Many of us have heard of a disease such as autoimmune hepatitis. What is this pathology? This is a chronic disease, which is an unresolved inflammatory phenomenon in such an important organ for our existence as the liver. This pathology does not have an established nature.
What happens with this?
If autoimmune hepatitis is diagnosed , what does it mean? This serious pathology, for completely incomprehensible reasons, gradually destroys liver cells. Moreover, in this process the illness is helped by the body’s own immune system. At the first stage of the disease, inflammation of the parenchyma, that is, the main part of the organ, occurs. This process progresses rapidly and can lead to cirrhosis.
In this case, the death of the cells of such an important organ for us - hepatocytes. Their place is immediately filled with coarse and inelastic connective tissue. As a result of this, the liver is simply not able to carry out its functions efficiently.
You can find different names for this ailment. However, most often in the medical literature, pathology is called so: active chronic autoimmune hepatitis. This is a rare disease that most often occurs in girls over 10 years old and in women under the age of thirty.
Symptoms
The clinical manifestations of the pathology are different. So, a quarter of all patients have no symptoms of autoimmune hepatitis. And this continues until a person has any complications. In such cases, the disease overtakes people suddenly or they show all the symptoms of viral hepatitis or other signs indicating liver damage. In the first scenario, a person begins to worry about weakness. Its body fluids turn dark. The skin, as well as the mucous membranes, turn yellow, appetite disappears. In the second case, extrahepatic symptoms occur. That is why doctors often suggest the presence of various systemic diseases in the body, such as rheumatoid arthritis, lupus erythematosus, etc.
But in general, the manifestations of pathology are excessive fatigue, fever, fever up to 39 degrees, lymph nodes, acne, abdominal pain, especially in the right hypochondrium, impaired joints, as well as active hair growth in all parts of the body . If the disease begins to provoke the synthesis of hormones of the adrenal glands, which are produced in excess, then the patient may experience a decrease in muscle tissue on the legs and arms, a quick set of excess weight, the appearance of stretch marks on the hips and a bright blush on the cheeks.
Sometimes in patients, the disease occurs suddenly, manifests itself acutely and is very difficult. All this is accompanied by the appearance of fulminant hepatitis, which provokes the rapid death of most of the liver cells. This, in turn, leads to the rapid formation of toxins that adversely affect and then affect the brain. It will be very difficult if autoimmune hepatitis (symptoms) has already appeared , treatment. Doctors give a prognosis in such cases that is extremely unfavorable for the patient.
Types of disease
The treatment of autoimmune hepatitis will directly depend on its type. One or another type of pathology is determined by the presence in the blood serum of a certain kind of antibody. In this case, three types of autoimmune chronic hepatitis are distinguished:
1. In the first type of disease, antibodies to actin protein, smooth muscle cells, antinuclear antibodies are detected.
2. The second type of disease is characterized by the presence of antibodies to microsomes, to kidney and liver cells.
3. The third type of pathology is diagnosed in cases of detecting antibodies to the substance that is responsible for protein synthesis, that is, to the hepatic soluble antigen.
Causes of pathology
Autoimmune hepatitis is a disease in which a person’s immunity begins an active fight against their own completely healthy tissues and cells. What are the reasons for this phenomenon? Modern medicine cannot answer this question yet. However, scientists have the assumption that a similar malfunction in the work of the body's defenses is caused by various previously transmitted viral diseases, in particular, hepatitis A, as well as B and C, herpes, Epstein-Barr virus.
Some researchers also believe that a certain gene plays the main role in the development of various autoimmune diseases. However, it is worth noting that the disease in children under 10 years of age is almost never detected.
Diagnostics
The treatment of autoimmune hepatitis will be much more effective if the disease is detected on the early steel of its development. However, the diagnosis of pathology is extremely difficult. As a rule, doctors make a similar diagnosis only with the gradual exclusion of the presence of other diseases. For this, the doctor analyzes the patient's complaints and anamnesis of his life. All this happens during the conversation. At the same time, the specialist finds out what bothers the person, and how long it lasts.
Then a physical examination is carried out, during which the doctor examines the mucous membranes and skin, measures the patient’s body temperature, taps and feels the liver, finding out its pain and increase in size. If there are suspicions of pathology, laboratory tests are performed. They are designed to identify the level of globulin and the activity of the enzyme AST. A direction is also given for an immunological blood test. They also examine it for the presence of hepatitis A virus, as well as B and C. The doctor gives a referral to a coprogram. In the course of this study, feces are checked for undigested food particles.
