantly monitor the patient's blood condition and the symptoms of cirrhosis. The earlier such treatment is started, the more effective the result will be.
For one procedure requires from 4 to 8 leeches.Basically they are divided into several consoles. As soon as leeches begin free sucking, they are removed. Such procedures are carried out twice a week. Then one session every 7 days. A total of 12 procedures are assigned.
Repeated courses are held at intervals of 2-3 months. The general course of treatment is quite long. Therefore, it is necessary to include foods high in iron (except meat) in the patient's diet.
Portal cirrhosis
Portal cirrhosis is the most common form.diseases. Causes may be hepatitis, poor circulation, alcohol, and poor digestion. Almost the entire liver is affected. Most often, this disease affects men after 40 years.
The first symptoms of cirrhosis are weakness, nausea.In the area of the stomach there are discomfort. Constipation or diarrhea may begin. If cirrhosis is caused by alcoholism, sexual desire decreases. Some people have yellow mucous membranes and skin.
The most characteristic symptom is the appearance at the top.parts of the body and abdomen of the vascular reticulum, red color of the fingers and palms. At the same time, fluid begins to accumulate in the abdominal cavity. Often develop gastritis.
Symptoms of cirrhosis in the initial stage areheaviness and pain in the right hypochondrium, loss of appetite, constant nausea. Insomnia, fatigue and impaired stool are observed. Gradually, the liver is thickened, increasing in size. Legs are swollen, cracks and white deposits can appear on the tongue.
There are three stages of cirrhosis. Symptoms in the first - it is an increase. On the second, on the contrary, it decreases. And the third becomes very small and dense to the touch.
Treatment of portal cirrhosis
In the treatment of portal cirrhosis to the patientbed rest is required. Any physical activity should be excluded. Treatment of liver cirrhosis is primarily aimed at eliminating the causes of the disease. And also to prevent complications that may appear.
In the treatment of portal cirrhosis, you must completely give up alcohol. This is one of the main causes of the disease. It is necessary to clean the liver.
If portal cirrhosis occurs due to hepatitis, treatment should be directed primarily to combat it. Drugs giving complications to the liver are necessarily excluded.
You must follow a strict diet.From the diet excluded spicy, fatty and fried foods. The number of seasonings should be kept to a minimum. It is forbidden to eat canned, smoked products and sausages. It is necessary to exclude chocolate, garlic, tomatoes and their juice, mushrooms from the diet. Salt intake is desirable to minimize.
Рекомендованы к употреблению различные овощные soups without frying. Any cereals, legumes and cereals. Dairy low-fat products, boiled poultry, turkey and rabbit. You must eat apples and crackers.
Питание должно быть по 5-6 раз в день.But in small portions. At the same time during the diet you need to drink herbal teas, liver charges. In the treatment of drugs prescribed hepatoprotectors of plant origin. They protect the liver tissue and restore its function.
In addition, diuretic drugs are prescribed, removing edema and removing excess fluid from the body. As well as drugs that relieve the symptoms of cirrhosis.
If this does not help, surgical intervention is applied. And a liver transplant is performed. Stem cell methods are being developed for the treatment of portal cirrhosis.
Postnecrotic cirrhosis
Postnecrotic cirrhosis is also prettycommon form of the disease. Most often appears after viral hepatitis and alcohol abuse. Less often - after poisoning with poisons, taking certain medications, acute infectious diseases. With post-necrotic cirrhosis, the liver tissue begins to die. Internal scars appear that impair the function and shape of the organ.
Symptoms of cirrhosis in the initial stageappear dramatically. Suddenly the stomach starts to hurt, diarrhea and vomiting appear. Mucous and skin turn yellow. The liver grows in size. With the feeling of pain. Nausea, loss of appetite and weight.
When exacerbation begins itching, severelythe temperature rises. Feces become pale, and urine dark. Ascites, anemia, heart failure appear. The ability to work is dramatically reduced. This is a very dangerous form of cirrhosis, as it causes liver cancer. Death can occur at any stage of the disease.
Treatment of postnecrotic cirrhosis
Лечение постнекротического цирроза направлено на complications arising from portal hypertension. Primarily ascites. In the diet decreases the protein content. Avoid drugs that provoke hepatic coma. If the need arises - antimicrobial therapy is carried out.
