Cirrhosis of the is a chronic disease characterized by the irreversible replacement of parenchymal hepatic tissue with a fibrous connective tissue or stroma. The liver affected by cirrhosis can be enlarged or reduced, its consistency is unusually dense, bumpy, rough. The death of patients with cirrhosis occurs within two to four years with severe pain and anguish in the terminal stage of the disease.
Consider the various forms of the disease, their causes, the first signs, symptoms and treatment of cirrhosis in men and women.
Cirrhosis of the liver is primary and secondary.
CONTENTS
Causes of the disease
Primary cirrhosis of the liver
represent the final stage of the development of hepatitis and dystrophic liver damage caused by Botkin's disease, syphilis, smallRia, tuberculosis.
Secondary cirrhosis of the liver
Develop due to prolonged blood stagnation in heart disease and with prolonged stagnation of bile in the liver.
One of the causes of cirrhosis is alcoholism. All cirrhosis is divided into a number of forms, of which the most interesting are atrophic, hypertrophic and mixed cirrhosis of the liver. In addition to atrophic and hypertrophic liver cirrhosis, mixed forms of cirrhosis with symptoms of both atrophic and hypertrophic cirrhosis also occur. For example, there are cases where along with jaundice, which is typical for hypertrophic cirrhosis, there is ascites and shriveled liver, characteristic of cirrhosis atrophic. Sometimes, along with an increase in the liver, there is an increase in the spleen.
Symptoms and treatment of cirrhosis
Atrophic cirrhosis of the liver
With atrophic cirrhosis of the liver, connective tissue grows around the liver lobules, which then undergoes wrinkling. As a result, the liver increases during the period of proliferation of connective tissue, and subsequently, along with the wrinkling process, its size significantly decreases. All these changes in the liver are irreversible.
The disease is detected only when the development of cicatricial changes causes painful sensations. The first signs of cirrhosis: patients complain of weight loss, weakness, poor appetite, nausea, heaviness in the epigastric region and an increase in the abdomen.
One of the main symptoms of the disease is hydrocephalus( ascites), which arises due to the appearance around the branches of the portal vein cicatricial changes and the stagnation caused by them in the veins of the abdominal cavity. The fluid in the abdominal cavity is free to move and has a low specific gravity. With a significant accumulation of the lower extremities begin to swell, which is explained by compression of the lower vena cava with ascites and a complicated outflow of venous blood from the lower limbs. Increase in the abdomen usually occurs not only because of dropsy, but also due to flatulence and enlarged spleen. After the release of ascites fluid, it accumulates again in a very short time.
Patients with atrophic cirrhosis suffer from increased thirst;urine in them is not enough, it shows bilirubin and urobilin. From the gastrointestinal tract is also found a number of violations: eructations, heartburn, bloating, heaviness in the epigastric region. Due to eating disorders, patients are depleted and anemic. They often die as a result of pneumonia, tuberculosis and liver failure.
The prognosis for atrophic liver cirrhosis is always poor. The disease progresses 2-3 years and ends with the death of the patient. With a more favorable course of the disease, when liver damage is slow, the maximum life expectancy does not exceed fifteen years.
Treatment of atrophic form
Basically, it is symptomatic. However, first of all, it is necessary to eliminate the disease that caused cirrhosis of the liver. The food of the patient should contain mainly carbohydrates and vitamins. Milk, cottage cheese, flour dishes, cereals, fruit juices, fruit, liver, yeast are recommended. Against stagnation in the organs of the abdominal cavity, prescribe light laxatives - rhubarb, English salt. They give diuretics. If the dropsy has reached a significant size, the amount of salt in the food should be sharply limited. Ascetic fluid is periodically released in a hospital. It is forbidden to drink alcohol, spices, excessive amounts of meat.