If necessary, instrumental diagnostics are performed. It includes ultrasound, examination of the stomach, esophagus and duodenum using endoscopic equipment. This study is designed to exclude the presence of tumors of various etiologies. The patient is sent for a liver biopsy, during which a small tissue sample of this organ is taken for the purpose of histological examination.
After the diagnosis of autoimmune hepatitis has been identified and the doctor has prescribed treatment, all recommendations received must be strictly followed. Only in this case can we talk about favorable forecasts for the development of the disease.
Ways to eliminate the pathology
After autoimmune hepatitis is detected (symptoms), and treatment for this ailment has become vital, the doctor can apply several methods. They are as follows:
- in compliance with a strict diet;
- in drug therapy;
- in surgical intervention.
Let's consider all these methods in more detail.
Diet
Treatment of chronic autoimmune hepatitis, which is in the acute stage, is carried out with strict observance of bed rest. When the phase of remission sets in, it is enough for the patient to properly organize his work and rest regimen, while avoiding all kinds of (emotional and physical) overwork. In addition, it is important to exclude the effects on the liver of various toxic substances, including alcohol and medications excreted by this body. During the period of remission, it is also not necessary to carry out physiotherapeutic procedures that affect the region of the liver. Balneotherapy is also prohibited.
For the normalization of the patient's condition, proper nutrition is of great importance. When treating chronic autoimmune hepatitis, gastroenterologists recommend the use of a diet (table No. 5). It includes vegetable soups and lean meats (poultry, beef). In the diet of patients can be included fish in baked or boiled form. The diet, which is recommended in cases where treatment of chronic autoimmune hepatitis is required, includes products such as low-fat cottage cheese and cheese, and if there is no intolerance, then dairy and sour-milk products. When preparing meals for people suffering from autoimmune hepatitis, it is important to consume butter and vegetable oil only in small quantities. The use of eggs should also be limited. They can be included in the diet only 2 or 3 times during the week, 1-2 eggs per day.
The diet does not consider any restrictions regarding vegetables and non-sour fruits. However, their use, like any other permitted food, must be within reasonable limits.
The diet recommended for the person who is being treated for autoimmune hepatitis excludes fried foods, fatty meats, savory and savory foods, sorrel and spinach, cocoa and strong coffee, alcohol and canned foods from the diet. Food at the same time must be fractional. It is important to eat at least four times a day, and it is better if a meal is made six times. It is also important to maintain a balanced diet so that the body receives all the substances necessary for it.
Drug use
If treatment of autoimmune hepatitis is required, the algorithm of the doctor’s actions will depend on the stage and course of the pathology. But in any case, in addition to using the diet, the patient is prescribed the necessary medications. Depending on the type of clinic observed in a patient diagnosed with autoimmune hepatitis, specialist treatment can be prescribed using various drugs.
Considering the fact that the main cause of this pathology is hyperactivation and malfunction of the body's defenses, which begin to intensively destroy healthy liver cells, the doctor must include drugs with the effect of suppressing immunity in the course of therapy. These are immunosuppressive drugs that are hormonal and anti-inflammatory. These include, first of all, such medicines as Prednisone and Azathioprine. It is these two drugs that are used in cases when autoimmune hepatitis is treated. In the course of therapy, they can be prescribed both individually and together.
As for Prednisolone, this drug has a wide spectrum of action. It has a positive effect on all types of metabolism, and also allows you to get a fairly good anti-inflammatory effect. Under the influence of this medication, the activity of the pathological process decreases. And this is due to both the direct immunosuppressive effect of the agent on K-cells and its inducing effect on the suppressor function of T-lymphocytes.
Only high doses of this drug can provide effective treatment if autoimmune hepatitis (symptoms) is detected. The prognosis of the course of the disease in such cases is quite favorable. So, when conducting clinical trials during the appointment of a course using the medication “Prednisolone”, a decrease in the intensity and frequency of immunopathological reactions observed in the liver tissue was observed.
Another drug for treating autoimmune hepatitis is Azathioprine. It affects the immune response using the mechanism of suppression of an actively developing clone of immune cells, as well as elimination of the elimination of inflammatory cells.
