Ascites in cirrhosis. Treatment: drugs, folk remedies. Diet, forecast

The human liver is gradually destroyed under the influence of various aggressive factors, such as toxins, hepatitis virus, alcohol. With this process, the sequential death of organ cells begins. They are replaced by connective tissue. But the latter cannot fully perform all the functions of the liver. As a result, a person develops cirrhosis. This is an extremely severe pathology. Often it is accompanied by serious complications. The most severe of these is ascites in cirrhosis . Treatment for such a patient requires more responsible, and the prognosis is significantly worsened.

Pathology characteristic

Let's look at what is ascites of the abdominal cavity. This pathology does not occur on its own. It develops against a background of cirrhosis of the liver or other pathologies. Ascites is a complication in which fluid accumulates in the abdominal cavity.

It should be noted that liver cells have a unique ability to regenerate. But, unfortunately, under the influence of negative factors that continuously or permanently affect the organ, internal reserves are gradually depleted. Healthy cells die. They are replaced by connective tissue.

The death of the liver leads to a deterioration in blood purification. A variety of harmful substances accumulate in the human body. The main filter is not able to produce the required number of enzymes and proteins. Namely, they ensure the flow of many important processes in the body.

As a result of the cessation of sufficient protein production, fluid leakage through the tissues and walls of the vessels is impaired. This leads to the fact that fluid gradually begins to accumulate in the abdominal cavity. This is how ascites develops in cirrhosis. Treatment should begin immediately, since the complications accompanying cirrhosis can progress quite quickly.

Causes of the development of the disease

Why does ascites occur? Pathology is mainly the result of insufficient protein synthesis. Lack of albumin reduces the ability of blood to be in the vascular bed. In other words, this leads to the fact that the fluid through the walls of the veins begins to easily penetrate into the abdominal cavity.

The high sodium content, provoked by the inability of the liver to neutralize certain substances, leads to an even greater fluid retention in the body.

In addition, considering the causes of ascites in cirrhosis, one more factor should be mentioned. A similar complication can be triggered by a deficiency of the lymphatic system. Basically, the liver produces lymph. Developing cirrhosis seriously violates this system. As a result, lymph pressure increases, and the fluid penetrates the peritoneum. Since the process of attenuation of the main filter does not end, fluid in the body gradually accumulates.

Thus, the development of ascites in cirrhosis is based on several factors:

1. Increased permeability of the liver vessels.
2. High lymph formation.
3. Impaired renal function, characteristic of cirrhosis. As a result, blood flow changes, sodium retention in the body is observed.
4. Increased pressure in the liver vessels. This leads to the penetration of fluid in large quantities into the tissue.

Symptoms of cirrhosis

Initially, let's consider what signs the liver pathology signals about itself. By the way, men often suffer from cirrhosis. Their disease is diagnosed almost 3 times more often than women. That is why we will analyze the symptoms that indicate the development of an ailment in the strong half.

If we consider the early signs of cirrhosis in men, then the following should be highlighted:

1. Under the rib, in the right side, an unpleasant feeling of heaviness or pain appears. Discomfort increases after physical exertion, taking spicy or fatty foods or alcohol.
2. Bad taste in the mouth - dryness, bitterness.
3. The occurrence of nausea, often ending with vomiting.
4. Feeling of weakness, increased fatigue.
5. Frequent and loose stools. Such disorders are often accompanied by bloating.
6. Strong weight loss, sometimes reaching exhaustion.
7. The appearance of skin itching. The skin becomes pale yellow.
8. Pathology in men is manifested by sexual impotence.
9. Enlarged liver is easily palpated under the skin. On palpation, you can determine that the organ has become dense and tuberous. The patient experiences pain while touching the area of ​​the liver.

In addition, pay attention to the visual signs of cirrhosis in men:

1. The palms are painted in a bright red shade. This occurs as a result of hyperthermia.
2. Red color takes on language. It is characterized by puffiness and a certain “varnishing” (texture change).
3. The presence of spider veins. They can be localized near the nose, in the corner of the eyes. Sometimes they start to bleed.
4. Breast enlargement. This symptomatology is characteristic exclusively for men. In this case, the genitals of the patient are significantly reduced.

In addition, cirrhosis is manifested by a number of specific symptoms:

1. Insufficient blood coagulation leads to bruising and bruising.
2. Urine acquires a cloudy, brownish tint. The feces become lighter.
3. Fever periodically appears, body temperature rises.
4. Immunity decreases.
5. Sometimes there is hemorrhoids with bleeding. Often it is complemented by varicose veins.

Symptoms of ascites

Against the background of the symptoms described above, a rather unpleasant complication can develop, characterized by accumulation of fluid in the peritoneum.

Symptoms of ascites do not immediately become noticeable. Pathology can only be determined when at least 1 liter of fluid accumulates in the peritoneum. In the future, the amount increases. Sometimes the patient accumulates up to 25 liters of fluid.

For pathology, the following symptoms are characteristic:

• the stomach increases in size;
• the skin in this area is excessively taut;
• during movement, waves inside the peritoneum are felt;
• when you tap on your stomach a dull sound is heard;
• veins become noticeable;
• nausea, swelling may appear;
• the patient experiences pain in the stomach;
• the navel protrudes.

It is very important to responsibly treat such a pathology as ascites in cirrhosis. Treatment should begin as early as possible. Otherwise, the disease will progress rapidly.

Disease complications

Unfortunately, this pathology can lead to serious consequences. One of the most serious complications is peritonitis. It occurs against the background of the fact that ascites fluid becomes infected. Peritonitis without timely medical attention can be fatal.

