Diagnosis of the liver

The problem of how to check the liver is important for sick people and for the healthy in the prevention organization, if the family already has cases of the disease. To learn the results of the study, you need to pass the tests, undergo an instrumental examination. The doctor can fully determine the scheme, so it is better to inform at the reception all that is disturbing and follow his advice.

When there are doubts in the health of the liver?

Suspicion of the disease occurs in people who have found themselves with characteristic symptoms in people with chronic diseases. If a person is sufficiently informed, then he knows that damage is possible with prolonged treatment with potent drugs, poisoning, food overload.

In the practice of a doctor, a check is needed when examining pregnant women, during the preparation of the patient for an operative intervention, after general anesthesia. Few people know that the liver supplies components for the synthesis of sex hormones, so the liver is checked for all men with a breakdown of potency, spouses in order to identify the causes of infertility.

Control of the organ is needed for patients who have experienced acute viral hepatitis, with a chronic form of the disease. Examination of the liver is necessarily carried out by patients with chronic anemias, neurological diseases.

Patients with renal insufficiency, when used in the treatment of hemodialysis, liver function is checked every course

Checking the liver is especially necessary for people with alcohol and drug addiction. In "light" intervals they understand that irreversible changes inevitably come, and try to be treated.

With a disturbed psyche with severe irritability, depression, the main cause is brain intoxication with substances that stop processing the liver. Diagnosis of liver diseases - a separate section, which engaged therapists, pediatricians, infectious disease specialists, gastroenterologists (in large specialized centers appeared hepatologists).

What are the symptoms of liver failure?

If the hepatic cells are disrupted, the inadequate functions are manifested by typical symptoms. It is impossible to skip them, because the unhealthy appearance, the general malaise do not allow a person to continue normal activities, life.

The most common symptoms are as follows. Yellowing first sclera, then skin - is associated with an increased level of bilirubin pigment in the blood. Under normal conditions, it is released when old erythrocytes and hemoglobin disintegrate, is destroyed in the liver, and is excreted with bile into the intestine.

Jaundice indicates that the liver ceases to disinfect this substance. Its accumulation in the future will lead to intoxication, damage to the brain. Yellowish plaque may initially appear on the tongue.

Bright yellowness gradually builds, begins with a sclera

The feeling of heaviness in the hypochondrium on the right - first worries after taking alcohol, overeating fatty and fried foods, spicy dishes. Then it becomes permanent. The pains appear only at a hyperemia and edema of a liver when sizes (a tumor growth, a cyst) increase. The parenchyma presses on the capsule, equipped with sensitive nerve endings.

Problems with the liver are always reflected in digestion in general. The failure of production of bile acids leads to insufficient digestion in the intestines, disrupts the assimilation of nutrients. Irritated bowels react with diarrhea or constipation. Fecal masses become significantly lighter due to the absence of stercobilin (a bilirubin derivative).

At the same time, urine becomes dark, as bilirubin from the blood passes through the kidneys and turns into urobilin. Often, patients with impaired liver function lack appetite, nausea, a feeling of bitterness in the mouth. The people around notice an unpleasant sweetish smell from the mouth.

The skin becomes dry (collagen and elastin is lost), pale, flaky, on the face, chest, on the shoulders are visible vascular "asterisks". The consequence of an increase in the level of bilirubin is a painful itching. Unhealthy combs are capable of suppurating. On the disrupted blood clotting speaks propensity to bleeding from the nose, oozing blood from the gums, bruises (bruises) on the body.

With severe liver damage, the pressure in the portal and inferior vena cava increases. This leads to bleeding from the enlarged veins of the esophagus, expressed in the admixture of blood in the vomit masses, feces. The stomach (ascites) begins to increase without increasing body weight. Around the navel, extended subcutaneous veins in the form of a ring protrude.

Functional liver failure manifests itself in a toxic effect on the cells of the brain, which causes fatigue, weakness, drowsiness, depression, insomnia, irritability, change in character. The appearance of these symptoms requires an immediate check of the liver.

What should the doctor see at the reception?

To determine the liver disease, the doctor has the opportunity to question the patient, to find out the most typical complaints and examination. As a result, a suspected diagnosis appears. To confirm, the doctor decides which tests to check for the liver. This is important, since not all qualitative studies can be carried out by the laboratory of the polyclinic, it is possible that some of the tests will have to be delivered in private institutions on paid terms.

During the diagnosis, doctors use an old method of determining the boundaries of the liver, like percussion on Kurlov. The method can not be considered reliable in modern conditions, because it depends on the practice of the doctor, the ability to detect the slightest change in sound.

The percussion is carried out with short blows along the middle phalanx of the third finger of the pressed palm, the finger moves to the place where the sound change is heard

The technique of percussion of the liver involves determining the boundaries of the lower and upper edge of the organ along the right median-clavicular and parasternal (passes along the external border of the sternum) lines. Then the distance between the extreme points is measured. Sometimes there is a need to percut on the anterior axillary line on the right.

The position of the left lobe is specified by percussion from the upper point of the midline of the sternum to the left at an angle of 45 degrees. The table shows the norm for children and adults.

