Fatty liver degeneration (or stethohepatosis in another way) is a chronic disease of this organ that is most common. Fatty infiltration (i.e. lipid accumulation) of the liver tissue is characteristic of it. According to statistics, about twenty-five percent of the population of developed countries suffer from this pathology. Most often, it is observed in people with obesity and type 2 diabetes. According to the international classification of diseases (ICD), fatty degeneration of the liver corresponds to code K76.0.
Causes of occurrence
The main reason for this liver disease, researchers call the so-called insulin resistance, which consists in lowering the sensitivity of white adipose tissue and muscles to insulin. This increases the amount of glucose in the blood serum (hyperglycemia) and insulin rises, that is, hyperinsulinemia develops.
The causes of fatty liver degeneration should be determined by a doctor.
Hyperinsulinemia increases the breakdown of lipids (i.e. fats) in the connective tissues, a large amount of free acids is released, and the rate of their oxidation in the glands decreases. Triglycerides accumulate excessively in the liver, lipoproteins, which are extremely low-density protein lipid complexes, are produced excessively. The balance between utilization and cell production is upset. The triggered chain reactions of the disorder are accompanied by the death of hepatocytes, the occurrence of inflammation, and proliferation of connective tissues.
The main reason for the progression of fatty degeneration of the liver is called the disturbances that occur in the intestinal microflora. Bacterial overgrowth in the small intestine leads to the entry of certain types of bacteria into the portal vein, and in addition, into its tributaries. This activates the body's immune response, develops inflammation, stimulates the production of fibrous tissue.
Fatty liver degeneration (according to ICD-10 code indicated above) develops against the background of an increase in the number of lipids in the blood, with diabetes and excess body fat. Doctors also call a common cause of the disease metabolic syndrome, which consists in a number of metabolic, clinical and hormonal disorders. Thus, the disease is a widespread pathology of a chronic nature. An increase in this morbidity is also observed at an early age, since the number of children who are overweight only increases. Now let's talk about the symptoms of this disease.
Symptoms
It is very difficult to detect fatty degeneration of the liver, because it is completely asymptomatic. In medical practice, only isolated cases of treatment of patients were noted, complaining of unexpressed pain in the right hypochondrium, a feeling of discomfort and weakness. A liver with signs of fatty degeneration is detected by chance. More often, patients turn at the stage of cirrhosis formation after a long course of the disease. Therefore, to diagnose deviations, the following symptoms of fatty liver degeneration come to the fore:
- Weight gain of visceral fat. In this case, excess body fat is observed, which is observed on the internal organs.
- Violation of lipid metabolism.
- Increased blood pressure.
- Decreased tissue sensitivity to insulin along with an increase in the level of this hormone in the blood, symptoms of glucose metabolism disorder, and so on.
As part of an external examination, the doctor reveals an unexpressed enlargement of the liver, however, the detection of this symptom can be difficult due to obesity in the patient. The symptoms of cirrhosis are indicated by hepatic signs:
- The presence of persistent expansion of small vessels of the skin in the form of stars and nets.
- The presence of redness of the palms.
- Breast enlargement in men.
An increase in the volume of the spleen along with abdominal dropsy can indicate cirrhosis, when an accumulation of free fluid is noted in the abdomen. Next, let's talk about diagnostic methods.
Diagnosis
The main instrumental technique for diagnosing fatty liver degeneration is an ultrasound scan. Computed tomography and magnetic resonance practice are also used. Progression of the disease threatens patients with cirrhosis. Therefore, in recent years, in the field of medical research practice, biological signs have been actively developed that make it possible to assess the severity of inflammatory processes in the liver along with the proliferation of connective tissues:
- Analysis of serum levels of adiponectin, that is, the hormone that is produced by adipose tissue in patients with insulin resistance, obesity, and type 2 diabetes.
- Enzyme-linked immunosorbent assay with numerical determination of M30 antibodies that selectively recognize cytokeratin-18, which is an intracellular filamentous formation that can be split during cell death due to the development of fatty liver disease. The volume of the cleaved fragments suggests the progression of the pathology.
- The serum value of hyaluronic acid of more than 2100 nanograms per milliliter indicates the formation of fibrosis.
Biological markers serve as promising methods for diagnosing fatty liver degeneration (ICD-10 K76.0) in the case of progression of degeneration, but their confirmation in a more reliable study is necessary. Commercial biochemical integrated diagnostic panels called FibroTest and its analogues are currently available. In liver diseases, they demonstrate moderate diagnostic accuracy from seventy-five to ninety percent. Now we turn to the question of treatment methods.
Treatment
Changes in the liver by type of hepatosis are associated with a whole range of disorders and deviations in metabolic processes, so treatment involves many therapeutic methods aimed at restoring the links that were involved in the pathological process.
