Toxic hepatitis - acute and chronic

Such liver disease as toxic hepatitis, acute or chronic course, develops as a result of getting into the body of various harmful substances (alcohol, drugs, toxins of fungi).

The toxic effect on liver cells, which is accompanied by inflammation of the cells and their death, is manifested by an increase in the liver in size, painful sensations in the right hypochondrium and jaundice.

Acute toxic hepatitis develops with a single ingestion of a large number of toxic substances. Symptoms of this form of the disease appear during the first 2-5 days after poisoning. Chronic form develops due to multiple entry of poisons, but in small amounts. In this case, the symptoms of the disease can manifest themselves years later.

Causes

What is it, and why is it developing? The causes of toxic hepatitis in adults can be the intake and inhalation of toxic substances (organic solvents and industrial poisons), poisoning with mushrooms (more often pale toadstool, less often fly agarics, morels and stitches). The disease leads to a single use of alcohol in large doses, and the use of alcoholic beverages for a long period of time.

instagram viewer

If a large dose of one of the following drugs is taken at a single-stage dose, significantly exceeding the recommended dose physician, toxic liver damage is observed and acute toxic hepatitis develops.

sulfonamides (Biseptol);
antiviral drugs (Interferon, etc.);
drugs against tuberculosis (Ftivazid);
antipyretics (Paracetamol, Aspirin);
anticonvulsants (Phenobarbital and others).

In addition, toxic liver disease is triggered by the following substances:

phosphorus, which is abundant in fertilizers used to increase the yield of orchard and garden crops.
arsenic, allocated at the enterprises of the metallurgical industry.
phenols contained in disinfectants.
Pesticides and insecticides used in agriculture in the control of weeds and insects.
aldehydes used in the food industry.

Poisons and their toxins can enter the human body in several ways: through the gastrointestinal tract, through the respiratory system, through the skin and through the blood. On the liver, they can have both direct action (with a direct effect on hepatocytes), and mediated (when there is a violation of blood flow in the vessels of the liver, which leads to their death and disruption of functions).

According to the ICD-10 on the etiology of the disease, toxic hepatitis can be immediate, cholestatic and immune. In the course of the disease, a classification for chronic and acute viral lesions has been adopted.

Symptoms of toxic hepatitis

In mild cases of toxic hepatitis, the disease occurs almost without symptoms, it is found only in a group examination (for example: the use of poisonous fungi).

In more severe cases, hepatitis can manifest itself in the form of the following symptoms:

Pain in the right upper quadrant, occur suddenly, 2-5 days after the penetration of hepatotropic venom into the body, are the result of the enlargement of the capsule with an enlarged liver (because of the acute inflammatory process in it);
Jaundice coloration of mucous membranes and skin;
Saturated urine of dark color;
Deboned feces;
Raise body temperature> 380C, general weakness, lack of appetite, nausea, vomiting (maybe with blood), joint pain;
Petechiae (small skin hemorrhages);
Nasal bleeding;
Hemorrhagic phenomena;
Skin can change its color to saffron or orange. Dimensions of the liver, as a result of acute dystrophy, can significantly decrease.

Chronic toxic hepatitis proceeds more smoothly, without acute manifestations. Possible blunt pain in the right upper quadrant, mild jaundice, slight intoxication, low-grade fever, bitterness in the mouth. These symptoms may subside for a while (remission), and again manifest (exacerbate).

Diagnostics

When diagnosing toxic hepatitis, laboratory and instrumental methods are used. A biochemical blood test is performed to determine the level of bilirubin and enzymes such as AST and ALT, alkaline phosphatase, gamma-glutamyl transpeptidase.

Treatment of toxic hepatitis

Treatment of the disease in adults, in the first place, implies the cessation of the entry of harmful substances into the body. If, for some reason, it is not possible to immediately go to a medical facility to receive full-value care, it is necessary to perform a number of operations that prevent the ingestion of a poisonous substance into the blood and, consequently, into the liver.

If the suspected poison has got into the digestive tract, you need to get rid of it with the help of false-induced vomiting. First, you need to take a comfortable position for this (position half-sitting with the head tilted forward). After that, you should irritate the root of the tongue by pressing on it with your finger (this is not used in all cases). To weaken the effect of poison on the walls of the stomach, you should drink milk, decoction of flaxseed. If there is an increased temperature, cold compresses can be applied to the forehead.

While all this is done, it is best to call an ambulance or immediately go to a medical facility. If there are signs of an acute form of toxic hepatitis, the patient needs urgent hospitalization. In the hospital, he will undergo the following treatment under the supervision of a doctor:

Gastric lavage from the remnants of poison. To do this, use slightly warm water with the expectation that an adult needs 10 liters of water.
Removal of poisons from the body (activated charcoal, droppers with solutions of elektolitov), hemosorption, plasmapheresis (purification of blood from toxic substances). Activated charcoal, absorbs on its surface the toxins left in the stomach, preventing them from getting into the blood.
The use of vitamins of group B and C.
To restore the liver use special hepatoprotectors, for example, Essentiale or Heptral.
Cholagogue preparations (Holosas, Holenzyme). Together with bile from the liver, a part of toxic substances
If the attack of the disease was caused by poisoning with mushrooms, then special antidotes are used that prevent toxic damage to the cells.

During treatment, the patient is assigned a strict bed rest and a certain diet.

Hepatoprotectors

Hepatoprotectors are drugs specially designed to increase the level of liver resistance to various negative factors. This remedy increases the ability of the liver to neutralize toxic substances. They are an important part of the treatment of toxic liver damage due to hepatitis.

Heptral. The main active substance - ademetionine, which stimulates the growth of liver cells, is involved in the synthesis of serotonin and detoxification of toxins. Ademetionin is produced by the liver, but with its diseases the concentration of this substance in the body decreases. Heptral replenishes the deficiency of ademethionine and stimulates its natural synthesis.
Essentiale forte. The drug normalizes the metabolism of carbohydrates, proteins and lipids in the liver, enhancing its detoxifying functions. It helps to restore the liver after its damage, prevents the formation of scar tissue in it. The preparation is based on special fats (so-called essential phospholipids), which are obtained from soybean beans.

As for the diet for home treatment, the use of alcohol and smoking is strictly prohibited.

To eat should be sick in small portions and often, thus, improving the excretion of bile. Food should not be fatty, fried, salty, with no seasoning, be rich in vitamins and vegetable fiber.

Therefore, the main products in the diet should be, fresh vegetables and fruits (various salads), legumes (beans, peas). Only use butter and vegetable oils. To eat meat only easily assimilated (chicken, rabbit). Completely abandon the smoked products, canned food. To make unloading days, one day a week, eat only vegetables or fruits.