Cirrhosis is a serious progressive disease. In a healthy state, this organ has a reddish-brown color. During the disease acquires a yellowish tint. With cirrhosis, the liver is rebuilt. As a result, healthy cells are affected and replaced with scar tissue. As a result, the work of this organ is disrupted, liver failure and portal hypertension develop.
Types of cirrhosis
Classification of cirrhosis occurs according to the etiology (causes of the disease) and morphology (external signs). Depending on the size of the nodes, it happens:
- fine-knotted (up to 3 mm in diameter);
- coarse (over 3 mm);
- mixed (with nodes of different diameters).
Depending on the etiology and morphology of cirrhosis is divided into:
- alcoholic;
- biliary (with stagnation in the liver of bile);
- compensated;
- post-necrotic;
- decompensated;
- portal;
- pigmentary.
Common signs of liver cirrhosis
Symptoms of cirrhosis depend on the stage of the disease. At the initial (class A) complications yet. This is an ideal time to eliminate the cause of the disease. During this period, you can save the liver and continue to lead a normal life, since this organ has great potential for regeneration.
With progressive cirrhosis, complications begin (classes B and C). The abdomen increases in volume, changes in behavior and consciousness appear. Gums and nose begin to bleed. Symptoms of cirrhosis in women are breast enlargement (gynecomastia) and cessation of menstruation.
Increased fatigue, weight loss, distracted attention, daytime drowsiness, and insomnia appear. Appetite is lost. A sensation of bloating appears in the abdomen. Jaundice develops. Feces and urine change their normal color. The lower legs swell and abdominal pain begins.
Fluid accumulates in the abdominal cavity. Bacterial infections appear. Frequent headaches torment. Symptoms of cirrhosis in men: sex drive partially or completely disappears and the mammary glands enlarge. Hair begins to fall out in the axillary zone and on the pubis.
With cirrhosis, the liver increases or, conversely, decreases. With any option, it becomes more dense. The size of the spleen increases. Signs of jaundice and portal hypertension appear. Often there is dull and aching pain in the region of the liver. It becomes stronger after physical work or in violation of the diet.
Itchy skin, nausea, and vomiting appear. The stool is broken (constipation or diarrhea). External signs are vascular "stars", redness of the palms. The tongue takes on a crimson color.
Treatment of liver cirrhosis
Cirrhosis is completely impossible to cure, but it can be slowed down in the early stages of the disease. With a progressive and neglected case, the efforts of doctors are aimed at removing unpleasant symptoms and complications.
The basis of the treatment of cirrhosis includes therapeutic measures:
- diet;
- diuretic drugs;
- antiviral therapy;
- glucocorticoid hormones;
- drugs that reduce pressure in the portal zone (Nitrosorbide, Anaprilin);
- hepatoprotectors protecting liver cells ("Ademethionine", "Silymarin");
- plasmapheresis;
- with exacerbations of cirrhosis, hospitalization is needed.
With surgical treatment, abdominal punctures are performed to remove accumulated fluid. Shunting operations are being done (creating new pathways for blood flow). Or make a liver transplant.
Treatment of cirrhosis of the liver with leeches
Treatment for cirrhosis with leeches is recommended, but is used only under medical supervision. Since it is necessary to constantly monitor the patient’s blood condition and symptoms of cirrhosis. The sooner such 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 begin 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.
A second course is carried out with an interval of 2-3 months. The general course of treatment is quite long. Therefore, the diet of the patient must include foods high in iron (except meat).
Portal cirrhosis
Portal cirrhosis is the most common form of the disease. Causes may include hepatitis, poor circulation, alcohol, and poor digestion. Almost the entire liver is affected. Most often, men after 40 years are affected by this disease.
The first symptoms of cirrhosis are weakness, nausea. In the stomach area there are unpleasant sensations. Constipation or diarrhea may begin. If cirrhosis occurs due to alcoholism, sexual desire is reduced. Some mucous membranes and integuments turn yellow.
The most characteristic symptom is the appearance of vascular nets in the upper part of the body and on the stomach, the red color of the fingers and palms. At the same time, fluid begins to accumulate in the abdominal cavity. Gastritis often develops.
Symptoms of liver cirrhosis in the initial stage are severity and pain in the right hypochondrium, loss of appetite, constant nausea. Insomnia, increased fatigue and impaired stool are observed. Gradually, the liver becomes denser, increasing in size. Legs swell, cracks and white plaque may appear on the tongue.
There are three stages of cirrhosis. Symptoms at the first are its increase. On the second, it, on the contrary, decreases. And on the third it becomes very small and dense to the touch.