The following symptoms indicate the development of such an ailment:

• weakening or absence of intestinal noise;
• worsening symptoms of encephalopathy;
• leukocytosis is observed in the blood;
• the temperature rises with cirrhosis of the liver with ascites;
• chills occur.

Of course, peritonitis is not the only pathology that can develop against the background of this disease.

Sometimes the following complications of ascites in cirrhosis of the liver are observed:

• the occurrence of hemorrhoids as a result of increased intra-abdominal pressure;
• hydrothorax (this is fluid effusion in the pleura);
• esophageal reflux (the contents of the stomach enter the esophagus);
• internal organs are displaced;
• diaphragmatic hernias appear.

Stages of the disease

Often the question arises, if ascites is diagnosed with cirrhosis of the liver, how many such patients live? Of course, the prognosis depends on the stage of the disease. It is unlikely to be cured of cirrhosis of the liver, in which ascites occurred. But if characteristic symptoms are noticed in a timely manner, then it is possible to slow the progression of the complication. At the last stage, recovering from an ailment is very problematic. That is why it is important to determine the disease in a timely manner.

For ascites, 3 degrees are characteristic:

1. The initial stage is characterized by a slight increase in the abdomen. With this degree, the patient accumulates about 3 liters of fluid in the peritoneum. The forecast is quite favorable. Therapeutic measures can delay the progression and thereby extend the life of the patient.
2. Further development of ascites is characterized by the accumulation of more fluid in the peritoneum (from 4 to 10 liters). The clinical manifestations of the disease are clearly visible. They cause serious discomfort to the patient. The shape of the abdomen is severely deformed. Many patients develop renal failure.
3. With 3 stages, more than 10 liters of fluid accumulate in the patient’s peritoneum. The patient's condition worsens. A person may have difficulty breathing, because a large stomach does not allow normal lung expansion. There is a violation of the functioning of the heart. Edema appears throughout the body.

Pathology prognosis

No doctor can say with a 100% guarantee if ascites is diagnosed with cirrhosis of the liver, how many patients with such an illness live. After all, each case is purely individual.

Unfortunately, often the pathology ends in death as a result of sequential intoxication with ketone bodies and acetones. According to statistics, about 10% of patients with this complication live for about one month.

However, very often, doctors timely compensate for the patient's condition with diuretics, potassium and magnesium drugs. This prevents the progression of the disease.

It is known that timely and competent manipulations can extend the life of a person, even in the presence of a complicated form of ascites, up to 10 years.

Pathology treatment

The therapy gives excellent results if it is started in the early stages. In this case, you can quite effectively deal with a pathology such as ascites in cirrhosis.

The treatment includes:

• drug therapy that controls the accumulation of fluid in the body;
• diet food;
• special methods that ensure the evacuation of fluid from the peritoneum.

To combat liver cirrhosis and ascites, doctors recommend the following drugs:

1. Essential phospholipids. These drugs provide restoration of damaged molecules of the fatty and carbohydrate layers of the cell membrane. Such drugs are Essentiale, Phosphogliv.
2. Antiviral medicines. They are drugs: Ribavirin, Adefovir. These medications are prescribed if the pathology has arisen against a background of viral hepatitis.
3. Synthetic hepatoprotectors. They normalize cholesterol levels and also protect against hepatocytes from the effects of bile acids. An excellent representative of this group is the drug "Ursodeoxycholic acid."
4. Anti-inflammatory steroid drugs. They are recommended for patients who have autoimmune liver damage. Such patients are prescribed the drug "Prednisolone".
5. Diuretics. With ascites and cirrhosis, diuretics are prescribed. The following preparations may be recommended: "Lasix", "Diacarb", "Aldactone", "Spirix".
6. Hepatoprotective amino acids. These medications improve metabolic processes in the body. However, they do not have hepatoprotective effects. Such medicines include medicines: Ornithine, Methionine.
7. To normalize colloidal pressure, doctors prescribe the drug "Albumin."

If drug treatment does not provide a positive effect, surgery is undertaken - laparocentesis. Such manipulation involves the removal of fluid from the peritoneum with a special needle.

Diet food

It is very important for a patient suffering from this ailment to adhere to a certain diet. As a rule, the patient is assigned table number 5.

The diet for cirrhosis of the liver with ascites is based on such features:

• calorie intake varies from 2500-2900 kcal;
• excludes food that stimulates the production of digestive enzymes in the body;
• limited intake of fatty, spicy, fried, salty;
• It is recommended to eat 4-5 times a day;
• allowed meat products, with streaks of fat;
• useful vegetable fiber;
• the volume of fluid during the day is 1.5 liters;
• in case of exacerbation of the disease, rubbed vegetables are recommended;
• daily diet: protein - 100 g, fats - 70 g, carbohydrates - 400-450 g.

Folk remedies

Sometimes not only medications and diet are recommended for a patient who is diagnosed with ascites in cirrhosis. Treatment with folk remedies, which is part of complex therapy, can bring quite tangible relief. However, one should know that it is impossible to cure pathology exclusively with the prescriptions of healers.

The following folk remedies are recommended:

1. Parsley broth. For 1 liter of water you will need 300 g of fresh raw materials. Boil, let stand and strain. A decoction must be taken at 0.5 tbsp. every hour during the morning. Therapy lasts 3 days.
2. Bean Pods. Boil the husk with 15 pods in 1 liter of water, about 10 minutes. Then infuse the product for 20 minutes. Strain. The first dose (200 ml) is recommended at about 5 in the morning. The second portion - drink 30 minutes before breakfast. The third - half an hour before lunch. The remainder should be consumed no later than 8 pm.

It should be recalled once again that ascites is a serious pathology that can very quickly lead to death. And most often, the death of patients is provoked by a late visit to doctors. Therefore, be attentive to your condition and the health of loved ones.