Hypertrophic cirrhosis of the liver
This type of cirrhosis is rare. The essence of the disease is the growth of the inside of the hepatic lobules of connective tissue, which does not shrivel, which leads to an increase in the liver. At the same time, splenic tissue proliferates, which explains the increase in the spleen.
Typical clinical symptoms of the disease are slowing jaundice, itching with scratching of the skin, a feeling of heaviness in the right hypochondrium and an increase in the abdomen. The amount of bilirubin and cholesterol in the blood increases. In urine are found bilirubin, urobilin, bile acids. Severe cases of the disease are accompanied by internal bleeding.
In cases of hypertrophic cirrhosis of the liver, ascites usually does not occur. This is due to the fact that there are no violations from the portal blood circulation. The liver function suffers little. The disease lasts 3-4 years, death occurs due to internal bleeding or an infection.
Treatment of hypertrophic form of
In hypertrophic cirrhosis treatment is nonspecific. Patients are advised to follow a certain regime, optimal to compensate for the process, avoid overwork. When the process is activated, bed rest is recommended in a hospital.
Patients should comply with known dietary restrictions and refrain from excessive amounts of animal fats, meat products. They recommend a milk-vegetable diet with a lot of cottage cheese, vegetables and fruits. Patients can eat young meat( in small quantities), poultry, fish dishes. Also necessary are products containing a large number of vitamins - ascorbic acid, B6, B12.Alcoholic beverages are strictly prohibited.
Alcoholic cirrhosis of the liver
Alcoholic, or portal, hepatitis is almost always caused by alcohol abuse. Especially often alcoholic liver cirrhosis manifests itself in those professional population groups, whose representatives easily become victims of alcoholism( workers of wineries, servants of restaurants, etc.).
In the initial stages of the disease, patients' complaints mainly concern the digestive tract: constipation, diarrhea, poor appetite, nausea, a feeling of pressure in the spoon after eating, bloating( bloating is one of the first and most consistent signs of beginning cirrhosis of the liver).All these complaints are caused by chronic gastritis of alcoholics and almost always depend on the disruption of the work of other parts of the digestive tract. At the onset of the disease, before the appearance of ascites, in patients it is possible to detect varicose nodules on the anterior abdominal wall( when examining the patients, wide veins visible through the skin of the abdominal wall are visible).
The liver with alcoholic cirrhosis decreases relatively early and acquires a large-tuberous appearance. From the side of the cardiovascular system, there is a tendency to hypotension, as well as characteristic signs of heart damage, depending on alcohol intoxication. Jaundice, including latent, is not a mandatory sign of alcoholic cirrhosis.
Endocrine disorders are clearly expressed in patients. Men often have testicular atrophy, weakening of sexual desire, loss of hair in the armpit and pubic area, a symptom of "liver palms"( palms are always warm and red).
In women, there are disorders of the menstrual cycle and the birth function. On the skin, in both men and women, small telangi-ectasias( small dilated vessels located under the skin) are often observed in the form of spiders or asterisks;they are usually located on the upper half of the body, in the area of the branching of the superior vena cava - the neck, face, chin, hands, shoulders.
The temperature for alcoholic cirrhosis of the liver is usually normal. Progressive depletion is observed.
The prognosis of the disease is not as favorable as in Botkin's disease, since the disease lasts for a long time, but in the early stage, a painful process can stop if alcohol abuse is stopped.
Treatment of alcoholic form
Treatment of alcoholic cirrhosis of the liver differs little from treating other cirrhosis of the liver. In this case, special attention should be given to the state of the gastrointestinal tract.
The diet should be tailored to account for these disorders. The total amount of protein in the diet should be at least 50 g per day. Of protein products, those that contain a large amount of tyrosine, especially cottage cheese, are particularly recommended. Animal fats are sharply restricted or completely banned.
Vitamins, especially vitamin C in any form and vitamin B12, have a big role in the treatment of alcoholic cirrhosis. Diuretic drugs are shown that significantly reduce the threat of ascites development. The diet is recommended with minimal salt intake.
