The main signs of diffuse fibrous changes in the liver. Pain under right lower rib on motion. Biliary dyskinesia

Not related to any specific disease; this is a general concept that means disturbances in the structure of tissues or cells and is called differently: fibrosis, hypertrophy, sclerosis, protein degeneration, and so on.

Diffuse changes in the liver mean the process of structural changes in it. This may be dystrophy of liver cells, stagnation in the intrahepatic bile ducts, changes in the density of liver tissue. Reasons for such diffuse changes enough: alcohol abuse, hepatitis, cholecystitis, any virus, medications, atherosclerosis of blood vessels. Treatment is prescribed based on the results of an ultrasound examination and biochemistry analyzes.

Signs of diffuse liver changes

1. Feelings of heaviness in the right precostal space, pain in the same place.
2. Aching pains, accompanied by the patient during the day, constantly and aggravated by jolting driving, running, during physical exertion, eating fatty, fried, spicy foods and subsiding at rest.
3. Absence, nausea, bitter belching, vomiting.
4. Change in the color of the sclera of the eyes and skin from pale yellow to bright yellow. Initially, yellowness of the eyes appears, then the skin color changes.
5. Simultaneously with the previous symptoms, cloudy urine and lightening of the feces occur.
6. An increase in the amount of bile components in the blood and, as a result, the appearance of skin itching.
7. Frequent general weakness, decreased performance, lethargy, fast fatiguability.
8. .
9. Tendency to faint.
10. Hemorrhages on the skin.
11. Violation menstrual cycle in women and impotence in men.
12.Enlargement of the liver in size , found on palpation (the liver sometimes sticks out from under the ribs). Sometimes - enlargement of the spleen.

Diagnosis of diffuse liver changes

At the first stage of diagnosis, the patient gives biochemical analysis blood. At the same time, liver tests are taken for bilirubin, ALT and AST, since various liver functions do not give a homogeneous character of the test results, therefore it is very difficult to identify violations by one analysis. Then the patient undergoes an ultrasound scan of the liver and pancreas.

Enlargement of the liver - hepatomegaly - is noted in cases where the size of this most important organ exceeds the natural, anatomically determined parameters. As physicians point out, this pathology cannot be considered a single liver disease, as it is a symptom characteristic of many diseases, including those affecting other human organs and systems.

The danger of liver enlargement lies in the complications of liver failure and other pathological conditions that disrupt the normal functioning of this organ and create many serious problems with health.

Therefore, such a common pathology as an enlarged liver should be discussed in more detail.

ICD-10 code

R16.0 Hepatomegaly, not elsewhere classified

Causes of liver enlargement

Perhaps the list below, which includes the causes of liver enlargement, is incomplete, but it should also make you realize the true extent of its pathogenesis and get an answer to the question - is liver enlargement dangerous?

So, an increase in the liver in an adult may be the result of:

• excessive alcohol consumption;
• cirrhosis of the liver;
• taking large doses of certain medications, vitamin complexes and dietary supplements;
• infectious diseases (malaria, tularemia, etc.);
• hepatitis viruses A, B, C;
• infectious lesions with enteroviruses, pathogens of intestinal infections, leptospira, Epstein-Barr virus (mononucleosis);
• toxic lesions of the parenchyma with industrial or vegetable poisons;
• fatty hepatosis (fatty degeneration or liver steatosis);
• disorders of copper metabolism in the liver (hepatolenticular degeneration or Wilson's disease);
• violations of iron metabolism in the liver (hemochromatosis);
• inflammation of the intrahepatic bile ducts(cholangitis);
• genetically determined systemic diseases (amyloidosis, hyperlipoproteinemia, glucosylceramide lipidosis, generalized glycogenosis, etc.);
• obliterating endarteritis liver veins;
• liver cancer (hepatocarcinoma, epithelioma or metastatic cancer);
• leukemia;
• diffuse non-Hodgkin's lymphoma;
• education multiple cysts(polycystic).

As a rule, an increase in the share of the liver is observed, moreover, an increase in the right lobe of the liver (which has a higher functional load in the work of the organ) is diagnosed more often than an increase in the left lobe of the liver. However, this is also not good, since the left lobe is so close to the pancreas that it is perhaps this gland that creates the problem.

Simultaneous enlargement of the liver and pancreas is possible with inflammation of the pancreas (pancreatitis). Inflammation is accompanied by intoxication, and the liver is involved in the removal of toxins from the blood. If the course of pancreatitis takes especially severe forms, the liver can not cope with its task and increases in size.

Diffuse enlargement of the liver is a clearly not localized change in the size of its lobules, consisting of hepatocytes (liver cells). For one of the above reasons, hepatocytes begin to die, and glandular tissue gives way to fibrous tissue. The latter continues to grow, thereby increasing (and deforming) certain parts of the organ, squeezing the hepatic veins and creating prerequisites for inflammation and swelling of the parenchyma.