Treatment for portal cirrhosis
In the treatment of portal cirrhosis, the patient needs bed rest. Any physical activity should be excluded. Treatment of cirrhosis is aimed 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 reasons for the development of the disease. It is necessary to cleanse the liver.
If portal cirrhosis has arisen due to hepatitis, treatment should be aimed primarily at combating it. Be sure to exclude drugs that give complications to the liver.
A strict diet is required. Spicy, greasy and fried foods are excluded from the diet. The amount of seasoning should be minimized. It is forbidden to eat canned food, smoked products and sausages. It is necessary to exclude chocolate, garlic, tomatoes and their juice, mushrooms from the diet. It is advisable to minimize salt intake.
Various vegetable soups without frying are recommended for use. Any cereals, legumes and cereals. Low-fat dairy products, boiled poultry, turkey and rabbit meat. You must eat apples and crackers.
Food should be 5-6 times a day. But in small portions. At the same time during the diet you need to drink decoctions of herbs, liver fees. In the treatment with drugs, hepatoprotectors of plant origin are prescribed. They protect liver tissue and restore its function.
In addition, diuretics are prescribed that remove swelling and remove excess fluid from the body. As well as drugs that relieve symptoms of cirrhosis.
If this does not help, surgery is used. And a liver transplant is performed. For the treatment of portal cirrhosis, stem cell methods are being developed.
Postnecrotic Cirrhosis
Postnecrotic cirrhosis is also a fairly common form of the disease. Most often appears after viral hepatitis and alcohol abuse. Less often - after poisoning by poisons, taking certain medications, acute infectious diseases. With post-necrotic cirrhosis, the death of liver tissue begins. Internal scars appear that disrupt the work and shape of the organ.
Symptoms of cirrhosis of the liver at the initial stage are manifested sharply. Suddenly, the stomach begins to hurt, diarrhea and vomiting appear. Mucous membranes and skin turn yellow. The liver grows in size. When feeling, pain appears. There is nausea, loss of appetite and weight.
With exacerbation, skin itching begins, the temperature rises greatly. Feces become pale and urine dark. Ascites, anemia, heart failure appear. Disability drops sharply. This is a very dangerous form of cirrhosis, as it causes liver cancer. Fatal outcome can occur at any stage of the disease.
Treatment of post-necrotic cirrhosis
Treatment of post-necrotic cirrhosis is aimed at complications arising from portal hypertension. First of all, ascites. In the diet, the protein content decreases. Avoid drugs that provoke hepatic coma. If necessary, antimicrobial therapy is performed.
If no complications are observed, then periodic examinations and observations of the patient are sufficient. If cirrhosis develops from a disease, then it is treated (if it can be treated).
Alcoholic cirrhosis of the liver
Another very common form of the disease is alcoholic cirrhosis. Symptoms of it can be pronounced, and sometimes they are not 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 an enlarged liver. Sometimes mild nausea may appear. General weakness in the body and rapid fatigue are observed.
- Subcompensation. Appetite worsens, body weight decreases sharply, nausea and vomiting appear.
- Decompensation. Complete depletion of the body, liver failure and jaundice begin. All the complications of cirrhosis and portal hypertension appear. Liquid (ascites) accumulates in the abdominal cavity. It is difficult to treat. There is increased bleeding. Consciousness attacks may occur. Often an additional bacterial infection occurs. In all patients, hepatomegaly appears, in a quarter - splenomegaly.
When alcoholic cirrhosis of the liver progresses, signs and symptoms are clearly manifested externally. There is an expansion of the vessels of the nose. The parotid glands noticeably increase in size. Facial features become puffy.
Due to the effects of ethanol, internal organ damage begins. Neuritis, pancreatitis, mastopathy, encephalopathy and other diseases may appear. Atrophy of the muscles is observed , in particular in the shoulder girdle.
Treatment of alcoholic cirrhosis of the liver
Symptoms of liver cirrhosis in men are detected more often than in women. Since alcohol is consumed more than the "strong half". With alcoholic cirrhosis, first of all, discussions are held during which the patient is set up to get rid of harmful dependence.
Then a special diet is prescribed. Destroyed liver cells, which have already been replaced by fibrous tissue, cannot be restored. Therefore, treatment is aimed at those that are still functioning to one degree or another. If necessary, antiviral treatment is used.
If withdrawal syndrome is present, then sedatives are used and the water-electrolyte balance is restored. With complications of alcoholic cirrhosis, hepatic encephalopathy prescribed glucocortisteroids with a course of 30 days. And ursodeoxycholic acid, which prevents cell death and has an anti-inflammatory effect.
As antioxidants, bile acids and vitamin E are used. They are needed for the utilization of ethanol, which accumulates in excess in the liver during alcoholic cirrhosis.
