In 1819 the inventor of a stethoscope, Frenchman Rene Laennek, for the first time described clinical characteristics of a disease and sounded a name of a mysterious illness - cirrhosis. Today already you will not confuse an illness with anything, the highest diseases of the digestive system mortality (except oncology) is observed among the people having cirrhosis. Are subject to cirrhosis generally people are more senior than forty years, men thus suffer from a disease twice more often than women.
Red, but not freckled
Cirrhosis - deformation of a liver by scarring owing to infectious diseases, intoxications, violation of a metabolism. Mainly suffer from cirrhosis a liver which the illness "paints" in yellowish color (the name from here - in translation from Greek "kirros" means "red", "citreous"), kidneys and lungs.
Cirrhosis - the chronic and progressing pathology which is considered reversible if to diagnose it at an early stage. Hepatocytes, cells of a liver, perish because of local inflammatory process. On their place "dead" sites of connecting fabric which surround the escaped cages are formed. The remained hepatocytes actively share, but cannot execute the work fully because of violation of integrity of structure of body - so there is a liver failure.
Reasons of developing of cirrhosis
By origin allocate cirrhoses:
- as result of a viral disease of a liver (in a risk zone - patients with chronic );
- owing to improper feeding;
- owing to chronic alcoholic intoxication. One of the most important reasons of developing of a disease - more than 40% of the people who are regularly taking in some years inevitably get sick with cirrhosis;
- holestatichesky (differ in strong jaundice and a painful skin itch);
- as continuation of toxic hepatitises;
- the genetically inherited;
- developing against , , a brucellosis;
- owing to autoimmune hepatitis - hyperactive immune activity of an organism which result are inflammatory processes in liver tissues;
- owing to the birth of children without bilious channels;
- owing to damage of a liver long reception of medicines;
- other etiology, in particular, (cryptogene) arising for the unknown reasons.
Craftiness of cirrhosis is expressed in complexity of its diagnostics at the initial stage - the liver is exposed to destructive processes very slowly, for several months and even years. For this period process of destruction of a liver takes place the following stages:
- Compensation. Actually there are only prerequisites to developing of cirrhosis - healthy hepatocytes work with hyperactivity.
- Subcompensation. Disturbing "calls" of an illness - loss in weight, apathy, lack of appetite, discomfort around the right podreberye - for the first time have an effect.
- Decompensation. As result of a liver failure there are a jaundice, a syndrome of portal hypertensia, a hepatic coma. The disease demands vigilant supervision in a hospital - human life is in danger.
Diagnosis of a disease
As the main clinical symptoms of cirrhosis (diagnostics on appearance) are recognized:
- existence of the increased density of a liver and a spleen;
- ascites (stagnation of liquid in an abdominal cavity);
- hepatic "stigmata": vascular tags in the form of asterisks on skin, "hepatic" palms (bright red color of palms), the red brilliant lips, crimson language, hormonal frustration, fingers similar to "drum sticks".
Diagnosis of a disease is defined by the following procedures:
- palpation (palpation) of a liver;
- endoscopy (survey of an internal endoscope);
- computer and magnetic resonance tomography, ultrasonography;
- blood capture for carrying out the biochemical analysis (at cirrhosis the low level of albumine and big percent of iron, enzymes and copper in blood is observed);
- liver biopsy.
Treatment of a disease
Lifelong refusal of alcohol intake - the best start in treatment of cirrhosis. The mode has to be sparing, and physical activity limited. The bed rest is very important (thanks to horizontal situation the liver krovosnabzhatsya actively that promotes acceleration of regenerator processes). To the patient the use of food within a table No. 5 (lack of fried and fat food is appointed. Daily power value on average 2700 kcal). The purpose of such diet – to provide good nutrition of the patient which promotes normalization of activity of a liver and activation of release of bile at the convenient mode for sick body. At observance of a diet in a liver the glycogen collects, the fatty and cholesteric exchange is adjusted, the zhelcheotdeleniye is stimulated.
The basis of treatment of cirrhosis is made by preparations which improve in hepatocytes and normalize membranes of hepatic cells - cocarboxylase, essentsialny phospholipids. At an edematous astsiticheskom a syndrome use of the native concentrated plasma and 20% of solution of albumine is shown. In an active stage of viral cirrhosis appoint application of glucocorticoid hormones. The perspective direction in fight against a disease is transplantation of stem cells.
Transplantation of a liver is an extreme way out when the patient is threatened by a hepatic coma and a lethal outcome. The donor organ can be received from the died person who had a healthy liver, or from the living donor which part of a liver changes to the patient. Such operation is not dangerous to the donor person - owing to the unique regeneration opportunities the liver quickly restores 85% of the initial weight.
Therapy is directed on normalization of work of system of digestion, disposal of intestinal dysbacteriosis, elimination of chronic inflammations in abdominal organs. Also treatment of dispepsichesky frustration, providing good nutrition accompanied by vitamin therapy and fermental preparations which do not contain bilious acids is considered (Pancreatinum, mezy forte).
Patients with an inactive form of cirrhosis do not need special medicamentous therapy, to them rather basic therapy.
General councils sick cirrhosis
Forget about haste - you have to give up all affairs as soon as feel exhaustion. You cannot lift weights which can cause bleedings in a digestive tract.
Watch work of intestines, the good frequency of a chair - not less than 1-2 times per day. The preparation appointed by the doctor with the maintenance of a laktuloza will help to achieve such result (dufalak) which dose fluctuates from three teaspoons to one-two dining rooms per day (it is appointed individually).
Mirsovetov recommends to limit or completely to exclude from the diet salt, especially if there are prerequisites of developing of hypostases and ascites. It is possible to use liquid no more, than one and a half liters per day. Take for the rule every day to measure the weight and volume of a waist at the level of a navel (the increase in parameters is a signal of a liquid delay in an organism).
Pay special attention to the balanced food and the correct day regimen.