Symptoms of an enlarged liver

A slightly pronounced pathology - an increase in the liver by 1 cm or an increase in the liver by 2 cm - a person may not feel. But the process of changing the natural size of the liver sooner or later begins to manifest itself with more obvious clinical symptoms.

The most typical symptoms of liver enlargement are: weakness and fatigue that patients feel even in the absence of intense exercise; discomfort(heaviness and discomfort) in the abdominal cavity; bouts of nausea; weight loss. Further, heartburn, halitosis (permanent bad smell mouth) skin itching and dyspepsia.

An enlarged liver in hepatitis is accompanied not only by general malaise, but also by yellowness of the skin and sclera, fever, aching in all joints, and nagging pain in the right hypochondrium.

Enlargement of the liver with cirrhosis takes place against the background of the same set of symptoms, which are joined by such signs of this disease: abdominal pain and an increase in its size, a quickly occurring feeling of satiety when eating, increased drowsiness during the day and insomnia at night, bleeding from the nose and bleeding gums, weight loss, hair loss, decreased ability to remember information. In addition to an increase in the liver with cirrhosis (first of both lobes, and then to a greater extent of the left), the size of the spleen in half of the patients also increases, and doctors determine they have hepatosplenomegaly - an increase in the liver and spleen.

In the clinical manifestation of damage to the body by the human immunodeficiency virus, an enlarged liver in HIV is diagnosed at stage 2B - with acute HIV infection without secondary diseases. In addition to enlargement of the liver and spleen, fever, skin rashes and rashes on the mucous membranes of the mouth and throat, swollen lymph nodes, and dyspepsia are noted at this stage.

Fatty liver with liver enlargement

Fatty hepatosis (or steatosis), according to the latest WHO data, affects 25% of adult Europeans and up to 10% of children and adolescents. In Europe, "fatty liver" develops in 90% of heavy drinkers and 94% of obese people. Regardless of the underlying cause of the pathology, fatty hepatosis with an increase in the liver for eight years in 10-12% of patients progresses to cirrhosis. And with concomitant inflammation of the liver tissues - in hepatocellular carcinoma.

Except alcohol intoxication liver and obesity, this disease is associated with impaired glucose tolerance in type II diabetes mellitus and the pathology of the metabolism of cholesterol and other fats (dyslipidemia). In terms of pathophysiology, fatty liver with or without liver enlargement develops due to metabolic damage. fatty acids, which can be caused by an imbalance between energy consumption and energy expenditure. As a result, an abnormal accumulation of lipids, in particular triglycerides, occurs in the liver tissues.

Under the pressure of accumulated fat and the resulting fatty infiltrates, parenchyma cells lose their viability, the size of the liver grows, and the normal functioning of the organ is disrupted.

On the early stages fatty liver may not have obvious symptoms, but over time, patients complain of nausea and increased gas formation in the intestines, as well as heaviness or pain in the hypochondrium on the right.

Liver enlargement in heart failure

The functional interaction of all body systems is so close that an increase in the liver in heart failure is an indicator of a decrease in blood ejection by the right ventricle of the heart and a consequence of circulatory disorders.

At the same time, blood circulation in the vessels of the liver slows down, venous congestion (hemodynamic dysfunction) is formed, and the liver swells, increasing in size. Since heart failure is most often chronic, prolonged oxygen deficiency inevitably leads to the death of some liver cells. Cells grow in their place. connective tissue, forming whole areas that disrupt the liver. These zones increase and thicken, and along with this there is an increase in the liver (most often its left lobe).

In clinical hepatology, this is referred to as hepatocellular necrosis and is diagnosed as cardiac cirrhosis or cardiac fibrosis. And cardiologists in such cases make a diagnosis - cardiogenic ischemic hepatitis, which, in fact, is an enlarged liver in heart failure.

Enlargement of the liver in a child

An enlarged liver in a child has enough reasons. So, it can be syphilis or tuberculosis, generalized cytomegaly or toxoplasmosis, congenital hepatitis or anomalies of the bile ducts.

With this pathogenesis, not only a moderate enlargement of the liver, but also a strong enlargement of the liver with a significant compaction of the parenchyma can be established by the end of the first year of a child's life.

Enlargement of the liver and spleen in infants - the so-called hepatolienal syndrome or hepatosplenomegaly - is the result of congenital elevated blood levels of immunoglobulins (hypergammaglobulinemia). This pathology, in addition to an increase in these organs, manifests itself in a delay general development child, poor appetite and very pale skin. Enlargement of the liver and spleen (with icteric symptoms) occurs in newborns with congenital aplastic anemia, which occurs due to the destruction of red blood cells, as well as due to extramedullary hematopoiesis - when red blood cells are not formed in bone marrow but directly in the liver and spleen.

Fatty hepatosis with an enlarged liver in children in almost half of the cases develops due to a significant excess of age norms of body weight. Although this pathology can occur in some chronic diseases of the gastrointestinal tract, after prolonged use of non-steroidal anti-inflammatory drugs, antibacterial or hormonal therapy.