Biliary cirrhosis
Biliary cirrhosis is less common than the above forms. This is a 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 a form such as biliary cirrhosis, the symptoms and causes are not yet fully understood. It is suggested that it may begin due to a genetic predisposition. And also with a violation of immunity or infection. Biliary cirrhosis is divided into primary and secondary.
Primary biliary cirrhosis
With such a form as primary biliary cirrhosis, symptoms and signs increase gradually. A person often for a long time does not even suspect a disease. And his condition for a long time does not even worsen. There are two stages.
At an early stage, itching of the skin begins. Moreover, this symptom appears long before jaundice. This symptom is ahead of her from six months to 1.5 years. But sometimes itching and jaundice occur simultaneously. Fatigue, severe weakness, depression, drowsiness appear.
At a late stage of a disease such as primary cirrhosis of the liver, the symptoms appear clearly. Ascites occurs. And this is the first sign of liver failure. Vascular "stars" appear, encephalopathy. Some have xanthomas and xanthelasms (plaques around the eyes). A quarter of patients show skin hyperpigmentation.
Treatment of primary biliary cirrhosis
Treatment of biliary cirrhosis is based on a decrease in the intensity of symptoms and a slowdown in the development of the disease. The treatment of emerging complications and the prevention of their occurrence are performed.
First of all, the patient must abandon all bad habits and taking drugs that destroy the liver. A strict diet is required and physical activity is prohibited. During cirrhosis therapy, all concomitant infectious chronic diseases are simultaneously treated.
If instrumental intervention is performed (dental procedures, etc.), then antibiotics are prescribed to prevent infection. Primary biliary cirrhosis, the symptoms of which signal a transition to the decompensation stage, requires bed rest and inpatient treatment. Physiotherapy, studies with exercise tests and balneological procedures are contraindicated.
During the compensation period, a balanced diet and diet No. 5 are necessary. In case of encephalopathy, the level of protein should be reduced. If ascites has appeared, exclude salt from the diet. Physical activity and low temperature operation are excluded. Walking and a number of physical exercises are recommended.
Some drugs are excluded: some types of antibiotics, aminoglycosides and non-steroidal drugs that have anti-inflammatory effects. Applicable:
- immunosuppressants;
- glucocorticoids (in minimal doses);
- ursodeoxycholic acid;
- D-penicillamine;
- antihistamines.
If the patient has begun the last stage, to which cirrhosis of the liver comes, signs and symptoms clearly indicate the need for surgical intervention. For example, a sharp increase in liver failure. In this case, only a liver transplant can save the patient . Most people after such an operation can live for almost 10 years. After transplantation, relapse is observed in only 15% of patients.
Secondary Biliary Cirrhosis
Secondary biliary cirrhosis develops with partial or complete obstruction of the bile ducts. Women suffer from them two times less than men. Typically, the secondary form occurs after surgery to remove the gallbladder, prolonged chronic pancreatitis, or with a tumor.
In a disease such as secondary biliary cirrhosis, the symptoms are primarily associated with the cause of obstruction. And then the same ones appear 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 procedures (bougienage, extraction of calculi, expansion of the ducts, etc.). After the operation, it becomes possible to extend the patient's life.
If surgery is not possible, then a therapy similar to that used for primary biliary cirrhosis is performed. Treatment in this case depends on the degree of obstruction, its causes and the possibility of their elimination.
Compensated Cirrhosis
With compensated cirrhosis, a person may not be aware of the disease, since there are no special symptoms. The liver is operating 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 of the hands, and nosebleeds. But with this form of the disease, people can live for decades. Moreover, without any complications.
Treatment of Compensated Cirrhosis
Treatment for compensated cirrhosis depends on the stage of the disease. If it is in a "sleeping" state and does not progress, then only vitamin-mineral complexes and strict diet No. 5 are prescribed. It is necessary to completely abandon cigarettes and alcohol. Do not take hepatotoxic drugs.
If compensated cirrhosis progresses, then diet No. 5a is prescribed until the exacerbation subsides. Vitamins B, folic acid and cocarboxylase are needed. Eating milk thistle helps remove toxins from the body. In addition, it has an anti-inflammatory, hepatoprotective effect and relieves muscle spasms.
Decompensated cirrhosis: symptoms and treatment
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Then, inflammatory processes and sclerotic changes of small capillaries begin. This leads to organ deformation. The liver grows and becomes denser. But her work is not disturbed. Symptoms of diabetes mellitus periodically occur: thirst, increased appetite. Sugar appears in the urine and its level in the blood increases.
The prognosis for pigmented cirrhosis is poor. Death occurs from liver failure, diabetic coma, or bleeding. During treatment, bloodletting, injection courses are prescribed. Diabetes and complications are stopped by symptomatic therapy.