Prevention: combating alcoholism
Consists in the fight against alcoholism and gastrointestinal disorders. The complete cessation of alcohol consumption is an essential element of preventive therapy.
Treatment of cirrhosis of the liver with folk remedies
With cirrhosis, folk medicine advises:
Brew corn stigmas and drink like tea for 6 months.
Drink black radish juice and eat it in any kind of daily.
Exclude from food or drastically limit potatoes and foods from white flour( cirrhosis of the liver can sometimes arise from overloading the liver with starch).
Dredged in April-May the roots of the dandelion officinalis cut into small pieces, dry, lightly fry( until stirring) and size.1 teaspoon of dandelion root powder brew 300 ml of boiling water, boil 2-3 minutes and drink as coffee or tea constantly.
Layer of dandelion flowers pour a layer of granulated sugar, repeat, put for 2 weeks under the press. Eat instead of jam.
When starting cirrhosis, the following tools are useful:
Carrot juice, tomato juice, and a mixture of carrot, beet and cucumber juices in a ratio of 10: 3: 3.
Gather 1 :
- chicory root;
- the herb of St. John's wort;
- yarrow herb;
- grass horsetail field.
Mix everything, grind it.1 tablespoon of the mixture pour a glass of boiling water and leave for 30 minutes. Take two thirds of the glass 2-3 times a day for 20 minutes before eating. The remedy is also useful for chronic hepatitis.
5-6 shredded horseradish leaves together with root , insist on 500 ml of vodka 7 days, strain and take 1 tablespoon three times daily before meals. Traditional medicine advises this remedy also for lung cancer.
Collection 2 :
- leaves of nettle dioecious - 10 g;
- Cinnamon rose hips - 20 g.
Pour a tablespoon of the collection into a glass of boiling water, boil for 10-15 minutes and strain. Take 1 glass twice a day.
Infusion of willow bark. 60 g of dried and crushed willow bark boil in one liter of water for 15-20 minutes. Insist, wrapped, day, strain. Drink one third of a glass three times a day before meals.
Cook the corn stigmas and young leaves from corn cobs for 10-15 minutes, then drink this infusion for 2 cups throughout the day.
Drink a glass of red beet and radish each day.
Drink birch juice for 200 ml per day.
Not only for cirrhosis, but also for diseases of the kidney or stomach, it is recommended to do moist wrap: soak before bedtime sheet in water at room temperature, squeeze it and turn from armpits to knees, but not above or below. Then lie down in bed, cover yourself with a very warm blanket and so lie for about an hour and a half, calmly and, if possible, without talking. Then wipe dry, put on dry clothes and go to bed. So do it twice a week - it has a very beneficial effect on the liver, digestive organs and protects against colds.
This method of treatment has an even greater effect if the sheet is moistened with dew, especially dew of forest or meadow flowers( Vanga's recipe).
In cases of cirrhosis, it is useful to carry out discharge days: two kg of cucumbers in five doses one day per week;1.5 kg of watermelons in five receptions one day a week.
Regularly include in the diet honey, grapefruit, porridge or pumpkin pulp juice, oat broth, broth of carrots with tops, leaves and berries of the viburnum, as well as asparagus, eggplant, beetroot, sea kale.
With cirrhosis, alcohol is excluded even in small doses.
Cabbage for garden. Drink the juice of cabbage 1-2 times a day for 100 ml. The juice of cabbage is very easy to get after rubbing on a grater of a cabbage head and pressing the received mass.
Milk thistle. 30 grams of powdered seeds are boiled in 500 ml of water, until half the water is left. Drink a tablespoon 4-5 times a day.
Asparagus asparagus. 3 teaspoons of raw material for 200 ml of boiling water. Boil 10 minutes, strain. Drink 50 ml every 4 hours.