Diagnosis of liver enlargement

Diagnosis of liver enlargement begins with a physical examination of the patient and palpation of the internal organs of the abdominal cavity to the right of the midline of the abdomen - in the epigastric region.

During a physical examination, the doctor may find a severe enlargement of the liver. What does it mean? This means that the liver protrudes from under the edge of the costal arch much more than is assumed by the anatomical norm (in an adult of average height it is no more than 1.5 cm), and is palpated significantly below the edge of the ribs. Then an increase in the liver by 3 cm, an increase in the liver by 5 cm or an increase in the liver by 6 cm is stated. But the final "verdict" is made only after a comprehensive examination of the patient, primarily with the help of ultrasound.

The enlargement of the liver on ultrasound confirms that there is, for example, “an increase in the liver of a homogeneous hyperechoic structure with an offset to the stomach, the contours are fuzzy” or that “diffuse hyperechogenicity of the liver and fuzziness of the vascular pattern and borders of the liver are revealed.” By the way, in an adult, a healthy liver has the following parameters (on ultrasound): the anterior-posterior size of the right lobe is up to 12.5 cm, the left lobe is up to 7 cm.

In addition to ultrasound examination, in the diagnosis of liver enlargement, the following are used:

• blood test for viral hepatitis (serum markers of viruses);
• biochemical blood test (for amylase and liver enzymes, bilirubin, prothrombin time, etc.);
• urinalysis for bilirubin;
• laboratory studies of the functional reserves of the liver (using biochemical and immunological tests);
• radiography;
• hepatoscintigraphy (radioisotope scan of the liver);
• CT or MRI of the abdomen;
• precision puncture biopsy (if necessary, obtain a sample of liver tissue to check for oncology).

An increase in the lymph nodes of the liver during ultrasound examination is noted by hepatologists with all types of liver cirrhosis, viral hepatitis, tuberculosis of the lymph nodes, lymphogranulomatosis, sarcoidosis, Gaucher disease, drug-induced lymphadenopathy, HIV infection, pancreatic cancer.

Treatment for liver enlargement

The treatment of liver enlargement is the treatment of the symptom, but, by and large, complex therapy a specific disease that led to a pathological change in this organ.

Drug therapy of a hypertrophied liver must be supported by proper nutrition, diet and vitamin intake. According to experts, in some diseases accompanied by an increase in the liver, damaged parenchyma and normal sizes body can be restored.

For the regeneration of liver cells, their normal functioning and protection against negative effects, hepatoprotective drugs are used - special drugs for liver enlargement.

The drug Gepabene - hepatoprotector plant origin(synonyms - Karsil, Levasil, Legalon, Silegon, Silebor, Simepar, Geparsil, Hepatofalk-Planta). The active substances of the drug are obtained from extracts of fumes officinalis (protipin) and fruits of milk thistle (silymarin and silibinin). They stimulate the synthesis of proteins and phospholipids in damaged liver cells, inhibit the formation of fibrous tissue and accelerate the process of parenchyma recovery.

This drug is prescribed for toxic hepatitis, chronic inflammatory liver diseases, disorders of its metabolism and functions with an increase in the liver of various etiologies. It is recommended to take one capsule three times a day (with meals). The minimum course of treatment is three months. Among the contraindications of this drug are acute forms of inflammation of the liver and bile ducts, age up to 18 years. With hemorrhoids and varicose veins, Gepabene is used with caution. During pregnancy and lactation, the drug is used only as prescribed by a doctor and under his control. Possible side effects are laxative and diuretic effects, as well as the appearance of a skin rash. Reception Gepabene is incompatible with the use of alcohol.

The therapeutic effect of Essentiale (Essentiale Forte) is based on the action of phospholipids (complex fat-containing compounds), which are similar in structure to natural phospholipids that are part of human tissue cells, ensuring their division and recovery in case of damage. Phospholipids block the growth of fibrous tissue cells, due to which this drug reduces the risk of developing cirrhosis of the liver. Essentiale is prescribed for liver steatosis, hepatitis, cirrhosis of the liver and its toxic lesions. The standard dose is 1-2 capsules three times a day (with meals). Side effects (in the form of diarrhea) are rare.

The drug Essliver differs from Essentiale by the presence in its composition - along with phospholipids - of vitamins B1, B2, B5, B6 and B12. And the combined hepatoprotective drug Phosphogliv (in capsules), in addition to phospholipids, contains glycyrrhizic acid, which has anti-inflammatory and antioxidant properties. It helps to reduce damage to hepatocyte membranes during inflammation and enlargement of the liver, as well as the normalization of metabolic processes. The method of application and dosage of the last two drugs are similar to Essentiale.

Medicines for liver enlargement include a preparation based on the artichoke plant - Artichol (synonyms - Hofitol, Cynarix, Artichoke extract). This drug helps to improve the condition of liver cells and normalize their functioning. Doctors recommend taking this drug 1-2 tablets three times a day (before meals). The course of treatment lasts from two weeks to a month, depending on the severity of the disease. As side effects, heartburn, diarrhea, pain in the stomach can be observed. And contraindications to its use are obstruction of the urinary tract and bile ducts, gallstones, as well as severe forms of renal and hepatic insufficiency.