You can not eat high-calorie foods with a high content of cholesterol and fats, it is necessary to limit fructose in the diet along with red meat. To adhere to fatty degeneration of the liver is best Mediterranean-type nutrition, that is, eat more fish, vegetables, and fruits, given their calorie content. Among other things, foods with polyunsaturated fatty acids, antioxidant vitamins C, E and fibers are suitable.
In programs to reduce weight, Mukofalk is used as a fiber food modifier. This drug is almost calorie-free, it consists of dietary soft fibers. Diet therapy can be carried out with the following options:
- A low-fat diet is less than thirty percent of total calories.
- Compliance with a diet low in carbohydrates is less than 60 grams per day.
- Low-calorie nutrition, that is, from 800 to 1500 calories per day.
It is worth noting that the use of very low-calorie nutrition (less than 500 kilocalories) is very dangerous, as this provokes inflammation of the liver along with the proliferation of connective tissue.
Increased physical activity
Patients suffering from fatty degeneration are recommended exercise and walks in the fresh air. For example, we are talking about walking at a moderate pace, swimming with riding a bike is not out of place. Duration of training should be from two to three hours per week. Achieving weight loss and improving the structure of the liver allows you to exercise. By constant physical activity, obesity of all internal organs decreases, insulin resistance decreases along with the accumulation of free fatty acids in the bloodstream.
Treatment will be much more effective if you combine physical activity with a low-calorie diet. Following a diet in combination with exercises three times a week for one hour each has proven to improve liver health by reducing abdominal obesity along with fat cells. It is necessary to achieve regular weight loss by at least one kilogram per week.
Consider the drugs for fatty liver degeneration below.
Drug use
There are no effective medications for the treatment of the disease in question. As part of the treatment of hepatosis and fatty liver degeneration, drugs are prescribed that reduce the degree of obesity, reduce the damage to the gland and contribute to the restoration of insulin resistance:
- For example, patients may be prescribed a weight loss medicine called Orlistat.
- Correction of insulin resistance is carried out using Metformin for patients with type 2 diabetes. The drug "Pioglitazone" is suitable for patients with non-alcoholic steatohepatitis.
- Medications that lower blood pressure are also prescribed.
A key problem in the course of this disease is that the disease increases the risk of the progression of certain deviations in the cardiovascular system. Next, we find out why the deficiency of phospholipids is dangerous.
Phospholipid deficiency in fatty liver
In the event that the human body experiences an excess or deficiency of a particular microelement, mineral or vitamin, it will certainly report this. Deficiency of phospholipids is dangerous with serious consequences. The fact is that an insufficient amount of such lipids can affect the functioning of almost all cells. As a result, fat deficiency can cause disorders in the functioning of the brain (for example, memory worsens) and digestive organs.
Deficiency of these substances will certainly lead to a weakening of the immune system, violate the integrity of the mucous membranes. A lack of phospholipids can also affect the quality of bone tissue, which ultimately leads to arthrosis or arthritis. In addition, dull hair along with dry skin and brittle nails are a signal of a lack of phospholipids in the body.
How to recover from alcohol fatty degeneration of the liver? About this - below.
From alcoholism
Alcoholic degeneration of the liver is the accumulation of fat droplets inside special cells of hepatocytes and between them under the influence of alcoholic beverages. This is the initial, and at the same time the most common format of alcoholic organ disease. Thus, various disorders in the structure and functions of the liver are observed in people, which develop as a result of prolonged intake of alcohol. The toxic effect does not depend on the variety of drinks taken and is determined by the volume of ethanol (i.e. pure alcohol) in them.
Symptoms of alcohol degeneration
The disease can develop gradually and imperceptibly for a person. In most situations, it is detected on the basis of laboratory and instrumental methods of research when the patient consults a doctor for any other reason. As the general condition worsens, the number and severity of symptoms increase in the liver. With prolonged ongoing alcoholic liver degeneration, the following symptoms may appear, combined into several different syndromes (a stable set of symptoms combined by one development):
- Hepatic cell failure syndrome.
- The development of telangiectasia (the appearance of spider veins on the face and body).
- Palmar or plantar erythema in the form of redness of the skin.
Among other things, a general feminization of the appearance for men is possible, when they acquire a part of the outlines and appearance of women:
- The appearance of deposits of fat on the hips, thin limbs and abdomen.
- The presence of scanty hair on the pubis and in the axillary region.
- The development of gynecomastia (i.e. the formation and enlargement of the mammary glands).
- The appearance of testicular atrophy (we are talking about a decrease in the volume of tissues of this organ, a violation of their functions).
- The appearance of impotence (a disorder of erectile and sexual function among men, when there is the impossibility of having normal sexual intercourse).
In addition, the following symptoms may be noted:
- The occurrence of hypertrophy (increase) of the salivary parotid glands (the so-called symptom of a hamster).
- The presence of an expanded capillary network on the face (symptom of dollar bills and a red face).