Thornless stalk. It is used for cirrhosis accompanied by ascites. Prepare the alcohol extract( 1:10).Drink 10-20 drops 2-3 times a day, as well as in the form of hot infusions. Infusion is prepared as follows: 15 g of crushed raw materials( root), pour 500 ml of boiling water, insist 1 hour, strain. This is a two-day dose. It is also recommended to take powder from the of the thorn root at the tip of the knife 2-3 times a day for several months.
The pickax is tenacious. Applied with cirrhosis of the liver, accompanied by ascites.4 teaspoons of the bedstuffs, pour 2 cups of boiling water, insist 1 hour, strain. Drink within one day.
The fragrant fragrant. Applied with cirrhosis of the liver, accompanied by ascites. Two tablespoons of raw material pour 2 cups of boiling water, insist 1 hour, strain. Drink 50 ml 4 times a day.
Treatment of cirrhosis in the official medicine: drugs and funds
Patients in the inactive compensated stage of cirrhosis of the liver in drug therapy do not need. They periodically appoint a complex of vitamins for oral administration.
For cirrhosis of moderate activity, preparations that include vitamins( vitamins B6 and B12, cocarboxylase, rutin, riboflavin, ascorbic acid, folic acid), lipoic acid, thistle extract are recommended to improve liver cell metabolism. Therapy courses are designed for 1-2 months.
Increasing importance among this group of drugs acquire medicinal products of plant origin.
Purified dry extract, obtained from the fruit of thistle spotted, containing flavolignans, and flavonoids, - the preparation Silimar has a pronounced hepatoprotective effect: suppresses the growth of indicator enzymes, prevents the development of cholestasis. It exhibits antioxidant and radioprotective properties, enhances the detoxification and exocrine function of the liver, has an antispasmodic and slight anti-inflammatory effect. With the use of the drug, clinical manifestations of the disease decrease and biochemical indices of the process in the liver decrease.
The choleretic function of the preparation was clearly traced at a minimum dosage of 50 mg per kg of weight during the 1 and 2 hours of the study and revealed an increase of 31.6% and 26.3%, respectively. In addition, in clinical trials, marked normalization of the function of the gallbladder in patients with manifestations of hypomotor dyskinesia. It is these moments that make it possible to use SILIMAR in patients with liver damage against the background of cholestasis syndrome, in contrast to its analogues. The drug is used at any age course from 25 days to 1.5 months for 1-2 tablets 3 times a day for 30 minutes before meals.
In the decompensated stage of liver cirrhosis with encephalopathy, ascites or severe hemorrhagic syndrome, the dose of lipoic acid or Lipamide is increased to 2-3 g per day, the course of treatment is 60-90 days. Ingestion is combined with parenteral administration of drugs for 10-20 days.
Similarly, the course of treatment Essentiale: inside 2-3 capsules 3 times a day and intravenously drip 10-20 ml 2-3 times a day on isotonic solution. The course of combined treatment is from 3 weeks to 2 months. As the phenomena of hepatic-cellular insufficiency disappear, they begin to receive the capsules inside. The total duration of the course of treatment is up to 6 months.
In viral cirrhosis of moderate activity, the use of prednisolone in a daily dose of 30 mg per day is indicated. Expressed cytopenia is also an indication of its purpose.
Gradually, the dose is reduced by 2.5 mg every 2 weeks. The maintenance dose of 15-7.5 mg is selected individually and taken 2-3 years. A high degree of activity and a rapidly progressive course require high doses of the drug - from 40 to 60 mg. The use of corticosteroids in the decompensated stage of the disease is not shown, since they contribute to the attachment of infectious complications and sepsis, gastrointestinal ulceration, osteoporosis, catabolic reactions leading to renal failure and hepatic encephalopathy.
