Cirrhosis of the liver in the stage of decompensation

Cirrhosis is a chronic disease with a tendency to progress. The disease leads to the development of irreversible changes in the cells of the organ. As a result, normal tissue is replaced by fibrous, because of which normal functioning is simply impossible. This affects the work of vital organs and body systems.

Damage and inflammation of liver cells leads to their complete death. Eighty percent of reported cases of cirrhosis were caused by viral hepatitis or alcoholism. Also provoke the appearance of a terrible disease can parasitic diseases, the taking of certain medicines, autoimmune processes and other.

The disease develops rather slowly. The first signs and may not be at all. Over the course of time, the following symptoms may appear: jaundice, pruritus, vascular sprouts, weakness, decreased performance, weight loss amid loss of appetite. In this article, we will talk in more detail about decompensated liver cirrhosis.

What does the decompensation stage mean?

Cirrhosis occurs in several stages and it is very important not to miss the first signs of the pathological process. Unfortunately, you can not completely get rid of the disease, but here's to slow down further progress in your abilities. At the first stage of the disease inflammatory-necrotic changes in the liver develop.

Compensated cirrhosis manifests itself in the form of weakness, fatigue, reduced concentration and attention, decreased appetite. Often patients write off these symptoms for vitamin deficiency or fatigue. Even at the second stage there are more serious symptoms. The skin acquires a yellow shade, itching appears, the body temperature rises.

Also patients are concerned about discomfort in the abdomen, and a nausea attack may result in vomiting with impurities of the biliary secret. Feces mass brightens, while urine acquires a darker shade. The liver tissue begins to be replaced by fibrous tissue, but at this stage the organ continues to work in the usual mode.

Decompensation of liver cirrhosis is associated with the emergence of life-threatening complications of

The third stage is decompensated cirrhosis of the liver. At this stage, serious complications can occur in the form of hepatic coma, blood infection, pneumonia, thrombosis of veins and other. This stage is also characterized by sudden bleeding from the nose, gums or anus.

Also in patients with diarrhea, complete impotence, a sharp decrease in body weight, vomiting, fever, as well as atrophy of the muscles of the hands and in the intercostal part. Patients should be in the hospital, since the likelihood of a lethal outcome is high. The third stage is characterized by complete impairment of functional activity and deformation of the liver.

At this stage, a large number of hepatocytes die. In this case, the area of ​​the organ damage is almost 90%.The terminal stage is characterized by a coma. The deformity of the liver affects the vast part. Against the background of a hepatic coma, the brain is affected. Most often the patient simply does not come out of a coma.

It is important not to miss the first symptoms of the disease

The provoking factors

Cirrhosis of the liver can go to the stage of decompensation under the influence of the following factors:

• addiction;
• alcoholism;
• improper power;
• contact with chemicals and radioactive substances;
• viral hepatitis;
• use of potent drugs;
• disorders in the work of the heart.

Symptoms of

The third symptom of cirrhosis is the appearance of the following symptoms:

• a strong attack of pain in the area of ​​the right hypochondrium. Sometimes unpleasant sensations acquire a permanent character, and to remove them you need to take strong remedies;
• signs of body intoxication: fever, dizziness, headache, lack of appetite;
• diarrheal disorders: diarrhea, constipation, heartburn, stomach pain, vomiting;
• uterine, gastric, intestinal bleeding. This is due to the fact that the liver ceases to produce substances that bind blood, and the spleen, which increases in size, ceases to produce platelets;
• disturbance of metabolic processes leads to atrophic changes in muscles, which makes the patient lose weight and feels weak and apathetic. Due to the violation of protein metabolism, the risk of fractures increases;
• hormonal imbalance entails infertility, impotence and decreased sexual desire;
• strong heat;
• splenomegaly, that is, an enlarged spleen in size;
• skin becomes dry and wrinkled;
• severe exhaustion;
• redness of the palms, soles and fingers;
• insomnia;
• aggression;
• strong abdominal enlargement in volumes;
• swelling on the legs;
• hardening of the liver;
• irritability;
• the skin acquires a bronze-yellow shade. This is due to the fact that bilirubin begins to accumulate under the skin.

Patients with severe itching

Separately it is necessary to say about changes in the mental state with cirrhosis. Why is this happening? One of the reasons is due to the fact that toxic substances enter the brain. In some cases, patients become inhibited and lose orientation. They may suffer from obscuration of consciousness, depression, irritability, imaginary anxiety.

Diagnostic examination

To assess the patient's condition, laboratory tests, biopsy, ultrasound, laparoscopic examination will help. With the help of ultrasound diagnosis, a specialist can pay attention to the increased size of the liver, as well as the presence of structural changes. The organ has a dense structure with nodules.

Laparoscopy allows to determine the variety and degree of pathology, as well as the general condition of the affected organ. Using a biopsy, one can learn about structural changes in the liver at the cellular level.

In the general analysis of blood in cirrhosis, the rate of erythrocyte sedimentation is increased, and hemoglobin levels are reduced. With microscopy of urinary sediment, a specialist will be able to see salts, as well as an elevated level of erythrocytes. In a biochemical study, the level of bilirubin, AsT, AlT will be increased. Laboratory tests will help in diagnosing.