Pediatricians believe that percussion is suitable for diagnosis in children after 7 years. Small deviations are possible with a different type of physique (in asthenics and hypersthenics). Do not confuse these dimensions with the value detected with ultrasound. Most often found displacement of the lower edge, which confirms further palpation (hepatitis).

The upper border of the liver is in contact with the right lung. The increase is possible with a large cyst, a tumor, an abscess. It is possible to fix smaller sizes. This sign accompanies primary biliary cirrhosis, other types of fibrosis of the hepatic tissue.

What tests should I take to check the liver?

It is necessary to check:

• general blood test - often show an increase in ESR, hemoglobin, eosinophilia are found in auto-allergic processes;
• in urine a positive test for urobilin is important;
• Gregersen's reaction - in case of a positive result indicates a hidden bleeding.

To check up a liver only by the general or common analyzes it will not be possible, because changes often accompany various diseases, are not specific. Among the methods of laboratory diagnosis, the main emphasis is placed on carrying out biochemical tests.

Mandatory test in the blood serum:

• protein and its fractions - against the background of a decrease in the overall level in liver diseases, globulins predominate over albumins;
• bilirubin - identified by type (direct or indirect), the growth of indirect (unconjugated) bilirubin indicates the disruption of its processing in the hepatic cells, accumulation leads to jaundice;
• timolovuyu test - is important for diagnosis of inflammation in hepatitis;
• impaired coagulability - able to confirm bad tests for fibrinogen, prothrombin index.

The change in fat metabolism and the onset of fatty hepatosis is judged by the concentration of cholesterol, triglycerides, lipoproteins

The value of enzyme assays

In the analysis of blood, it is possible to detect the disturbed content of enzymes, which are mainly in hepatocytes. Therefore, their growth indicates the degree of destruction of liver cells (hepatitis, cirrhosis, cancer). Transaminases - aspartic and alanine proportional to the degree of damage. Alkaline phosphatase - often grows with a tumor process.

In addition, lactate dehydrogenase, gamma-glutamyltransferase, sorbitol dehydrogenase, gamma-glutamintranspeptidase, fructose-1-phosphataldolase (F-1-FA) is determined. To eliminate pancreatic diseases, the aldolase of blood and urine diastase are checked.

What do you need to check for viral hepatitis?

If suspected of viral hepatitis, confirmation by markers is necessary. For this, immunological reactions are required:

• on total antibodies;
• viral load.

In a specialized laboratory, immunological methods of liver examination are used:

• linked immunosorbent assay;
• immunoblotting;
• radioisotope diagnostics.

Liver examination with medical equipment

In modern medicine, to check the pathology of the liver, objective indicators of apparatus based on the penetrating and reflecting ability of ultrasonic vibrations, resonating the possibility of magnetic radiation, the accumulation of isotopes in the "related" tissue are used.

Ultrasound diagnosis of the liver is carried out in planned and emergency order in any hospital. The procedure is safe for young children, pregnant women. It allows to reveal the exact sizes of the organ, the density of the parenchyma structure, the node and the localization of the neoplasm, cysts, the degree of lesion.

Computer and magnetic resonance tomography are even more informative. They give a result in a multidimensional image, it is possible to see the degree of replacement of the parenchyma with a scar tissue. Better display intrahepatic ducts and vessels. Scanning - is carried out by intravenous introduction of isotopes, which are delivered by blood to the liver. Here they are distributed across all functioning cells.

When scanning, it is possible to identify areas of cicatricial changes in non-functioning tissue, to establish tumor growth (the isotope does not pass into malignant cells), the degree of the remaining healthy parenchyma. Biopsy - is assigned only if there are insufficient results for other types of studies, for differential diagnosis with tumors.

At a biopsy in a liver enter a needle which take away a material and further process it or him laboratory by

Is it worth it to check beets?

Folk recommendations for checking the liver after eating boiled beet, if there are enough methods available in hospitals, do not have proven effectiveness. The beetroot "test" requires in the evening to eat medium-sized cooked beets. Next comes the "decoding" w

If the liver works well, the urine should color after 16 hours, with an earlier color (for example, after 3 hours), a conclusion is made about a poor function. It seems to us that this test will work better for persuading people who suffer from alcoholism, even for a while to stop drinking. In other cases, use is not advisable.

What is done to detect cirrhosis?

To identify cirrhosis, the patient is carried out all the described diagnostics. Fibrogastroduodenoscopy is also necessary. The doctor in conclusion notes blood-overflowed and dilated veins of the stomach and esophagus, signs of concomitant gastritis, duodenitis. To determine the type of cirrhosis, all immunological and biochemical tests are necessary.

In addition to the alcoholic cause, the disease can be a consequence of chronic viral hepatitis C. It is important to consider that for a long time the pathology is asymptomatic. Significantly more than with other pathologies, a liver biopsy is indicated.

In some cases it is necessary to resort to laparoscopy under general anesthesia (the introduction of an optical tube into the abdominal cavity). Any person can check the liver, if he feels unwell with his health, he has discovered typical symptoms. The main thing is not to postpone and get an answer to solve your problem.