Chronic hepatitis (classification is described below) is a disease that has necrotic changes in the tissues of the liver cells, while the structure of the organ itself and the signs of hypertension are not disturbed. Patients often complain of pain in the right hypochondrium, nausea, vomiting, poor appetite, indigestion, general weakness, rapid weight loss, yellowness and itching of the skin. This disease can be diagnosed using ultrasound of the abdomen, liver biopsy, as well as a blood test. The disease is not completely treated, therapy is aimed at eliminating the causes of this pathology, generally improving the condition of a person and achieving long-term remission. But you need to remember that killing hepatitis from the path of infection is much easier.
Chronic hepatitis
Chronic hepatitis is called inflammation of the parenchyma and stroma of the liver. This disease develops for various reasons, it lasts more than 6 months. Pathology has a serious clinical problem, given that the disease progresses very quickly.
According to statistics, in the world more than 400 million people have chronic hepatitis, a little less than 200 million patients complain that they are fighting hepatitis C. Moreover, 50 million people with type 1 disease and 100-200 million each year are added second.
It should be noted that active chronic hepatitis is more common than any other similar liver diseases. The disease occurs quite often, and, as a rule, men are affected by it. Over the past 30 years, scientists have been able to highlight a lot of important information about this disease, it became clear how it develops, its causes. Therefore, the most effective treatments have been developed. Every year they improve. It should be noted that this issue is addressed not only by specialist doctors, but also by therapists, infectious disease specialists, gastroenterologists, and so on. The outcome of a person’s life directly depends on what form of hepatitis is present, how much it is launched, and the age of the patient plays a significant role.
Classification of chronic hepatitis
This disease is classified according to several signs. We are talking about etiology, the degree of rapid growth of pathology. And also according to biopsy. Chronic hepatitis B, C, D, A is isolated, in addition to them there is also drug, cryptogenic and autoimmune. In this case, the degree of development of the disease can be different. Distinguish between minimal, moderate, pronounced. We will talk about them a little lower. In addition, based on histological studies, biopsies divide hepatitis into 4 stages. They are called, respectively, 0, 1, 2, 3, 4.
Process Activity Classification
- Minimum degree of activity: ALT is 3 times higher than normal. The thymol sample increases to 5E, and gamma globulin increases to almost 30%.
- Moderate: the concentration of the above enzymes increases 10 times, the thymol sample is 8 units. Gamma globulin increases to 35%.
- Expressed is characterized by the fact that enzymes increase more than 10 times, the sample - more than 8. Globulin increases by more than 35%.
Stages of hepatitis
At the zero stage, fibrosis is absent. On this form, the activity of chronic hepatitis is practically not detected.
The first stage is characterized by the fact that there is a slight decomposition of the tissue. The connecting surface grows near the liver and bile. The second stage is characterized by the fact that fibrosis is already a moderate degree. Appearing in the septum, the tissue combines the tracts, forms the branches of veins, arteries, ducts, nerves. It, connecting, forms a hexagon.
During the third stage, severe fibrosis is observed. The fourth stage is characterized by the fact that the connective tissue grows, and the structure of the liver changes as much as possible.
Causes of Hepatitis
Chronic hepatitis (classification can be read above) is most often the result of a transferred virus. We are talking about hepatitis B, C, D bacteria, and A. is least likely to occur. Each pathogen acts differently on the liver of any person. For example, the hepatitis B virus does not violate hepatocytes, and the development of pathology is directly related to the response of the immune system to this virus. Hepatitis C and D bacteria are toxic. They affect the liver, cause its inflammation.
The second common cause is intoxication. Diagnosis of chronic hepatitis in this case is much simpler. As a rule, it is affected by alcohol, medicines, heavy metals and chemicals. Toxins accumulate in the liver over time, because of this, a malfunction of the organs begins, bile and other substances accumulate, and metabolic disorders occur. Because of this, necrosis occurs.
Metabolites are considered antigens to which the immune system reacts violently. Hepatitis can also be provoked due to poor nutrition, alcohol abuse, leading an improper lifestyle. The causative agents are infectious diseases: malaria and other diseases. They can cause metabolic disturbances.