Treatment of patients with ascites is carried out by combining diuretic drugs: Aldosterone antagonists and thiazide series drugs. Effective are combinations of spironolactone - ethacrynic acid, Spironolactone - Triumpur, cSyronolactone - Furosemide. Daily diuresis should not exceed 2.5-3 liters to avoid a noticeable imbalance of electrolytes. With the advent of powerful diuretics, Paracentesis was practically stopped due to the loss of protein that occurs with it and the risk of infection.
There is no effective treatment for primary biliary cirrhosis. Corticosteroids do not have a significant effect on the course of the disease, but slow its progression.
D-penicillamine inhibits the inflammatory response of connective tissue, the development of fibrosis, reduces the content of immunoglobulins, the level of copper in the hepatocytes. A noticeable effect is observed only after prolonged use( 1.5-2 years).
Temporary relief brings plasmapheresis. Conduct liver transplantation.
Indications for surgical treatment of CP are: severe portal hypertension with varicose-dilated esophagus veins in those with bleeding, with esophageal varices without bleeding;if a sharply enlarged coronary vein of the stomach is detected in combination with high portal hypertension;hypersplenism with an indication of an anamnesis for esophageal bleeding or when it is threatened.
Various types of portocaval anastomoses are applied: mesenteric and cava, splenorenal in combination with splenectomy or without it. Contraindications to surgical intervention are progressive jaundice and age over 55 years.
Nutrition for cirrhosis of the liver
With cirrhosis of the liver, the patient is given a full balanced 5-6 meals a day for better outflow of bile, regular stool( diet within table 5).Limit the intake of protein and table salt. In ascites, a salt-free diet is prescribed, supplementing the diet with products rich in potassium. With itching and bradycardia, reduce the volume of meat proteins, legume products containing tryptophan, tyrosine, cystine and methionine, which are sources of toxic metabolites and ammonia.
All dishes are cooked on water or steam, and baked in the oven. The following foods and foods are recommended for patients:
- wheat bread made from flour of I and II sorts, bread of rye, yesterday's baking;Avoid puff pastry and puff pastry, fried patties;
- vegetable and cereal soups on vegetable broth, dairy with pasta, borsch and vegan vegetarian;flour and vegetables for refueling are not roasted, but dried;meat, fish and mushroom broths are excluded;
- meat and poultry - lean beef, veal, meat pork, rabbit, chicken in boiled or baked after boiling;excluded goose, duck, liver, kidneys, brains, smoked products, sausages, canned food;
- fish - low-fat varieties in boiled, baked form;
- dairy products - milk, kefir, acidophilus, yogurt, sour cream as seasoning to dishes, bold cottage cheese and dishes from it;
- eggs - in the form of a protein omelet;eggs are hard-boiled and fried;
- cereals - any dish from cereals;
- vegetables are different in boiled, baked and stewed;excluded spinach, sorrel, radish, radish, garlic, mushrooms;
- snacks - salad of fresh vegetables with vegetable oil, fruit salads, vinaigrettes;
- fruits, non-acid berries, compotes, jelly;
- drinks - tea, coffee with milk, fruit, berry and vegetable juices.
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First signs of liver disease
With the slightest sign of liver problems, it is necessary to do your examination without delay, in order to understand what is happening with this body, and to start competent treatment in time.
Contents:
- Skin changes
- Digestive disorders
- Hormonal shifts
- Nervous system disorders
- Problems with blood coagulation
- Signs of intoxication
Changes in the function and structure of the liver affect a wide variety of organs and systems. Often, not only ignorant philistines, but even doctors do not associate problems with skin or stool with hepatic ailments. And only surveys accidentally reveal the true "culprit" of malaise. What are the manifestations of the liver can "signal" about their unhappiness?
Cirrhosis: causes, symptoms and treatment of liver cirrhosis
How to cure liver cirrhosis with folk remedies
Liver cells have a unique ability to regenerate after the release of harmful substances into the body. Our task is to help them in this.
Source: Allega G.N. Official and traditional medicine. The most detailed encyclopedia.- Moscow: Izd-vo Eksmo, 2012.