In addition to the fact that medicinal plants are the basis of many hepatoprotective drugs, herbs for liver enlargement are widely used in the form of home-made infusions and decoctions. With this pathology, phytotherapists advise using dandelion, corn silk, calendula, sandy immortelle, yarrow, peppermint. Standard Recipe water infusion: for 200-250 ml of boiling water, a tablespoon of dry grass or flowers is taken, brewed with boiling water, infused until cool, filtered and taken 50 ml 3-4 times a day (25-30 minutes before meals).

Diet with an enlarged liver

A strictly observed diet with an enlarged liver is the key to successful treatment. With a hypertrophied liver, it is necessary to completely abandon the use of fatty, fried, smoked and spicy foods, since such food overloads the liver and the entire digestive system.

In addition, a diet with an enlarged liver is incompatible with such food products like legumes, radish, radish, spinach and sorrel; sausage and spicy cheeses; margarine and spreads; white bread and rich pastries; vinegar, mustard and pepper; confectionery with cream, chocolate and ice cream; carbonated drinks and alcohol.

Everything else (especially vegetables and fruits) can be eaten, and at least five times a day, but little by little. After 19 hours, eating is not recommended even with a healthy liver, and even with an enlarged liver, it is absolutely impossible. Here is a glass of water with a spoon natural honey possible and necessary.

The daily diet should contain 100 g of animal proteins, about the same amount of vegetable proteins and 50 g of vegetable fats. The volume of carbohydrate food is 450-500 g, while sugar intake should be reduced to 50-60 g per day, and salt - up to 10-12 g. The daily volume of liquid (excluding liquid food) is at least 1.5 liters.

Prevention of liver enlargement

The best prevention of liver enlargement caused by excess weight or addiction to strong drinks, you yourself understand which one. Here, without following the principles of a healthy lifestyle, nothing will work ...

Unfortunately, it is impossible to predict how the liver will behave and how much it can increase, for example, with hepatitis, mononucleosis, Wilson's disease, hemochromatosis or cholangitis. But even in such cases, rational nutrition, the use of vitamins, physical activity, hardening and giving up bad habits will help the liver cope with cleaning the blood of toxins, producing bile and enzymes, regulating protein carbohydrate and fat metabolism in the body. Also, to help the liver with the threat of hepatomegaly, B vitamins, vitamin E, zinc (to restore liver tissue) and selenium (in order to increase overall immunity and reduce the risk of inflammatory diseases liver).

Liver enlargement prognosis

The prognosis for liver enlargement is rather alarming. Since the pronounced signs of this pathology do not appear immediately, treatment in a third of cases begins when the process reaches the “point of no return”. And the most likely consequences of liver enlargement are partial or complete loss of its functionality.

An increase in the size of the liver is called hepatomegaly. This is not a disease, but a syndrome. Often the spleen is involved in the process. In this case, we are talking about hepatosplenomegaly. These organs increase at a certain rate. With this pathology, the liver is palpated in the epigastric zone, which is not normally observed. In a healthy person, the diameter of the organ is about 20 cm, the left lobe does not exceed 6-8 cm. The size of the right lobe is no more than 12.5 cm. Normally, the width of the liver is 23-27 cm.

The distance from the blunt posterior edge to the sharp anterior one is in the range of 14 to 20 cm. Experienced Doctors should know the size of the common duct of the liver. Normally, its diameter varies from 3 to 5 mm. In healthy people, this organ has a soft texture. It is easy to feel in the hypochondrium. In various diseases, the organ thickens and increases by 5 cm or more. Liver enlargement is detected during ultrasound.

Etiological factors

Experienced physicians know the causes of hepatomegaly. There are the following etiological factors:

• viral hepatitis;
• fatty hepatosis;
• violation of the outflow of bile;
• bacterial infections;
• cirrhosis;
• thrombosis of the hepatic and portal veins;
• Budd-Chiari syndrome;
• amoebiasis;
• Infectious mononucleosis;
• thrombophlebitis;
• cholangitis;
• benign tumors;
• cysts;
• alcoholism;
• drug intoxication;
• amyloidosis;
• autoimmune diseases;
• trauma;
• hemochromatosis;
• acute and chronic heart failure;
• malaria;
• leishmaniasis
• leukemia;
• lymphogranulomatosis;
• hemolytic disease;
• lipid metabolism disorder;
• helminths;
• cholelithiasis.

This is facilitated congenital diseases(TORCH infection), inflammatory pathology and poisoning. In children under 7 years of age, signs of liver enlargement may be normal. The exit of the organ from under the edge of the costal arch by 1-2 cm is allowed. With age, the liver acquires a normal size. In the event that hepatomegaly is combined with other symptoms, this indicates a pathology.