Pathogenesis of the disease
The pathogenesis of the disease is due to the fact that liver cell tissue is damaged. The immune system reacts very actively, an aggressive autoimmune mechanism appears, respectively, chronic inflammation develops. They last quite a while.
Symptoms of the disease
Symptoms of chronic hepatitis (the classification of which is quite complicated) are quite different for each person, moreover, they directly depend on the form of the disease. Signs at the inactive stage are weakly expressed, they may not even appear. The patient does not feel bad, but after drinking alcohol or having vitamin deficiency, he will immediately feel a sharp malaise. In the right hypochondrium, possible slight pain. During the examination, the doctor may detect a significant increase in the liver.
Clinical signs with an already active form of this disease are quite pronounced, and they manifest as much as possible. Patients complain of flatulence, nausea, bloating, diarrhea, poor appetite. In addition, asthenovegetative syndrome occurs, that is, we are talking about fatigue, poor concentration, weight loss, headaches, and liver failure syndrome can also play a role. A person complains of jaundice, constant fever, tissues constantly bleed, and fluid forms in the abdominal cavity. Abdominal pain is long and severe.
Chronic hepatitis causes problems with the spleen and lymph nodes. They significantly increase in size. Bile has a very weak outflow, which is why jaundice develops. Itching may appear. On the skin, you can find special vascular asterisks. During the disease, the liver enlarges. At the same time, palpation is quite painful, the organ is very dense.
Symptoms of hepatitis D
Chronic viral hepatitis is difficult to diagnose. It proceeds most severely, usually characterized by liver failure, which is expressed in the maximum form. Most of the patients complain of jaundice and very severe itching. In addition to these signs, lesions of muscles, joints, lungs and other organs can be diagnosed.
Symptoms of hepatitis C
Hepatitis C has its own characteristics. This disease is quite prolonged, and more than 90% of cases of acute forms of this disease result in it becoming chronic. Often patients complain of a slight enlargement of the liver, as well as a general malaise. Unfortunately, the course of the pathology is undulating: a person may not pay attention to pains that pass after a while. But a few years after infection in 40% of cases, this disease ends in cirrhosis.
Symptoms of autoimmune hepatitis
An autoimmune chronic hepatitis disease occurs, as a rule, in women who are already over 30. They complain that they feel weak, get tired pretty quickly, the skin gets a yellow tint, and it constantly hurts in the right side. It should be noted that this disease is quite insidious. In 25% of patients, this disease disappears under acute hepatitis C with the manifestation of some syndromes and fever. Extrahepatic signs can be found in every second patient, damage to the lungs, blood vessels, heart, thyroid gland, and tissues can occur.
Symptoms of chronic hepatitis drug
This disease has a very large number of symptoms, but there are no specific symptoms. Sometimes the disease can disguise as obstructive jaundice.
Hepatitis Diagnosis
In order to have a positive result after treatment of chronic persistent hepatitis, it is necessary to diagnose this disease in time. All procedures are performed under the supervision of a gastroenterologist. This diagnosis is made only after examination. We are talking about taking a blood test, an ultrasound of the abdominal cavity, as well as a study of the blood supply to the liver, and a biopsy. Thanks to a blood test, you can distinguish the form of this disease if there are specific markers - viruses or antigens that fight microorganisms. It is so easy to identify the stage of chronic hepatitis. The pathogenesis is complex.
For viral hepatitis A or E, certain types of markers are characteristic. If we are talking about hepatitis B, then during the diagnosis several groups of markers are distinguished. Moreover, their number and ratio clearly indicates the state of developmental pathology. Moreover, thanks to this analysis, a forecast can already be made.
Hepatitis D virus is detected using certain markers, we are talking about Anti-HD. Liver functions are evaluated using a special biochemical analysis. In this case, the body is checked for transferase, bilirubin, alkaline phosphatase. Signs of hepatitis in this case are very pronounced. In chronic hepatitis, their number will be increased several times. If damage to the liver cells occurs, the concentration of albumin in the blood will decrease sharply, and the globulin will increase.
