The main symptoms of liver cirrhosis. Treatment of cirrhosis of the liver
Cirrhosis of the liver is a serious progressive disease. In healthy condition this organ has a red-brown color. During the illness acquires a yellowish tinge. With cirrhosis, liver changes take place. As a result, healthy cells are affected and replaced with scar tissue. As a consequence - the work of this body is disrupted, liver failure and portal hypertension develop.
Types of liver cirrhosis
Classification of cirrhosis occurs due to etiology( causes of disease) and morphology( external signs).Depending on the size of the nodes, it happens:
- shallow node( up to 3 mm in diameter);
- large-nodular( more than 3 mm);
- mixed( with nodes of different diameters).
Depending on the etiology and morphology, cirrhosis is divided into:
- biliary( with congestion in the liver of bile);
Common signs of liver cirrhosis
Symptoms of cirrhosis depend on the stage of the disease. At the initial( class A) complications yet. This is the ideal time to eliminate the cause of the disease. During this period, you can keep the liver and continue to lead a normal life, as this body has great opportunities for regeneration.
With progressive cirrhosis complications begin( classes B and C).The abdomen increases in volume, there are changes in behavior and consciousness. Begin to bleed the gums and nose. Symptoms of cirrhosis in women are an increase in the mammary glands( gynecosmastia) and the cessation of menstruation.
There is increased fatigue, weight loss, attention deficit, daytime drowsiness, insomnia. Appetite disappears. A sensation of swelling appears in the abdomen. Develops jaundice. Cal and urine change the normal color. The lower leg swells and pains in the abdomen begin.
In the abdominal cavity fluid is accumulated. There are bacterial infections. Excruciate frequent headaches. Symptoms of cirrhosis in men: partial or complete loss of sexual desire and breast enlargement. Begin to drop hair in the armpit and pubic areas.
With cirrhosis, the liver increases or, conversely, decreases. At any variant it becomes more dense. The size of the spleen increases. There are signs of jaundice and portal hypertension. Often there is dull and aching pain in the liver region. It becomes stronger after physical work or in violation of diet.
Appears skin itching, nausea and vomiting. Violated stool( constipation or diarrhea).External signs are vascular "stars", redness of the palms. The language becomes crimson.
Treatment of cirrhosis of the liver
Cirrhosis can not be cured completely, but it can be slowed down in the early stages of the disease. With a progressive and neglected case, the efforts of physicians are aimed at the removal of unpleasant symptoms and complications.
The basis of cirrhosis treatment includes therapeutic measures:
- antiviral therapy;
- glucocorticoid hormones;
- preparations that reduce the pressure in the portal zone( "Nitrosorbide", "Anaprilin");
- hepatoprotectors, protecting liver cells( "Ademetionin", "Silymarin");
- with exacerbations of cirrhosis needs hospitalization.
For surgical treatment, abdominal punctures are performed to remove accumulated fluid. Shunt operations are performed( creating new ways for blood flow).Or they make a liver transplant.
Treatment of liver cirrhosis with leeches
Treatment of cirrhosis with leeches is recommended, but only applied under the supervision of a doctor. Since it is necessary to constantly monitor the patient's blood and symptoms of cirrhosis. The earlier this treatment is started, the more effective the result will be.
For one procedure, 4 to 8 leeches are required. Basically, they are divided into several consoles. As soon as leeches start free sucking, they are removed. Such procedures are carried out twice a week. Then one session every 7 days. In total, 12 procedures are prescribed.
Repeated course is conducted at intervals of 2-3 months. The general course of treatment is quite long. Therefore, in the diet of the patient it is necessary to include foods with a high content of iron( except meat).
Portal cirrhosis is the most common form of the disease. The causes may be hepatitis, circulatory disorders, alcohol and poor digestion. Almost all of the liver is affected. Most often this disease affects men after 40 years.
The first symptoms of cirrhosis are weakness, nausea. Unpleasant sensations arise in the stomach region. Constipation or diarrhea may occur. If the cirrhosis has arisen because of alcoholism, the sexual inclination decreases. Some have yellow mucous membranes and skin.
The most typical symptom is the appearance in the upper part of the trunk and on the abdomen of the vascular mesh, the red coloring of the fingers and palms. At the same time, fluid begins to accumulate in the abdominal cavity. Often develops gastritis.
Symptoms of cirrhosis at the initial stage - this is the severity and pain in the right upper quadrant, loss of appetite, constant nausea. Insomnia, fatigue and stools are observed. Gradually the liver thickens, increases in size. Swollen legs, the tongue may appear cracks and white coating.
There are three stages of cirrhosis of the liver. Symptoms at the first is its increase. On the second, on the contrary, it decreases. And the third becomes very small and dense to the touch.
Treatment of portal cirrhosis
The treatment of portal cirrhosis requires bed rest. Any physical activity should be excluded. Treatment of cirrhosis of the liver is directed primarily at eliminating the causes of the disease. And also to prevent complications that may appear.
