And whether you know...
May 5, 2012
Cirrhosis is very serious illness of a liver at which in body there is irreversible substitution of parenchymatous tissue of liver fibrous connecting fabric or a stroma. Today cirrhosis is a widespread illness around the world: among patients of working-age it is considered one of six main reasons of death. This disease affects males more often. If to compare incidence of cirrhosis at women, then the illness ratio at men and at women makes one to three. Most often cirrhosis affects people who already were forty years old.
Most often development of cirrhosis happens as a result of long intoxication alcohol, and also C and D develops against a viral hepatitis In. In more exceptional cases cirrhosis develops at the people having diseases of the zhelchevyvodyashchy ways having congestive heart failure and also at the patients who had different intoxications of chemical and medicinal character. Sometimes symptoms of cirrhosis appear at people who suffer from hereditary disbolism. Also at a certain number of patients primary biliary cirrhosis which etiology remains obscure develops.
Cirrhosis arises as one of the most dangerous complications of many illnesses of a liver. At an illness which as a result conducts to cirrhosis liver cells are to some extent destroyed. As a result on a liver there are cicatricial new growths, and activity of body cannot normally develop further. Sometimes development of cirrhosis is provoked by poisonings with toxic substances, fats, medicines, alcohol.
Thus, the following states are basic reasons of development of cirrhosis:
— Alcoholic cirrhosis. This cause of illness arises against an alcohol abuse. In this case an important point is the quantity and frequency of the use of alcohol.
— Cryptogenic cirrhosis. The reason given forms of this illness is not established till today. This form of cirrhosis is considered the main indication for transplantation of a liver. Progressing of an illness happens extraordinary quickly.
— Cirrhosis which provokes a chronic viral hepatitis. People who have a viral hepatitis should take constantly courses of the supporting treatment, otherwise cirrhosis is inevitable.
— Genetically inherited cirrhosis. In this case there is an accumulation of toxins, and the subsequent destruction of a liver.
— Primary biliary cirrhosis. Meets at women more often. At the same time there is a blocking of bilious channels in a liver that leads to its destruction.
— Primary sclerosing cholangitis. Occurs seldom at the people having ulcer colitis. There is an infection bilious a channel, fabrics are damaged, cirrhosis develops.
— Autoimmune hepatitis. Arises owing to strong immune activity of an organism.
— The birth of children without bilious channels.
— Damage of a liver drugs.
Cirrhosis – it the illness which often leads to death of the person is very serious. Work of a liver in a human body is extremely important: this body provides removal of toxins, and also waste of life activity of the person. Function of a liver is also synthesis of many substances which are irreplaceable for full functioning of an organism. Besides, development of cirrhosis breaks interaction of bilious channels and a liver that leads to serious violations of digestive process.
What occurs at cirrhosis?
The liver which is affected by cirrhosis either decreases, or increases in sizes, on it there are roughnesses, hillocks, it becomes very dense. At cirrhosis there is a liver tissue necrosis. The processes happening at this disease are diffusion: the body in general is involved in them. It becomes frequent continuation of development of cirrhosis a liver cancer.
In a liver there are so-called cirrhotic nodes. They are regenerator nodes of the recovered fabric on site of death of hepatic cells. Such cells are surrounded by fibrous, connecting fabric. However though cells are also recovered, but their blood supply is not normal. As a result, they cannot carry out the functions. Initially fibrosis can be reversible. Therefore at the slightest aggravations of process it is necessary to begin immediately the therapy promoting reduction of fibrosis.
Cirrhosis is classified by structure of the arising nodes. If the small nodular form of a disease develops, then diameter of the majority of nodes in a liver does not exceed 3 mm. The similar form of an illness is often shown at alcoholic cirrhosis, and also at cirrhosis which arises owing to disturbance of outflow of bile and a venous blood. At such form of cirrhosis the liver or has the normal sizes, or increases.
If at the patient the macronodular form of cirrhosis develops, then the size of nodes sometimes makes even several centimeters. This form of cirrhosis is shown against a chronic viral hepatitis, and also owing to some genetic disorders. In this case the liver most often decreases in sizes.
Displays of cirrhosis depend on that, function of a liver, and also from weight of intra hepatic disturbances is how reduced. Very often diagnose cirrhosis when at the patient the developed clinical manifestations take place. Quite often the disease is revealed already at the last stage.
Cirrhosis symptoms rather long time can not be shown in general. The illness sometimes proceeds asymptomatically for several years. Sometimes, that symptoms of cirrhosis are minimum and are even atypical. Very often at the person at whom cirrhosis develops only the asthenic syndrome is shown. At the same time the patient is disturbed by feeling of drowsiness and fatigue, it reduces ability to active work. However very few people from people can suspect development of a serious illness, writing off similar symptoms for usual overfatigue. Sometimes at development of cirrhosis of people also notices decrease in memory, it loses former ingenuity.
However at the attentive attitude towards own health it is possible to notice also other symptoms of cirrhosis. Some of them are characteristic also of other diseases of this body. On skin and in the opinion of the person small yellowness is shown. Such yellowing happens owing to too high content in bilirubin blood.
Developing of an itch of skin, redness of palms is possible. Skin can become too dry, there can be baldness and problems with a potentiality at men. At the same time women can note failures of a menstrual cycle, heavy feeling in a stomach, a periodic eructation, nausea.