Hepatomegaly in the inflammatory process

Causes of liver enlargement in adults and children include hepatitis. It can be acute, chronic, drug-induced, alcoholic, viral and autoimmune. This disease is characterized by diffuse inflammation of the parenchyma of the organ. The chronic form of hepatitis lasts more than six months. Acute hepatitis develops quickly and is characterized by violent symptoms.

The liver becomes inflamed in hepatitis for several reasons. The following factors are of greatest importance:

• alcoholism;
• non-compliance with the sanitary and hygienic regime in preschool and school institutions;
• the use of contaminated vegetables, fruits, berries and herbs;
• drinking unboiled water;
• transfusion of blood from an infected person;
• sharing utensils with a patient with hepatitis B and C;
• unprotected sex;
• use of non-sterile instruments;
• injecting drug use.

What symptoms are characteristic of hepatitis, not everyone knows. In this disease, hepatomegaly is combined with icterus of the skin and sclera, pain in the right hypochondrium, heaviness, petechial rash, itching, dark urine, bradycardia, weakness, and fever. Symptoms of liver enlargement are nonspecific. You can learn about the state of the liver by the results of ultrasound, tomography and biochemical analysis.

With echinococcosis, the liver can increase significantly. There are few symptoms of this pathology. Along with hepatomegaly, subfebrile temperature is observed, small rash, weight loss, loss of appetite, heaviness in the hypochondrium, diarrhea and nausea with vomiting. The first complaints in a person appear a few months or years after infection.

An increase in the liver by 2 cm or more is possible if a person has heart failure of the right ventricular type. Its consequences can be very dangerous. In the development of this pathology are involved:

• stenosis of the pulmonary artery;
• thromboembolism;
• insufficiency of the tricuspid valve;
• pulmonary valve insufficiency;
• stenosis of the tricuspid valve;
• pericarditis.

You can understand that the liver is enlarged by a number of symptoms. They include swelling of the legs, pain in the right hypochondrium, bulging of the veins in the neck, shortness of breath, cyanosis of the skin, increased venous pressure and pain in the heart. In chronic heart failure, a decrease in diuresis and an increase in the abdomen are possible. Palpation is determined by the expansion of the boundaries of the liver and cardiac dullness. The legs of such patients swell. Why the liver is enlarged with right ventricular failure, what this means, is not known to everyone. It is based on stagnation of blood in the pulmonary circulation.

Hepatomegaly with alcohol

If the liver is enlarged, then alcohol abuse may be the cause. Alcohol causes hepatosis (fatty degeneration of the organ) and hepatitis. Diffuse inflammation develops 5-7 years after the start of regular ethanol use. The disease threatens dangerous consequences up to cirrhosis.

The prognosis is not always favorable. Hepatomegaly is most often detected with icteric form alcoholic hepatitis. It is associated with diarrhoea, nausea, pain, emaciation, jaundice, fever, and tenderness of the right abdomen. On palpation, the liver is greatly enlarged. In the absence of cirrhosis, it is smooth.

With an increase in the liver against the background of fatty hepatosis, a person looks healthy. Symptoms are poor. Very often, the disease is discovered by chance. Severe damage rarely develops. Hepatomegaly can be detected on ultrasound. Symptoms include aching pain in the hypochondrium on the right, discomfort and asthenia.

Patient examination plan

With an enlarged liver, treatment is carried out after a comprehensive examination. Hepatomegaly can only be determined by instrumental methods or by palpation of the abdomen. The following studies are required:

• general blood analysis;
• biochemical analysis;
• blood analysis;
• polymerase chain reaction;
• virological research;
• puncture biopsy;
• radioisotope scanning;
• CT scan;
• dopplerography;
• bioassays;
• coagulogram;
• immunological research.

An experienced doctor understands how to deliver correct diagnosis. Low concentration of prothrombin and albumin, increased alkaline phosphatase and gamma globulins, indication of alcoholism, parenchymal heterogeneity, increased width portal vein These are all signs of cirrhosis. The detection of circulating immune complexes in the patient's body indicates an autoimmune origin of hepatomegaly.

How to heal the sick

Treatment for liver enlargement is determined by the underlying disease. The drugs are selected by the doctor. The main aspects of therapy are:

• dieting;
• the use of antiviral drugs;
• increasing the resistance of hepatocytes to the effects of adverse factors.

Treatment of viral hepatitis A in an adult involves bed rest, proper nutrition, plenty of fluids, avoidance of alcohol, the use of antispasmodics and lactulose preparations. Sometimes cholagogues are prescribed. Patients are shown diet number 5. The causes and treatment of hepatomegaly are directly related.

If an increase in the organ is due to hepatitis B, then detoxification therapy is performed. sorbents are used. Antiviral drugs and alpha-interferon are prescribed. AT terminal stage it is impossible to shrink the liver. An organ transplant is required.