In the treatment of portal cirrhosis, it is necessary to completely abandon alcohol. This is one of the main causes of the disease. You need to clean the liver.
If portal cirrhosis is caused by hepatitis, treatment should be directed primarily at fighting it. It is necessary to exclude drugs that complicate the liver.
A strict diet is required. From the diet is excluded from acute, fatty and fried foods. The amount of seasonings should be reduced to a minimum. It is forbidden to eat canned food, smoked products and sausages. From the diet it is necessary to exclude chocolate, garlic, tomatoes and their juice, mushrooms. Salt consumption should be minimized.
Various vegetable soups without roasting are recommended. Any cereals, legumes and cereals. Dairy low-fat products, boiled poultry, turkey and rabbit. You need to eat apples and croutons.
Food should be 5-6 times a day. But in small portions. At the same time during the diet you need to drink broths from herbs, hepatic collections. When treating medicinal products, hepatoprotectors of plant origin are prescribed. They protect the liver tissue and restore its functions.
In addition, diuretics are prescribed, which remove swelling and remove excess liquid from the body. And also medicines that relieve the symptoms of cirrhosis.
If this does not help, surgery is used. And liver transplantation is performed. For the treatment of portal cirrhosis, methods are now being developed with the use of stem cells.
Post-necrotic cirrhosis is also a fairly common form of the disease. Most often occurs after viral hepatitis and alcohol abuse. Less often - after poisoning with poisons, taking certain medications, acute infectious diseases. With postnecrotic cirrhosis, the death of liver tissue begins. Internal scars appear that disrupt the work and form of the organ.
Symptoms of cirrhosis at the initial stage manifest themselves sharply. Suddenly, the stomach begins to ache, diarrhea and vomiting appear. Mucous and the skin turn yellow. The liver increases in size. When you feel, pain appears. Appears nausea, loss of appetite and weight.
On exacerbation, itching begins, and the temperature rises. The feces become pale and the urine dark. Appears ascites, anemia, heart failure. Disability is dramatically reduced. This is a very dangerous form of cirrhosis, as it causes liver cancer. Lethal outcome can occur at any stage of the disease.
Treatment of postnecrotic cirrhosis
Treatment of postnecrotic cirrhosis is aimed at complications arising from portal hypertension. First of all, ascites. In the diet, the protein content decreases. Avoid drugs that provoke a hepatic coma. If necessary, antimicrobial therapy is performed.
If complications are not observed, then enough periodic examinations and observations of the patient. If cirrhosis develops from the disease, then it is he who is treated( if it is amenable to therapy).
Alcoholic cirrhosis of the liver
Another very common form of the disease is alcoholic cirrhosis. Symptoms of it can be pronounced, and sometimes they do not exist 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 the enlarged liver. Sometimes there may be a slight nausea. There is general weakness in the body and rapid fatigue.
- Subcompensation. Appetite worsens, body weight decreases, nausea and vomiting appear.
- Decompensation. Complete exhaustion of the body, liver failure and jaundice begin. There are all the complications of cirrhosis and portal hypertension. In the abdominal cavity accumulates fluid( ascites).He can hardly be treated. There is increased bleeding. There may be attacks of consciousness. Often an additional bacterial infection occurs. All patients develop hepatomegaly, and a quarter have splenomegaly.
When alcoholic cirrhosis of the liver progresses, signs and symptoms are clearly manifested and externally. There is an expansion of the vessels of the nose. Parotid glands are markedly enlarged in size. The facial features become puffy.
Because of the effects of ethanol, internal organ damage begins. There may be neuritis, pancreatitis, mastopathy, encephalopathy and other diseases. There is muscle atrophy, in particular in the shoulder girdle.
Treatment of alcoholic liver cirrhosis
Symptoms of liver cirrhosis in men are more common than in women. Since alcohol consumes more "strong half".When alcoholic cirrhosis is primarily conducted conversations, during which the patient is set to get rid of harmful addiction.
Then a special diet is prescribed. Destroyed liver cells, which have already been replaced by fibrous tissue, are not subject to recovery. Therefore, the treatment is aimed at those that still function to some extent. If necessary, antiviral treatment is used.
If there is a withdrawal syndrome, then sedatives are used and the water-electrolyte balance is restored. When complicating alcoholic cirrhosis with hepatic encephalopathy, glucocorticosteroids are given a course of 30 days. And ursodeoxycholic acid, which prevents cell death and has an anti-inflammatory effect.
Bile acids and vitamin E are used as antioxidants. They are needed for the utilization of ethanol, which is accumulated in the liver in alcoholic cirrhosis in an overabundance.
Biliary cirrhosis is less common than the forms described above. This disease, in which its functions and structure are violated. The consequence of the cessation of bile outflow, and a change in the structure of its ducts.
In a disease of such a form as biliary cirrhosis, the symptoms and causes of the onset are not yet fully understood. It is assumed that it can begin because of a genetic predisposition. And also with a 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 symptoms increase gradually. A person often does not even suspect a disease for a long time. And his condition for a long time does not even worsen. There are two stages.
