The formulation of the diagnosis of liver cirrhosis is quite complicated, due to the variety of causes of the disease, the stage of the course, as well as the presence of pathologies in other organs. For the correct diagnosis you need the presence of special knowledge, skills and experience.
However, attention to your health, as well as the ability to recognize the first signs of organ damage, will help to identify and prevent the subsequent spread of the disease in a timely manner. The timely help of a doctor will help save a person's life and strengthen his health.
Main classification
For an accurate formulation of the diagnosis of liver cirrhosis, the classification is carried out according to several parameters. In medicine, several different classifications of this disease are distinguished, namely according to:
- morphological features;
- cause of occurrence;
- flow stages;
- stages of clinical course.
In accordance with morphological characteristics, cirrhosis of the liver is divided into such types as:
- small-knot;
- coarse-knot;
- mixed;
- septal.
In the classification, the size of the scar tissue of the affected organ plays a very important role. Depending on the causes of the disease, the disease is divided into types such as:
- alcoholic;
- viral;
- congenital;
- secondary;
- alimentary;
- cardiac.
According to the diagnosis, alcoholic cirrhosis of the liver is a complex lesion that occurs as a result of prolonged and regular abuse of alcohol. A congenital form of the disease is diagnosed in children born without bile ducts, or if they are not sufficiently developed. Alimentary type of the disease occurs against the background of diabetes or obesity. In formulating a diagnosis of cirrhosis of the viral etiology, viral hepatitis is important. Basically, pathology develops with a prolonged course of this disease. Cardiac cirrhosis is formed against a background of poor blood circulation as a result of heart disease.
Depending on the clinical development of the disease, its types are distinguished, such as:
- fast progressing;
- slowly progressing;
- sluggish;
- latent.
Rapidly progressing cirrhosis is characterized by the rapid development of the disease. It can provoke the occurrence of many complications. Requires urgent treatment, the absence of which can lead to death. Slowly progressing pathology basically does not provoke any complications. The disease is less aggressive in nature and proceeds much more slowly. The pain is quite restrained.
Sluggish cirrhosis is characterized by an almost complete absence of symptoms and minor changes in the tests. Latent cirrhosis is characterized by a complete absence of complaints and changes in analyzes. In addition, it does not provoke any complications.
Depending on the wording of the diagnosis of liver cirrhosis, the classification of the disease is divided into the main and complicated diagnosis. The main diagnosis characterizes the general condition of the patient’s liver, its functioning, as well as the degree of damage. A complicated course is characterized by the occurrence of some concomitant diseases, namely:
- portal hypertension;
- ascites;
- encephalopathy.
The timely detection of these diseases can play a very important role in choosing the course of therapy.
Causes of occurrence
According to the diagnosis, cirrhosis of the liver is a late stage of various inflammatory diseases of the liver and some other organs. As a result of damage and inflammation, part of the liver cells die. In their place, connective tissue gradually grows. It surrounds healthy, intact cells, but does not perform their functions.
The remaining intact cells begin to divide very quickly. The structure of the affected organ is violated, and its functions are not performed well enough. As a result of this, liver failure develops. All the causes of the onset of the disease are not yet fully established. However, it was proved that the death of affected liver cells is observed as a result of:
- prolonged course of liver disease;
- alcohol addiction;
- autoimmune mechanisms;
- viral hepatitis;
- metabolic disorders;
- blockage of the bile ducts;
- exposure to toxic substances;
- stagnation of venous blood in the liver.
If it is impossible to determine the exact cause of the disease, then doctors talk about cryptogenic cirrhosis. It is worth noting that this chronic disease is provoked by many different factors.
Developmental stages
Given the formulation of the diagnosis of liver cirrhosis, the features of its course, as well as symptoms, it is possible to determine the presence of the disease. The development of the disease occurs gradually and depends on the features of the course of the pathology that provoked it and treatment. This process can take from about a year to several tens of years. Doctors distinguish 3 stages of cirrhosis, namely:
- compensation;
- subcompensation;
- decompensation.
Compensation or the initial stage is characterized by a slight severity of symptoms. A person may complain of a feeling of heaviness in the right hypochondrium, flatulence, decreased performance. During the diagnosis, there is a slight increase in the affected organ, the edge of which becomes densified and pointed. The spleen may also slightly increase.
With subcompensation, a much more pronounced decrease in the functioning of the affected organ occurs, which is due to the sharp increase in dead hepatocytes. With the passage of this stage, the patient notes a change in the affected organ. He has severe weakness, poor performance, apathy, weight loss, nausea. If timely treatment is carried out, there is still the opportunity to transfer the disease to the stage of compensation. When taking the prescribed medications, the diseased organ may well function.
Decompensation is characterized by signs of liver failure and complications of hypertension. All this is complicated by internal bleeding and can trigger the death of the patient. This condition is characterized by an increase in ascites and the formation of swelling, which requires urgent treatment with diuretics in large quantities.
First signs
When formulating a diagnosis of liver cirrhosis, it is necessary to take into account the stage of the course of the disease. The initial stage of the course of the disease is characterized by the fact that the signs practically do not appear. Only heaviness in the right hypochondrium can be felt. Basically, similar symptoms are observed after physical exertion or food intake. Perhaps the periodic appearance of bitterness in the oral cavity. Patients have a sharp decrease in performance, drowsiness, weakness.
At this stage of the course of the disease, there is a high probability of restoration of the functional activity of the liver and elimination of the pathological process. As you know, this body has the ability to recover, therefore, an appeal to a doctor gives a high chance of cure.