What to do if the liver has increased against the background of cirrhosis, not everyone knows. In this situation, a strict diet is prescribed. With the development of complications, you need to reduce protein intake. Many drugs are contraindicated. According to indications, Dufalac or Normase is prescribed. Hepatoprotectors are used (Heptral, Essentiale Forte, Hepamerz). Phytopreparations are often prescribed (Liv-52) and homeopathic remedies(Galsten). With an enlarged liver and spleen against the background of mononucleosis, antiviral drugs (Arbidol, Valtrex, Acyclovir Forte), as well as immunomodulators, are prescribed.

Isoprinosine is often used. If the liver is swollen and there are signs of a secondary infection, then antibiotics are prescribed. Methods of treatment of alcoholic hepatitis are diet, avoidance of alcohol, intake of cholagogues, inhibitors of tissue proteinases and hepatoprotectors. If the organ has increased by 3 cm, then surgery may be required. It is necessary for the formation of cysts and abscesses.

How to prevent hepatomegaly

You need to know not only why a person has an enlarged liver, what to do with hepatomegaly, but also how to prevent this condition. For this you need:

• do not drink alcohol;
• drink only boiled water;
• wash hands before eating;
• wash vegetables and fruits;
• refuse to visit tattoo parlors;
• use sterile instruments for medical procedures;
• eat well;
• lead a healthy lifestyle;
• treat chronic diseases;
• avoid contact with chemicals.

If the underlying disease is not cured, then complications in the form of liver failure are possible.

hepatit.care

The reasons

Factors that lead to hepatomegaly can be divided into several groups:

Inflammatory diseases:

• viral hepatitis;
• infectious diseases.

Volumetric formations:

• cyst;
• benign tumors;
• hemangiomas;
• carcinomas.

Exchange disorders

• hemochromatosis;
• pathology of fat metabolism (steatosis);

Toxic damage:

• alcohol;
• medications, including Reye's syndrome;
• hepatotropic poisons;

Bile flow disorders:

• cholestatic hepatosis;
• cholelithiasis;
• cholecystitis.

Hereditary metabolic diseases:

• Wilson's disease;
• Nimmann-Pick disease.

Helminthiases.

Diseases of the cardiovascular system:

• heart failure;
• hepatic vein thrombosis.

Sarcoidosis.

The mechanism of liver enlargement

Pathological processes in the liver are associated with the death of hepatocytes. Hepatitis viruses have a direct cytolytic effect (complete destruction of the cell) or cytopathic (damage to intracellular organelles). The immune system reacts by activating macrophages, leukocytes and specific antibodies. Their actions directed at viruses cause damage to their own cells.

Damage from toxic substances develop either from their direct effect on cells with the development of necrosis, or after undergoing biotransformation, when more toxic substances are formed. For example, in the case of ethanol, acetaldehyde is formed.

Any damage is accompanied inflammatory reaction, edema develops. The liver increases in size. In areas of necrosis, macrophages begin their work, fibrous tissue is synthesized. Gradually areas of fibrosis increase. cirrhosis develops.

When fat metabolism is disturbed, droplets of fat accumulate in the liver cells. Gradually, the number of damaged hepatocytes increases. And this leads to an increase in the size of the liver.

Liver enlargement in young children

In children under one year old, the liver is richly supplied with blood. Therefore, any impact on it causes an increase in size. These can be infectious effects, blood flow disorders, exposure to toxins, tumors, injuries. In children under one year, the severity of other symptoms is insignificant, so it is not always possible to suspect hepatomegaly. Small child can not always explain his complaints of pain in the hypochondrium. Therefore, hepatomegaly is either an accidental finding, or is detected after the addition of symptoms such as vomiting, the appearance of jaundice.

Hepatomegaly is typical for children with 2 and 3 degrees of rickets. Liver enlargement is triggered by a complex mechanism of calcium malabsorption resulting in activation of alkaline phosphatase.

Fatty hepatosis

A disease that develops against the background of alcohol abuse or diabetes mellitus, obesity. Violation of lipid metabolism leads to a delay in the liver cells of fats, their accumulation in the form of drops gradually leads to a breakthrough of the membrane and the release of fatty contents. The work of the liver is disrupted, which is manifested by typical symptoms - fatigue, dyspepsia, stool disorders.

Heart failure

The appearance of disorders in the work of the heart leads to the development of heart failure, which means that the release of blood decreases and the blood flow drops. In the vessels of the liver, blood flow slows down, it stagnates in the veins. Plasma sweats into the liver tissue, edema develops and the organ increases in size.

Chronic heart failure leads to hypoxia of the liver tissue, it appears foci of cell death - necrosis. Dead hepatocytes are replaced fibrous tissue. Cirrhosis develops over time

Enlarged lymph nodes

Sometimes there is a primary increase not in the liver itself, but in the lymph nodes located at the gates of the liver. Initially, hepatomegaly becomes noticeable, but during the examination it turns out that the main reason is an increase in lymph nodes.

This may be accompanied by additional symptoms - sweating, weight loss, soreness in the corresponding area, a slight rise in temperature. The reason for this increase is infectious viral, bacterial, fungal infections, tumor metastases.