Next, it is necessary to conduct an ultrasound of the abdominal cavity, this is the most painless and safe way. Thanks to it, you can find out the sizes of the internal organs, and accordingly, find out the changes that have occurred. The most accurate research method will be a biopsy. Thanks to her, you can find out the form, also the stage of this disease. After its implementation, you can already accurately diagnose and prescribe treatment. Thanks to comprehensive research, as well as their results, we can already judge how common the process and the likely outcome of a person are.
Disease treatment
Treatment of chronic toxic hepatitis is carried out in order to eliminate the causes of pathology, stop symptoms and improve a person's condition. It should be noted that therapy should be as comprehensive as possible. Most patients undergo a basic course, which allows to minimize the load on the liver. If a person has constipation, then he is prescribed mild laxatives, which help improve digestion. As a rule, these are preparations without bile content. All patients should reduce physical activity. They must observe a low-activity lifestyle, half-bed mode.
Medications are prescribed in a minimal amount, because they can have a strong effect on the liver. It is dangerous in the treatment of chronic toxic hepatitis. Moreover, a full-fledged diet No. 5 is prescribed. It is enriched with proteins and vitamins, all the necessary minerals.
Injections are often prescribed. We are talking about vitamins B1, B6, B12. Fatty, fried and other foods that are heavy, as well as hard drinks (alcohol) are prohibited. In order to protect liver cells, it is necessary to use hepaprotectors. They are taken two to three months, the course of administration is repeated once a year.
Unfortunately, viral chronic hepatitis is rather difficult to treat, therefore immunomodulators are prescribed to patients. They act on microorganisms, therefore, more active work of the human immune system begins. It is forbidden to use these drugs on their own, as they have a huge list of contraindications and side effects.
You also need to talk about interferons. They are often prescribed for admission up to three times a week. Because of them, the temperature can rise, so before you make an injection, you need to take an antipyretic. It should be noted that in 25% of chronic hepatitis diseases, these treatments bring a positive result. If a child is sick with hepatitis, then this group of drugs is prescribed as rectal suppositories. In this case, the signs of hepatitis are reduced.
In order to improve a person's condition, intensive therapy can be carried out. It is allowed to use interferon and antiviral drugs at the same time, and in large doses.
Due to the fact that doctors are constantly looking for new drugs, special pegylated interferons were invented . Thanks to them, you can fight viruses much more efficiently, this drug is in the body much longer. These medicines are considered highly effective, they should not be used as often as the above drugs. If chronic hepatitis is caused by intoxication, then a special therapy is carried out, which removes all unnecessary substances from the body. Moreover, any source of the penetration of toxins into the blood must be excluded. Including, it is necessary to exclude any drug if it is in such a risk group, to leave work if it is associated with chemical production.
If chronic hepatitis (cirrhosis is the final stage of the disease) is associated with the autoimmune system, then special hormonal agents must be used. They are taken orally. After the effect occurs, their intake is reduced to a minimum. If the results are not available, then doctors prescribe a liver transplant.
Prevention
Patients and carriers of the virus do not pose a great danger to surrounding people. It should be noted that infection by airborne droplets and household methods is impossible. You can get infected only after contact with blood or any other biological fluids.
In order to reduce the risk of developing this disease, it is necessary to use contraceptive methods during sexual intercourse, and also not to use other people's hygiene items. Difficult to treat hepatitis. Getting out of the way of infection is quite easy, in the later stages it is difficult. In order to prevent hepatitis B, human immunoglobulin must be used on the first day after infection. In addition, you can also get vaccinated against this type of disease. Unfortunately, other prophylaxis for the forms of this disease has not been developed.
Forecast
The prognosis for chronic hepatitis (the etiology of the disease is complex) depends on what form and type it is present. If we are talking about the dosage form, then it is almost completely cured. The autoimmune form also responds well. Viral can be cured only in 5% of cases, in the rest it is transformed into cirrhosis.
If several pathogens are combined, that is, several hepatitis is present in the body, then a rather severe form of the disease occurs, which progresses as quickly as possible. If adequate therapy will be absent, then quite quickly in 70% of cases, this disease will develop into cirrhosis. The ICD code for chronic hepatitis is B12.