Main reasons
- Chronic viral hepatitis B and C
- Alcohol abuse
- Non-alcoholic fatty liver disease associated with obesity and diabetes
- Autoimmune diseases of the liver and biliary tract
- Hereditary storage diseases - hemochromatosis, Wilson's disease
- Long-term drug and toxic load
- Long-term disruption of bile flow
Нередко причин несколько сразу: например, гепатит C в сочетании с лишним весом и алкоголем. Устранение даже одной of них замедляет прогрессирование.
How it manifests itself
At the early (compensated) stage, a person feels satisfactory: fatigue, heaviness in the right hypochondrium, and loss of appetite are possible. With decompensation, signs appear associated with two mechanisms - a decrease in the synthetic function of the liver and portal hypertension, that is, an increase in pressure in the portal vein system.
- Fatigue, weakness, decreased performance
- Yellowness of the skin and sclera
- Enlarged abdomen due to ascites, swelling of the legs
- Spider veins on the skin, redness of the palms
- Bleeding gums, bruises from minor injuries
- Enlarged spleen, decreased platelets in tests
- Sleep disturbances and decreased attention, followed by confusion
Survey
- Биохимия крови: АЛТ, АСТ, билирубин, альбумин, щелочная фосфатаза, ГГТ.
- Коагулограмма и протромбин — печень синтезирует факторы свёртывания, и их снижение отражает тяжесть поражения.
- Общий анализ крови: снижение тромбоцитов — ранний признак портальной гипертензии.
- УЗИ печени и селезёнки с оценкой диаметра воротной вены и наличия свободной жидкости.
- Гастроскопия — выявление варикозно расширенных вен пищевода и желудка.
- Маркёры вирусных гепатитов B и C, при необходимости — аутоиммунные и метаболические тесты.
- МСКТ или МРТ и альфа-фетопротеин — при подозрении на опухолевый узел.
Treatment: two directions
The first and most important thing is the impact on the cause. The second is the prevention and treatment of complications of portal hypertension.
- Antiviral therapy for hepatitis C and control of hepatitis B
- Complete abstinence from alcohol - in case of alcoholism, this is a decisive factor
- Weight loss and diabetes control in fatty liver disease
- Diet with limited salt for ascites, protein control as recommended by a doctor
- Endoscopic ligation of esophageal varices - prevention and control of bleeding
- Splenic artery embolization is an intervention used for hypersplenism and portal hypertension
- Drug therapy for complications: diuretics for ascites, drugs for the prevention of encephalopathy
- For end-stage liver transplantation is discussed
A separate task is regular screening for liver cancer: in case of cirrhosis, it is carried out according to a schedule determined by the doctor, usually with ultrasound and blood tests.
What is strictly forbidden
- Drink alcohol in any dose
- Take painkillers and dietary supplements without consulting your doctor - the liver does not remove them as before
- Ignore black stools or bloody vomit
- Severely limiting protein on your own will worsen nutrition and muscle mass.
- Do “liver cleansing” with herbs and tubages