If no complications are observed, then periodic examinations and observations of the patient are sufficient. If cirrhosis develops from a disease, then it is he who is treated (if it is amenable to therapy).
Alcoholic cirrhosis
Another very common form of the disease- alcoholic cirrhosis. Its symptoms can be pronounced, and sometimes they are not present at all for a long time. They appear depending on the degree of liver damage. There are three stages:
- Compensation. There are almost no signs of cirrhosis, except for an enlarged liver. Sometimes, mild nausea may occur. There is a general weakness in the body and fatigue.
- Subcompensation. Appetite deteriorates, body weight decreases sharply, nausea and vomiting appear.
- Decompensation.Complete depletion of the body, liver failure and jaundice begin. All complications of cirrhosis and portal hypertension appear. Fluid (ascites) accumulates in the abdominal cavity. It is difficult to treat. There is increased bleeding. There may be bouts of disorders of consciousness. Often additionally, a bacterial infection occurs. Hepatomegaly appears in all patients, and in a quarter - splenomegaly.
When alcoholic cirrhosis progresses,signs and symptoms are clearly visible and externally. There is an expansion of the vessels of the nose. Parotid glands markedly increase in size. Facial features become puffy.
Due to the effects of ethanol begins the internalorgan damage. Neuritis, pancreatitis, mastopathy, encephalopathy and other diseases may appear. There is atrophy of the muscles, particularly in the shoulder girdle.
Treatment of alcoholic cirrhosis
Symptoms of cirrhosis in men are foundmore often than women. Since alcohol consumes more "strong half". In case of alcoholic cirrhosis, conversations are primarily conducted, during which the patient is encouraged to get rid of harmful addiction.
Then assigned a special diet.The destroyed liver cells, which have already been replaced by fibrous tissue, cannot be restored. Therefore, treatment is aimed at those who are still functioning to varying degrees. If necessary, apply antiviral treatment.
If there is a withdrawal syndrome, then they are used.sedatives and restored water and electrolyte balance. With the complication of alcoholic cirrhosis, hepatic encephalopathy is prescribed glucocortistoids with a course of 30 days. And ursodeoxycholic acid, which prevents cell death and has anti-inflammatory effect.
Bile acids and vitamin E are used as antioxidants. They are needed for ethanol utilization, which accumulates in the excess in the liver during alcoholic cirrhosis.
Biliary cirrhosis
Biliary cirrhosis is less common thanthe above forms. This is a disease in which its functions and structure are violated. The consequence of the termination of the bile outflow, and the change in the structure of its ducts.
A disease of the form of biliary cirrhosisliver, symptoms and causes of occurrence until the end has not yet been studied. It is believed that it may begin due to genetic predisposition. And also in violation of immunity or infection. Biliary cirrhosis is divided into primary and secondary.
Primary biliary cirrhosis
With a form such as primary biliary cirrhosis,symptoms and signs increase gradually. A person often does not even suspect a disease for a long time. And his condition does not even deteriorate for a long time. There are two stages.
На ранней начинается зуд кожи.And this sign appears even long before jaundice. This symptom is ahead of her from six months to 1.5 years. But sometimes itching and jaundice occur simultaneously. Appear fatigue, severe weakness, depression, drowsiness.
In the advanced stage of a disease such asprimary cirrhosis, symptoms manifest clearly. Ascites occurs. And this is the first sign of liver failure. Appear vascular "stars", encephalopathy. Some have xanthomas and xanthelasma (plaques around the eyes). A quarter of patients show skin hyperpigmentation.
Treatment of primary biliary cirrhosis
Treatment of biliary cirrhosis is based on reducing the intensity of symptoms and slowing the progression of the disease. The therapy of the appeared complications and the prevention of their occurrence is carried out.
First of all, the patient must refuseall bad habits and taking medicines that destroy the liver. A strict diet is required and physical exercise is prohibited. During the treatment of cirrhosis, all concomitant infectious chronic diseases are treated simultaneously.
If instrumental intervention is performed(dental procedures, etc.), antibiotics are prescribed to prevent infection. Primary biliary cirrhosis, the symptoms of which signal the transition to the decompensation stage, requires bed rest and inpatient treatment. Physiotherapy, stress testing and balneological procedures are contraindicated.