At later stages of a disease symptoms of cirrhosis become more expressed. At men chest glands sometimes increase, the hair loss on a breast and extremities can be noted. In an abdominal cavity of the person liquid collects owing to what the stomach increases. In parallel the patient's legs can grow thin, on skin there are bruises without the reason, veins on a stomach and standing act.
Symptoms of cirrhosis is also darkening and opacification of urine of the patient, at the same time the kcal becomes lighter.
Sometimes patients note emergence of the bleeding hemorrhoids, for them not characteristic earlier. Also the constant current of blood from gums is noted. At first they krovit only in the course of toothbrushing, later blood can go without the reason, and wounds on gingivas do not begin to live a long time. Reduced coagulability of blood becomes the reason of the described phenomena.
If at sick there are suspicions on the development of cirrhosis, symptoms described above have to guard at once the person and to become a pretext of immediate visit to the doctor.
Complications of cirrhosis
If at the patient are shown cirrhosis, symptoms of a disease can be also more serious. In this case it is about complications of cirrhosis. In the course of progressing of a disease there is amassment of water and salt in an organism that as a result it becomes initial the reason of hypostases of legs, and later — belly part. As a rule, hypostases disturb the person in the evening.
Complication of cirrhosis it becomes frequent spontaneous bacterial peritonitis. In a peritoneum liquid accumulates, as becomes premises for reproduction of pathogenic bacteriums. In this case it is about danger to human life which has cirrhosis. Symptoms at the same time can not be shown at all, or the patient suffers from a fever, abdominal pains, fever, diarrhea, a small appetite.
At cirrhosis often there are internal bleedings in view of creation of an obstacle to a normal blood flow cicatricial fabric. Bleeding can arise around a liver, the internal varicosity also sometimes develops. All these manifestations can be life-threatening the patient. At similar bleedings at the patient vomiting with the content of blood, faints, dizzinesses is often shown.
One more complication of cirrhosis — hepatic encephalopathy. This very dangerous state at which there is an accumulation of toxins in the patient's blood. As a result emergence of disturbance of functions of a brain is possible. At this state symptoms can be shown by a day dream and wakefulness at night, constant irritability, concentration loss. As a result the coma and the subsequent lethal outcome is possible.
Gepatorenalny syndrome – one more complication of cirrhosis. In this case there is a decrease in functionality of kidneys that leads to their slow destruction. The most dangerous complication of cirrhosis is the liver cancer. Today this form of cancer — the second for number of lethal outcomes from all oncological diseases.
Diagnosis of cirrhosis
The most exact method allowing to diagnose cirrhosis is the liver biopsy today. Also poll of the patient is important, the doctor has to learn about that how many alcohol the patient takes whether the patient has a viral hepatitis. The specialist carries out a liver palpation to define whether it is increased.
Besides, the doctor surely estimates symptoms which are shown at the patient.
Endoscopy at which the gullet varicosity is fixed is sometimes carried out.
Besides, at suspicion the computer tomography, ultrasonography, a magnetic resonance tomography is in certain cases appointed to cirrhosis. Also carrying out blood test is appointed.
Treatment of cirrhosis
Treatment of cirrhosis has to be directed to eliminating further damage of tissues of liver first of all. It is also important not to allow or treat complications of a disease, to carry out preventive measures for prevention of cancer of liver. In certain cases, described above, it is necessary to make a liver transplantation. Change needs to be carried out if treatment of cirrhosis does not bring results. However it is necessary to consider that this method has many contraindications.
To reach normalization of a metabolism of hepatic cells reception of vitamin complexes, and also drugs inosine, Essentiale is applied. If at the patient autoimmune cirrhosis takes place, to it appoint treatment glucocorticoids.
If the person has bleedings or other serious symptoms of an illness, he needs to be hospitalized urgently.
In general efficiency of treatment of cirrhosis first of all depends on that, how fully the person observes the rest mode, the corresponding diet at cirrhosis. It is very important to refuse the use of alcoholic drinks completely. A necessary condition at treatment of cirrhosis is continuous supervision at the attending physician. In general treatment of this illness has to be directed to suspending progressing of an illness.
Diet at cirrhosis
Observance of a diet at cirrhosis provides, first of all, refusal of food in which the high content of protein takes place. At patients with cirrhosis digestion of proteinaceous food is broken, and as a result intensity of processes of rotting increases in intestines. The diet at cirrhosis provides periodic carrying out fasting days during which the patient does not eat food supporting squirrels at all. Besides, the important moment is restriction of the use together with the main food of table salt.
The diet at cirrhosis provides an exception of all products which contain baking soda and baking powder. It is impossible to use a pickles, bacon, ham, seafood, corned beef, canned food, sausage, sauces with salt, cheeses, ice cream. To improve taste of products, it is possible to use instead of spice salt, lemon juice.
The diet at cirrhosis allows the use of a small amount of dietary meat – a rabbit, veal, poultry. Once a day it is possible to eat one egg.
Prevention of cirrhosis
The most important measure of prevention in this case is maintaining a healthy lifestyle. It is necessary to adhere to the principles of the healthy and healthy nutrition, not to allow an alcohol abuse. If at the person chronic hepatitises develop, they need to be treated in time, choosing the correct tactics of therapy. Food of people for whom cirrhosis is already diagnosed has to happen only agrees with norms of the corresponding diet. It is periodically necessary to use vitamins and minerals. Carry out by the patient with cirrhosis vaccination of patients against hepatitises A and B.