Features of treatment

Treatment of cirrhosis of the liver at the stage of decompensation implies the maintenance of the functioning of vital organs and body systems, as well as the prevention of dangerous complications. Drug therapy includes the use of such drugs:

• vitamins, a special role in the treatment of vitamins B play;
• hepatoprotectors;
• diuretics in combination with preparations of magnesium and potassium to prevent swelling and ascites;
• means that accelerate the recovery process;
• antibiotics;
• immunostimulants.

In severe cases, surgery for a liver transplant or part of the

is indicated. Along with this, it is important to radically change your lifestyle. This means giving up bad habits and adjusting the diet. Patients are assigned a treatment table number 5.With decompensated cirrhosis, antiviral drugs are strictly prohibited. Such drugs increase the development of necrotic changes in the organ.

We will outline the main rules of the medical process for decompensated cirrhosis:

• it is important to limit the intake of salt and liquid, this will help to remove swelling with ascites;
• reception of vitamins and minerals;
• reception of iron preparations for anemia;
• rejection of fatty, fried and heavy food.

Patients are allowed to include in the diet mashed soups, dairy products, kissels, compotes, fruit drinks, dog-boiled broth. Strongly forbidden muffin, strong coffee, beans, onions, garlic, radish. Recipes of traditional medicine will also help to remove unpleasant sensations.

Consider the most effective methods:

• in equal proportions take horsetail, rhizome chicory, St. John's wort and yarrow. A tablespoon of dry herbs pour a glass of steep boiling water. The product should be infused for four hours. Take the broth should be half an hour before the main meal;
• Connect one part of the nettle, as well as two parts of the root of the wheatgrass and dogrose. A tablespoon of raw material is poured into a glass of water and cooked on fire for fifteen minutes. Take the drug should be twice a day for 250 g.

But as you know, any disease is easier to prevent, and cirrhosis is no exception. The main preventive measure is the exclusion of alcoholic beverages. An important role is played by the diet. It should limit the consumption of fatty, fried foods, as well as fast foods.

Do not forget also about simple precautions:

• wash your hands before eating;
• they should be thoroughly rinsed under running water before cooking vegetables and fruits;
• observe the rules of personal hygiene;
• refuse from promiscuity;
• do not use drugs;
• monitor the blood pressure level;
• for cardiovascular disorders please consult a specialist.

From fats of animal origin will have to refuse

Forecast

How do patients with cirrhosis live? The prognosis largely depends on the stage of the pathological process. With a compensated form, it is possible to live up to ten years. To live with decompensated cirrhosis of the liver can only one or two years. According to statistics, the life span of forty percent of patients does not exceed more than three years.

Specialists claim that only one in five can live five more years. In ascites, only a quarter of all patients can survive three years. If hepatic encephalopathy has developed, it will not be possible to live more than a year. Coming into a coma almost always ends in death.

It is impossible to unequivocally answer the question about how many patients live with stage 4 of cirrhosis, since a lethal outcome as a result of complications can occur at any time. A common cause of death at the stage of decompensation are gastric and intestinal bleeding. Ascites, complicated with peritonitis, is on the second place.

Possible complications of

As a result of the progression of the disease, serious complications can occur, such as cancer, bleeding, fluid accumulation and much more. Let's talk about the most common processes that occur at the stage of decompensation.

Hepatic encephalopathy

Pathology leads to neuropsychiatric disorders, which manifest themselves as changes in behavior and consciousness. With cirrhosis, blood accumulates toxic substances, which primarily affect the brain. The person becomes inattentive and irritable, his sleep is disturbed, while drowsiness acquires a permanent character.

Gradually the patient is lost in time, his speech is disrupted, and behavior becomes inadequate. Treatment includes infusion therapy. Hepatoprotectors contribute to reducing the concentration of toxins in the circulatory system. Sometimes even a gastric lavage is required. Antibacterial agents are used to reduce the absorption of decomposition products.

Brain damage is primarily associated with ingestion of toxic substances

Ascite

Due to accumulation of fluid, the stomach increases in size. With cirrhosis, deformed cells squeeze the blood vessels, which leads to a violation of blood supply. About the accumulation of fluid can be said with the daily measurement of the abdominal circumference. The umbilical ring is stretched, and the navel is turned outward. On the skin of the abdomen, veins are clearly visible.

Patients are recommended bed rest. The amount of salt is sharply limited, and the consumption of liquid decreases. Under the control of diuresis, diuretic drugs are prescribed. If there is no response to these drugs, abdominal puncture

is performed. Hepatic coma

The pathological process causes a decrease in the number of active cells. If, along with a violation of the functional activity of the liver, changes occur on the part of metabolic processes, the hepatic coma develops. It appears suddenly and lasts from 1 to 3 days.

Treatment is carried out in the intensive care unit, where permanent monitoring of vital functions must take place. Patients are assigned parenteral nutrition by administering medicinal solutions with nutrients. Detoxication therapy is carried out.

So, cirrhosis of the liver is a dangerous progressive disease, which, in the final analysis, can lead to death. Decompensation is the third stage of the disease, in which serious structural disorders of the organ and severe clinical symptoms are observed.

The prognosis is generally unfavorable, which is why it is so important not to miss the first symptoms. Careful adherence to medical recommendations, adjusting the diet, avoiding bad habits - all this will help prolong life.