Cirrhosis is the end stage of severe liver disease, at which the regeneration of liver structure, replacement of normal tissue by fibrous growths, loss of hepatocytes, causing the liver gradually loses its function. At the same time the most important signs of cirrhosis are involvement in the pathological process of the whole liver tissue, the violation of its lobular structure and portal hypertension.
Cirrhosis can hurt people of any age, most often the disease strikes people between the ages of 35-55 years. Men get sick more often, which is associated with a high degree of cirrhosis of alcoholic origin.
Causes of cirrhosis
Cirrhosis relates to polyetiology diseases, it means that the set of reasons may cause him. The most common cause of cirrhosis include:
- Chronic alcoholism;
- Viral hepatitis, particularly hepatitis C;
- Violation of the outflow of bile from the bile duct (chronic holeostaz);
- Hepatitis non-viral origin (toxic-allergic);
- Chronic intoxication of some chemical substances, including drugs.
In addition, the cause of cirrhosis may be some types of cardiovascular disease, autoimmune processes, metabolic disorders (fatty liver), hemochromatosis, and some other hereditary diseases, as well as specific infections (syphilis, brucellosis, etc.). In addition, there are cirrhosis, the cause of which can not be found.
Types and stages of cirrhosis
Depending on the cause of cirrhosis, it may be a primary, which developed as an independent pathology, or secondary, are a symptom of the common diseases such as diabetes mellitus or syphilis.
Depending on the morphological features distinguish cirrhosis:
- Portal cirrhosis;
- Biliary cirrhosis;
- Postnecrotic cirrhosis;
By activity flow of cirrhosis are active and inactive.
Depending on the type of nodes:
- MKD cirrhosis;
- SKD cirrhosis;
The chronic process distinguish the following stages of cirrhosis:
- The initial stage of cirrhosis, or stage payment. Destruction of vessels and parenchyma mild, beginning inflammatory necrotic process;
- Stage subcompensation. The growth of destructive processes, the gradual replacement of fibrous tissue parenchyma, but at this stage most of cirrhosis of the liver retained by the remaining hepatocytes;
- Decompensation. This end-stage cirrhosis, which is almost complete degeneration of the liver with the loss of its functions.
Symptoms of cirrhosis
Cirrhosis develops long-term, for months or years. Brightness clinical manifestations of cirrhosis depends on the stage and on the degree of activity. Thus the early symptoms of cirrhosis, tended to remain undetected, especially against the existing pathology.
The early signs of cirrhosis include asthenic syndrome: fatigue, malaise, fatigue, difficulty concentrating, loss of appetite. The first drew the attention of the symptoms of cirrhosis are usually the following: yellowness of the skin, itching, redness of the palms, periodic fever, nausea, feeling of heaviness in the upper abdomen, a feeling of fullness after a small amount of food, weight loss, susceptibility to infectious diseases. The characteristic signs of cirrhosis is visible and palpable increase and seal liver, sometimes even to the touch is defined by its dense nodular structure.
Another symptom of cirrhosis is the increase in stomach due to accumulations in the abdominal cavity free fluid (ascites). Increased abdominal noteworthy also because it takes place against the backdrop of significant weight loss.
As the process, joined the symptoms of cirrhosis, caused by portal hypertension. Show through the veins in the body, there are nasal bleeding, hemorrhoids may appear. There is a need to address the question of how to treat hemorrhoids. Signs of cirrhosis in developing stage is turbidity and darkening of the urine, and feces on the contrary, becomes lighter.
Diagnosis of cirrhosis
The diagnosis of cirrhosis is made by anamnesis, studying clinical disease and laboratory data and hardware research. Feature cirrhosis is that the biochemical tests (liver function tests) is pretty long may not show significant deviations from the norm.
The following hardware methods of diagnosis of cirrhosis:
- X-ray examination of the liver;
- Doppler hepatic, portal and splenic veins;
- Radionuclide scanning of the liver;
- Computer or magnetic resonance imaging of the liver;
- Percutaneous liver biopsy.
If in doubt, apply a laparoscopic examination.
Treatment of cirrhosis
Treatment of cirrhosis should be active and urgent, but cirrhotic changes in the liver is irreversible. The goal of treatment is to maintain cirrhosis acceptable quality of life for the patient and the cessation of disease progression.
Treatment of cirrhosis begin with eliminating the main damaging factor, if any, possible (for example, a complete cessation of alcohol intake). Under acute effects needs bed rest, after exercise should be gentle. The fundamental principles of diet therapy is the treatment of cirrhosis and the normalization of life.
Diet in cirrhosis is to restrict protein products, animal proteins are replaced with plant, one or two days a week to be protein-free. Limited use of salt as well as products containing baking soda or baking powder, fatty foods, canned food. Nutrition should be a fraction, small meals 5-6 times a day.
Drug treatment of cirrhosis is the use of drugs to compensate for the removal of the existing disorders and acute decrease in activity of (symptomatic treatment of cirrhosis). When mechanical blockage biliary tract surgical removal of obstacles carry out (stone removal, removal of the stenosis), bleeding from dilated veins in the esophagus and the stomach stage subcompensation also use surgery.
When inactive cirrhosis recommended spa treatment courses, strengthening therapy once or twice a year, as well as regular medical supervision.
Prognosis depends on the stage of cirrhosis, and the activity of the process, as well as on how serious a patient would react to the treatment of cirrhosis and dieting. This discipline and inactivity of the patient, which is removed to catch comparatively early, it is possible for many years to hold the compensation stage cirrhosis. When active in the stage of cirrhosis subcompensation and with decompensated cirrhosis prognosis is poor.