Main symptoms
In the formulation of the clinical diagnosis of liver cirrhosis, the symptomatology is very important. For a long time, the disease may not manifest itself at all. Deviations in the analyzes can be detected quite by accident during routine examinations. Symptoms of the course of this disease are quite nonspecific and can occur with the course of most known diseases, therefore, it is quite difficult to recognize cirrhosis. These include such as:
- high fatigue;
- the presence of vomiting;
- bloating;
- lack of appetite;
- mood swings;
- exhaustion.
However, there may be quite specific signs by which the presence of cirrhosis can be recognized. These include:
- hepatomegaly;
- splenomegaly;
- jaundice;
- itchy skin;
- anemia;
- temperature rise;
- heaviness on the right side.
In the presence of cirrhosis in humans, there is an increase in liver in size due to the formation of nodes and replacement with connective tissue. At the last stage, a decrease in the liver due to its drying out is observed. With the accumulation of bile in the body, severe skin itching is observed.
An exacerbation of the pathological process is characterized by the fact that there is an increase in temperature. This is due to the death of liver cells. It is impossible to bring down the temperature, it itself decreases with the improvement of the liver.
Diagnostics
To make a diagnosis of liver cirrhosis, you need to undergo a comprehensive examination. The doctor may suspect the course of the disease during a medical examination. On the skin, you can notice the characteristic vascular asterisks, which occur mainly in places most exposed to sunlight. In addition, you can see cracks in the corners of the lips, dry skin, subcutaneous hemorrhage.
To confirm the clinical diagnosis of liver cirrhosis, additional research methods are prescribed, namely:
- blood analysis;
- biochemical tests;
- ultrasound diagnostics;
- coagulogram;
- liver biopsy;
- tomography.
All this allows you to determine the course of the disease at any stage of its development and prescribe the correct treatment. You can give an example of the formulation of the diagnosis of liver cirrhosis, namely: small-node viral cirrhosis of the liver, the initial stage, sluggish, compensated.
Treatment feature
The correct formulation of the clinical diagnosis of liver cirrhosis makes it possible to prescribe adequate therapy. It is impossible to completely cure the disease, despite all the possibilities of modern medicine. The only effective option would be a liver transplant, but this method is not suitable for everyone and is quite expensive.
The essence of treatment is to conduct such therapeutic measures as:
- taking diuretics;
- dieting;
- taking medications that reduce the pressure in the collar vein.
In the presence of autoimmune disorders, glucocorticoid hormones are prescribed. If there is hepatitis in the diagnosis of liver cirrhosis, antiviral therapy is required. Also, the patient is prescribed drugs that protect liver cells from damage. If the liver can no longer purify the blood from toxic substances, then plasmapheresis is performed.
If the disease is detected in the initial stages, it is possible to stop its progression by conducting adequate therapy. If the pathology is detected in the later stages, then the doctors manage to only slightly slow its progression.
Liver transplant
When making a diagnosis of liver cirrhosis, it is very important to conduct a comprehensive treatment in a timely manner, which will help eliminate unpleasant symptoms. The most effective method of treatment is a liver transplant. This is a very complex intervention, which lasts more than 8 hours and is not carried out in every medical center.
The operation is effective even when the liver can not cope with its functions, but transplantation is not performed at the initial stages of the disease. An organ or part thereof is taken from a deceased person. Urgent transplantation is indicated in cases such as:
- the presence of ascites;
- albumin below 30;
- internal bleeding.
However, it is worth noting that such an operation has its specific contraindications, which include such as:
- the patient's age is less than 2 and older than 60 years;
- malignant tumor;
- the presence of infection in the body;
- severe dysfunction of the lungs and heart;
- obesity of any degree;
- brain damage.
After a liver transplant, the prognosis is quite favorable, but there may be a risk of liver rejection, even with a good operation. Also, among the most common complications, hepatic artery thrombosis should be distinguished.
Forecast
Many patients are interested in how many people live with such a diagnosis with cirrhosis of the liver, and what complications of a similar pathology can be. According to statistics, the life expectancy of a patient with a compensated type of disease can be more than 10 years. With a decompensated type of pathology, approximately half of the patients die in the first 3 years after diagnosis. Patients with encephalopathy can live no more than 1 year.
The most effective method to increase life expectancy is to change the patient’s lifestyle, abandon bad habits, follow a diet, and undergo regular medical examinations.
Possible complications
Reliable criteria for the diagnosis of liver cirrhosis are a change in the structure of this organ, which can provoke very dangerous changes and disorders. It is very important to identify the disease in a timely manner, as this guarantees the most successful treatment. As liver cirrhosis progresses, the occurrence of such consequences as:
- hepatic coma;
- collar vein thrombosis;
- bleeding from dilated veins of the esophagus;
- liver cancer;
- infectious complications.
In some cases, all these complications are the first signs of cirrhosis.
Prophylaxis
Prevention of cirrhosis is quite simple and implies timely treatment of diseases that provoke such a violation, especially alcoholism and hepatitis. Among the main preventive measures, it is necessary to highlight such as:
- hepatitis vaccination;
- annual endoscopic and ultrasound examination;
- intake of vitamins;
- balanced diet;
- refusal to drink alcohol and tobacco;
- timely treatment of drug addiction;
- avoid overeating or starvation.
Symptoms in cirrhosis increase very slowly, and the functionality of the affected organ is impaired. The disease is dangerous because it is difficult to identify in a timely manner, which provokes the development of many complications. That is why it is important to periodically undergo preventive examinations.