Hepatomegaly after exercise

Prolonged exposure to an inadequate force load leads to the development of pain syndrome. The mechanism of pain is associated with a violation of the outflow of blood and with excessive stretching of the liver capsule, which causes pain. All athletes are affected by this condition.

Symptoms

A slight increase in the liver is not accompanied by overstretching of its capsule. Therefore, subjective sensations do not arise. Gradually, the process of resizing will manifest itself with other symptoms.

There is weakness, increased fatigue. Discomfort in the hypochondrium is replaced by a feeling of fullness, and then a distinct dull pain. Some are concerned about dyspeptic symptoms - nausea, vomiting, bad breath, heartburn. Digestive disorders indicate serious pathology liver, this is manifested by bloating, flatulence, constipation and diarrhea. Symptoms of intoxication join - fever, malaise, headache.

In some cases, itching appears, which is caused by deposition and free circulation in the blood bile acids. If this is accompanied by a violation of bilirubin metabolism, then jaundice develops. Its cause may be in increased hemolysis of red blood cells, damage to the liver itself, and impaired bile outflow.

Effects

An increase in the liver associated with an inflammatory response to an infection disappears without a trace if there is no gross damage and there is no degeneration into fibrosis and cirrhosis. Severe diseases accompanied by hepatomegaly can provoke the development of liver failure.

Diagnostics

Establishing the fact of an enlarged liver does not give an idea of ​​the cause of this condition. To do this, you need to conduct an in-depth diagnosis.

At the first visit to the patient, an anamnesis is carefully collected, all complaints are clarified. Pay attention to the following issues:

• how long ago the malaise, pain appeared;
• whether there are dyspeptic disorders;
• the relationship of the onset of symptoms with food intake, the use of certain foods;
• what digestive disorders have appeared recently;
• worried about itchy skin;
• whether the color of feces, urine, skin changed;

Next, proceed to inspection. It is possible to determine violations of fat metabolism by the general physique. The veins of the anterior abdominal wall can bulge, forming a bizarre plexus - the "head of a jellyfish." This condition develops with portal hypertension. Also, this condition is characterized by the development of ascites and edema of the whole body.

Pay attention to hemorrhages in the skin. Their presence indicates violations in the coagulation system. Skin color is important for establishing a violation of bilirubin metabolism. The patient is asked to show the tongue - often it is lined with a yellow coating.

After examination, the doctor performs palpation. In the supine position, the liver is palpated through the anterior abdominal wall. Normally, its edge is hidden behind the costal arch. But with an increase, it will protrude from under them. Palpation determines the consistency, soreness, the edge of the liver, the presence of separate large formations.

Laboratory diagnostics

Examination of blood and urine helps to suggest the cause of hepatomegaly. In the general blood test, there may be a sign of inflammation - an increase in the number of leukocytes, a shift leukocyte formula to the left. Some conditions are characterized by a decrease in platelets. If the cause of hepatomegaly was hemolysis, then in the blood it will manifest itself as anemia and a decrease in the number of red blood cells.

A general urine test will reflect the condition of the kidneys. A change in its color to a darker one indicates a violation of bilirubin metabolism.

A biochemical blood test reflects the degree of liver damage. Perhaps the development of cytolysis syndrome - the destruction of hepatocytes under the influence of a damaging factor. It is characterized by an increase in ALT, AST, GGTP, LDH, bilirubin due to two fractions. Cholestasis in the analyzes is characterized by an increase in alkaline phosphatase, GGTP, 5-nucleotidase, and a decrease in the content of fat-soluble vitamins.

Hepatocellular insufficiency is manifested by a decrease in the content of albumins, proteins, an increase in bilirubin. Portal hypertension is accompanied by thrombocytopenia, anemia and leukopenia.

Ultrasound of the liver

This is a painless public method that allows you to determine the size of the liver, the state of its parenchyma, the presence of volumetric formations, and blood flow. A big plus is the absence of radiation exposure, so it can be used in young children and pregnant women.

To obtain the most reliable result, you must pass special training, the purpose of which is to reduce the amount of gases in the intestines. 2-3 days before the study, it is necessary to refuse food that contributes to increased gas formation. These are legumes, bread and milk, sweets. If there is constipation, mild laxatives such as lactulose syrup are recommended.

Ultrasound is performed on an empty stomach, 8-10 hours after eating. But for emergency indications, you can conduct a study at any time.

During the study, the size of the liver, its deviation from the norm, is determined. Heterogeneity of the parenchyma, a decrease in echogenicity, depletion of the vascular pattern, together with an increase in the liver, indicate an inflammatory process. Nodes of regeneration, tuberosity, changes in the vascular pattern and signs of portal hypertension are signs of cirrhosis.

X-ray of the liver

Methods of X-ray examination are very diverse. Plain radiography allows you to determine the size of the organ, its location relative to neighboring ones, the presence of various inclusions, cysts, calcifications.

The use of vascular contrasting reveals a picture of changes in the blood flow of the organ, allows you to see the places of narrowing or thrombosis, violations of the vascular pattern.