The drug "Azathioprine" affects both the primary and secondary immune response. However, when treating with this medication, many experts note its insufficient effect. This is due to impaired activation of the drug, as well as an acceleration of its destruction in cases of liver disease. To eliminate this problem, another hormonal drug is prescribed in the course of therapy - Prednisolone. He is able to activate the action of "Azathioprine." In addition, side effects after treatment of autoimmune hepatitis with the combined use of two drugs are four times less than those observed with the use of only one "Prednisolone". This clearly indicates the need for just such an approach to treatment.
The use of two drugs simultaneously inhibits the development of the inflammatory process and makes it possible for the body's defenses to independently eliminate existing failures. Unfortunately, patients are forced to take these medicines from six months to 4 years. However, doctors do not give any guarantees that this course will be the only one. Many patients have to repeat it more than once during their lives.
A similar therapy algorithm is also used in cases where autoimmune hepatitis is treated in children.
Coenzyme and metabolic preparations can be used to eliminate pathology. They are such vitamin and multivitamin complexes as Cocarboxylase, Riboxin, and many others. In complex therapy, hepatoprotectors, which contain phospholipids, are also used. These are drugs such as Livolin, Essentiale, Heptral and many others. According to experts, the appointment of such funds should be done only in remission, when there is no pronounced inflammatory process.
In order to remove from the body those toxic metabolic products that the liver cannot cope with, doctors prescribe intravenous infusion therapy. As a rule, in such cases, the drug "Reosorbilact" or saline is used. The procedure is carried out under the constant control of blood pressure and urine output.
Alternative treatment regimen
Treatment using a combination of drugs such as Prednisone and Azathioprine has been effectively used in medical practice for almost five decades. Such therapy has significantly increased the life expectancy of patients with autoimmune hepatitis.
However, at present, discussions are growing more and more about the use of other regimens that would become shorter for patients and cause fewer side effects. For example, specialists are considering the possibility that autoimmune hepatitis “Budenofalk” can be treated. This is a drug belonging to the group of glucocorticosteroids of the 2nd generation. In addition, it has a minimal amount of side effects and is ninety percent metabolized by the liver the first time it passes through it. This contributes to the restoration of health in patients suffering from autoimmune hepatitis.
The results of the clinical trials convincingly proved the fact that the Budenofalk drug, when used in combination with Azathioprine, induced and supported remission in those people with autoimmune hepatitis who so far had no signs of liver cirrhosis. In this case, therapy ended with the occurrence of less than after the use of "Prednisolone" side effects.
According to researchers, this drug is able to become the new standard of clinical therapy used in getting rid of autoimmune hepatitis.
Surgery
In cases where the use of drug therapy for four years does not improve the patient’s condition and does not normalize his biochemical blood counts, the patient is undergoing surgery.
It is a donor organ transplant operation. As a rule, for this, part of the liver of a native person is taken.
Folk remedies
The use of funds, the recipe of which was created by the healers on the basis of natural components, allows you to evacuate bile, eliminate nausea and intoxication, and also relieve pain.
It should be borne in mind that if a person has autoimmune hepatitis, treatment with folk remedies will only alleviate the symptoms of the disease, but will not completely get rid of it. Such methods are quite effective only for those pathologies that are easily treatable. This refers to hepatitis A or its toxic type.
Various herbs with a choleretic effect have proved themselves well in the fight against inflammatory phenomena in the liver. Of these, infusions and decoctions are prepared. These medicinal herbs include:
- roots and leaves of nettle;
- mint and anise;
- yarrow;
- seeds of garden dill;
- St. John's wort;
- birch leaves.
From medicinal herbs are made fees that are taken before meals. Prepared infusion of rose hips replace tea. They drink it through a straw, since this tool has a negative effect on tooth enamel.
It positively affects the condition of the liver and the juice of various vegetables, because it contains a large number of vitamins and beneficial elements. For the treatment of hepatitis at home, juice can be used:
- Jerusalem artichoke;
- raw potatoes;
- carrots diluted with water;
- celery and dandelion leaves;
- raw beets, diluted with water.
Forecast
The survival of patients suffering from autoimmune hepatitis depends entirely on the intensity of the inflammatory process in the liver. In mild cases, in 80% of people it is more than 15 years. However, in the absence of proper therapy and in severe illness, only a few manage to survive more than five years.