In the period of compensation, rationalnutrition and diet number 5. When you have encephalopathy, you need to reduce the level of protein. If ascites appears, eliminate salt from the diet. Physical loads and work at a low temperature are excluded. We recommend walking and a number of physical exercises.
Some drugs are excluded: some types of antibiotics, aminoglycosides and nonsteroidal drugs that have anti-inflammatory effects. Apply to:
- immunosuppressants;
- glucocorticoids (in minimal doses);
- ursodeoxycholic acid;
- D-penicillamine;
- antihistamine drugs.
If the patient has started the last stage, beforecirrhosis of the liver, signs and symptoms clearly indicate the need for surgical intervention. For example, a sharp increase in liver failure. In this case, only a liver transplant can save the patient. Most people after such an operation can live for almost 10 years. After transplantation, relapse is observed in only 15% of patients.
Secondary biliary cirrhosis
Secondary biliary cirrhosis develops withpartial or complete obstruction of the pathways leading to bile. Women suffer from them two times less often than men. Usually, the secondary form occurs after surgery to remove the gallbladder, prolonged chronic pancreatitis, or with a tumor.
With a disease such as secondary biliary cirrhosis, the symptoms are primarily associated with the cause of the obstruction. And then appear the same as in the primary form.
Treatment of secondary biliary cirrhosis
In the treatment of secondary biliary cirrhosisinitially eliminated the cause of the disease. With the help of surgical procedures (bougienage, extraction of stones, dilation of ducts, etc.). After the operation, it is possible to prolong the life of the patient.
Если хирургическое вмешательство невозможно, то therapy is carried out, similar to that used in primary biliary cirrhosis. Treatment in this case depends on the degree of obstruction, its causes and the possibility of their elimination.
Compensated liver cirrhosis
With compensated cirrhosis, a person may notknow about the disease, as there are no special symptoms. The liver works normally. The patient does not bother. And the diagnosis can be made only on a scheduled examination. Or suddenly - during the operation.
The only symptoms of cirrhosis that mayoccur with compensated cirrhosis is a rise in temperature, redness of the palms and bleeding from the nose. But with this form of the disease, people can live for decades. Moreover, without any complications.
Treatment of compensated cirrhosis
Treatment of compensated cirrhosis depends onstage of the disease. If it is in a “sleeping” state and does not progress, then only vitamin-mineral complexes and strict diet No. 5 are prescribed. It is necessary to completely give up cigarettes and alcohol. Do not take hepatotoxic drugs.
If compensated cirrhosis progresses, thenDiet number 5a is prescribed until the exacerbation subsides. Vitamins B, folic acid and cocarboxylase are needed. The use of milk thistle helps remove toxins from the body. In addition, it has anti-inflammatory, hepatoprotective effects and relieves muscle spasms.
Decompensated cirrhosis: symptoms and treatment
При декомпенсированном циррозе печень находится в worse condition than when compensated. The process of fibrosis begins. All signs of cirrhosis are present. The most noticeable are deterioration of the general condition, jaundice and ascites.
In the treatment of decompensated cirrhosis accentdone to eliminate local manifestations (ascites, etc.) and existing pathologies. In the acute course of the disease, devices supporting the function of the liver are used. But for this, the patient must be transported to special medical centers where the devices are installed.
With decompensated cirrhosis with the presence ofactive hepatitis B therapy is applied "lamivudine." It significantly improves the condition of the patient and has a positive effect on the liver. At the first manifestations of decompensation, liver transplantation will be the best option.
Liver cirrhosis: symptoms and treatment
Pigmented cirrhosis is manifested externally.spots on the skin and the presence of sugar in the urine. Another name for the disease is bronze diabetes. Most often, it is inherited in the form of a defective series of enzymes. As a result, lipofuscin and hemosiderin are deposited in many organs (including the liver).
Then inflammatory processes begin andsclerotic changes of small capillaries. This leads to deformation of the organs. The liver increases and becomes more dense. But her work is not disturbed. Periodically there are symptoms of diabetes: thirst, increased appetite. Sugar appears in the urine and its level in the blood increases.
The prognosis of pigmented cirrhosis is unfavorable.Death occurs from liver failure, diabetic coma or bleeding. In the treatment prescribed bloodletting, injection rates. Diabetes and complications stop with symptomatic therapy.