- The presence of a tendency to bruise.
- The appearance of Dupuytren's contracture (the appearance of a painless subcutaneous cord in the form of a tissue seal in the form of a tourniquet). We are talking about the curvature and shortening of the tendons of the palm, leading to a limitation of functions and deformation.
- The presence of icteric coloration of the skin, oral mucosa and sclera (white membranes of the eyeballs).
- The occurrence of dyspeptic disorders in the form of digestive disorders, for example, a decrease in appetite, combined with rumbling in the abdomen and frequent stools.
- The appearance of pain or heaviness in the right hypochondrium, characterized by low intensity. Such discomfort is usually intermittent and does not cause serious inconvenience to the patient.
It is worth noting that the state of patients with fatty degeneration of the liver significantly improves immediately after stopping alcoholic beverages. Periods of sharp deterioration are directly related to continued consumption of alcohol, which leads to the development of acute alcoholic hepatitis (i.e., inflammation of the liver).
The drug "Siofor"
Means "Siofor" belongs to the group of modern biguanides. It is prescribed for the effective regulation of the volume of concentrated glucose among insulin-dependent patients. This tool is indispensable in the case when proper nutrition in combination with regular exercise does not help in the fight against glycemia, which increases weight. An equally important advantage of the drug in question is its ability to effectively reduce cholesterol, in addition to this they are provided with unique assistance in the process of combating overweight. "Siofor" in case of fatty degeneration of the liver is indispensable.
The drug is one of the most popular hypoglycemic drugs. Its main active ingredient is the substance metformin. The main ingredient of the drug has no effect on the functioning of beta cells in the human body. Due to this, people do not produce excessive amounts of insulin, respectively, hypoglycemia does not form. By taking the described drug, it is possible to achieve the following effects:
- Slowing down the absorption of active glucose within the digestive system.
- Decreasing the rate of glucose production in the liver.
- Significant improvement in overall tissue sensitivity to sugar-containing hormones.
Diffuse hepatosis of the liver
The tissues of a healthy liver are usually homogeneous; multiple blood vessels pass along them along with the bile ducts. Diffuse liver changes are characterized by the fact that in the cells of this organ, namely in hepatocytes, excess fat can settle and accumulate. Normal healthy cells die gradually. The liver becomes heterogeneous, and more often than not, against the background of diffuse infiltration, it undergoes almost all the various changes. There are three types of diffuse hepatosis in case of fatty liver degeneration:
- Focal (when only a small area of the organ is affected).
- Local (for example, in one of the shares).
- Total (the entire organ is usually affected).
Causes of the disease
Diffuse changes in the liver and hepatosis can provoke:
- The effect of malnutrition (when fatty foods and fast food prevail).
- The presence of metabolic disorders in the human body.
- The onset of diabetes along with the disruption of the thyroid gland.
- The onset of obesity and the effects of alcoholism.
- Prolonged use of certain medications, such as antibiotics.
Unfortunately, diffuse hepatosis of this organ is far from always possible to distinguish from chronic inflammatory processes, all the more difficult to determine its cause in order to prescribe the correct treatment. Therefore, in conjunction with laboratory tests and ultrasound, biopsy and computed tomography are prescribed.
How to treat hepatosis of the liver?
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In order to restore hepatocytes, hepatoprotectors are used. Sometimes, in addition to the diet, the doctor prescribes all kinds of biologically active additives to the main diet. In the process of recovery and immediately after it, it is required to constantly monitor the weight, refusing alcohol and smoking, while continuing to adhere to a strict diet. It is important to achieve normalization of the normal functioning of the nervous system, and at the same time improve immunity. All this will certainly help to avoid all kinds of relapses in the future.
Possible complications of this disease
It is worth noting that such a pathology as fatty degeneration can be complicated by the addition of additional inflammatory processes. For example, steatohepatitis, fibrosis or cirrhosis of the liver, cholestasis (bile stasis) are often observed along with the development of organ failure. That is why it is very important to undergo a regular medical examination of your body, and in addition, follow certain preventive measures, which we will consider further.
Prevention of this pathology
The main prevention of this disease consists, first of all, in the patient's complete refusal to drink alcohol. In addition, strict adherence to the diet, maintaining optimal weight, along with maintaining a healthy lifestyle and eliminating bad habits, are equally important.
In cases where such a disease was detected in a person at the initial stage, there is a fairly high probability that it will be possible to achieve a complete cure. In more severe cases, treatment must begin with the fight against the underlying disease, which caused the development of fatty degeneration of this organ.
Thus, patients in any case need a diet with the mandatory exception of alcohol. Obese patients need to lose all excess weight. During drug treatment, it is advisable to prescribe hepatoprotectors along with vitamin therapy, lipotropic drugs, ursodeoxycholic acid preparations, etc.
We examined how the treatment of fatty degeneration of the liver.