Early on itchy skin starts. And this sign appears long before jaundice. This symptom is six months to 1.5 years ahead of her. But sometimes itching and jaundice occur simultaneously. There is fatigue, severe weakness, depression, drowsiness.
In the late stage of a disease such as primary cirrhosis, the symptoms manifest themselves clearly. There is ascites. And this is the first sign of liver failure. There are vascular "stars", encephalopathy. Some have xanthomas and xanthelasms( plaques around the eyes).In a quarter of patients, skin hyperpigmentation manifests itself.
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 treatment of the complications arising and the prevention of their occurrence are performed.
First of all, the patient must give up all bad habits and taking medicines that destroy the liver. A strict diet is necessary and physical activities are prohibited. During the treatment of cirrhosis all concomitant infectious chronic diseases are treated simultaneously.
If instrumental intervention( dental manipulations, etc.) is performed, antibiotics are prescribed to prevent infection. Primary biliary cirrhosis, the symptoms of which signal a transition to the decompensation stage, require bed rest and inpatient treatment. Contraindicated physiotherapy, studies with stress tests and balneological procedures.
In the period of compensation, you need a rational diet and diet number 5. When encephalopathy occurs, you need to reduce the level of protein. If there was ascites - to exclude from the diet salt. Exercise and work at low temperature are excluded. Walking and a number of physical exercises are recommended.
Some medicines are excluded: some types of antibiotics, aminoglycosides and non-steroidal agents that have an anti-inflammatory effect. Applied:
- glucocorticoids( in minimal doses);
- ursodeoxycholic acid;
If the patient has started the last stage, to which cirrhosis reaches the liver, signs and symptoms clearly indicate the need for surgical intervention. For example, a sharp increase in liver failure. In this case, the patient can save only a liver transplant. Most people after this operation can live almost 10 years. After transplantation relapse is observed only in 15% of patients.
Secondary biliary cirrhosis
Secondary biliary cirrhosis develops with partial or complete obstruction of the bile ducts. Women suffer from them twice as often as men. Usually a secondary form occurs after surgery to remove the gallbladder, chronic chronic pancreatitis, or a tumor.
In a disease such as secondary biliary cirrhosis, the symptoms are primarily associated with the cause of obstruction. And then they appear the same as in the primary form.
Treatment of secondary biliary cirrhosis
In the treatment of secondary biliary cirrhosis, the cause of the disease is initially eliminated. With the help of surgical manipulations( bougieirovanie, extraction of concrements, expansion of ducts, etc.).After the end of the operation, it is possible to prolong the patient's life.
If surgical intervention is not possible, then therapy similar to that used for 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 not be aware of the disease, since there are no special symptoms. The liver works normally. The patient does not bother. And the diagnosis can only be made on a routine examination. Or suddenly - during surgery.
The only symptoms of cirrhosis that can occur with compensated cirrhosis are fever, redness of the palms and nose bleeding. But with this form of disease people can live for decades. And, without any complications.
Treatment of compensated cirrhosis of the liver
Treatment of compensated cirrhosis depends on the stage of the disease. If it is in a "dormant" state and does not progress, then only vitamin-mineral complexes and a strict diet number 5 are prescribed. It is necessary to completely abandon cigarettes and alcohol. Do not take hepatotoxic drugs.
If compensated cirrhosis progresses, diet No. 5a is prescribed until the exacerbation subsides. You need vitamins B, folic acid and cocarboxylase. The use of milk thistle helps to remove toxins from the body. In addition, it has anti-inflammatory, hepatoprotective action and relieves muscle spasms.
Decompensated cirrhosis: symptoms and treatment
With decompensated cirrhosis, the liver is in a worse state than with a compensated one. The process of fibrosis begins. There are all the signs of cirrhosis. The most notable are worsening of the general condition, jaundice and ascites.
In the treatment of decompensated cirrhosis, the emphasis is on eliminating local manifestations( ascites, etc.) and existing pathologies. In acute disease, apparatus supporting liver function is used. But for this patient needs to be transported to special medical centers, where the devices are installed.
When decompensated cirrhosis with the presence of active hepatitis B, Lamivudine therapy is used. It significantly improves the patient's condition and positively affects the liver. At the first manifestations of decompensation, the best option would be liver transplantation.
Pigmented cirrhosis of the liver: symptoms and treatment
Pigmented cirrhosis of the liver is externally stained 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 an inferior number of enzymes. As a result, many organs( including the liver) are deposited lipofuscin and hemosiderin.
Then the inflammatory processes and sclerotic changes of small capillaries begin. This leads to deformation of the organs. The liver is enlarged and becomes denser. But her work is not broken. Periodically, symptoms of diabetes: thirst, increased appetite. In the urine appears sugar and increases its level in the blood.
The prognosis for pigmental cirrhosis is unfavorable. Death comes from liver failure, diabetic coma, or bleeding. At treatment, bloodletting, injection courses are prescribed. Diabetes and complications are stopped by symptomatic therapy.