Computed tomography is a series of layered x-rays. They clearly show the size of the organ, the change in its shape, the condition of the bile ducts, the presence of volumetric formations - cysts, abscesses, tumors.

Liver biopsy

Examination of liver tissues is necessary in the presence of a tumor (except for hemangioma), cirrhosis. This method allows you to determine the histological structure of the tissue, the characteristics of the cells. For biopsy for cirrhosis, it is important to determine inflammatory process and the degree of fibrosis, to determine the tactics of treatment or to monitor the effectiveness of the therapy.

A biopsy of cysts is also carried out for therapeutic purposes - drainage is established through which it is possible to administer medication and wash the cyst cavity.

Treatment

The choice of treatment depends on the cause of the liver enlargement.

Infectious viral hepatitis requires etiological treatment. Botkin's disease has no specific treatment, supportive therapy and diet are used. Viruses of other types are treated with the use of special preparations of interferons. Hepatoprotectors, vitamins are also used.

Patients with severe toxic liver damage are treated in toxicology or intensive care units. Detoxification methods are used with the use of drop solutions, hepatoprotectors. Poisoning with some hepatropic poisons requires the introduction of an antidote.

Hepatomegaly caused by a violation of the outflow of bile is treated depending on the condition. Calculous cholecystitis, which has led to blockage of the duct by a stone and is accompanied by an attack of hepatic colic, requires an emergency surgical treatment. Acalculous cholecystitis is an infectious inflammation that requires antibiotics to treat.

If the cause of the liver enlargement is a heart pathology, then the treatment is aimed at eliminating the underlying cause. Treatment of heart pathology is carried out by a therapist together with a cardiologist, it is possible that a consultation with a vascular surgeon and further surgical elimination of heart pathology will be required.

Liver tumors and metastases are treated according to the degree of spread. Surgical removal of the affected lobe of the liver if present limited education adjacent lymph nodes. Surgical treatment supported by chemotherapy and radiation treatment. Efficiency depends on the stage at which the tumor was detected, its sensitivity to drugs for treatment.

It is possible to use such a method as embolization of the vessels that feed the tumor. For this, endoscopic blockage of the vessel is performed, which has the main function of maintaining it. The result is necrosis pathological tissue and cure.

Some severe toxic or diffuse liver lesions can only be cured by an organ transplant. The liver has good regenerative abilities and can recover from a small fragment. For transplantation, you can use a part of an organ of a close relative that is compatible in several ways, for example, blood type, antigenic structure.

Hepatomegaly resulting from cirrhosis requires lifelong treatment. It is aimed at slowing the progression of the disease and improving the patient's quality of life. Cirrhosis can be radically cured only with a liver transplant. The remaining methods are aimed at maintaining the function of the organ. Various groups of heptoprotectors are used - essential phospholipids, ursodeoxycholic acid, plant extracts. They have the ability to restore cell membranes, have a protective effect, regulate metabolism in liver cells. For antioxidant protection and regulation of metabolic processes, vitamin complexes and amino acids are prescribed.

The development of ascites - adverse symptom for which diuretics are used. Be sure to follow the daily routine and special nutrition.

Diet

For patients with liver pathology, diet No. 5 according to Pevzner is prescribed. Its main principles are sparing food and fractional nutrition sufficient in terms of calories and nutrient content. Alcohol, fried foods, fatty foods are strictly prohibited. great content salt. Marinades and preserves of industrial and home production, sauces (mayonnaise, ketchup) contain a lot of sugar and salt, vinegar, which irritates the digestive system.

Smoked meats, sausages contain a lot of preservatives and hidden fats, so they are also banned. Legumes, vegetables with coarse fiber during periods of exacerbation of the disease are also not recommended. Mushrooms, nuts are coarse and heavy food. You can not eat very hot and cold dishes. This also applies to ice cream. Give preference to cooking methods such as boiling, stewing, baking.

Permitted foods include cereals, vegetables in any form, fruits. You can cook lean meat - beef, chicken, turkey, rabbit. Choose from fish too lean varieties. Milk and dairy products should be low fat. Sweets and yeast baking from white flour as much as possible to limit.

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What does an enlarged liver mean?

An enlarged liver is not a disease, but a symptom of a liver problem. In medicine, this phenomenon is called hepatomegaly and means that the liver ceases to perform its functions. Hepatomegaly, if left untreated, can lead to the development of a fatal disease - liver failure. To detect an enlarged liver, a simple medical examination is sufficient.

To identify the causes, more thorough research and analysis will be required:

Ultrasound or tomography to accurately determine the size of the liver and assess the general condition.

MRI - will accurately show the condition of the bile ducts.

Blood tests. Necessary for examination of liver enzymes, the presence of viral infections and other disorders.

Biopsy. This study is prescribed for suspected cancer or fatty disease.

Causes of liver enlargement

Liver diseases:

• Fatty hepatosis ( a large number of fat cells in the liver).

  Cholestatic hepatosis (impaired flow of bile)

  Hepatitis

  Viral or bacterial infections

Hereditary diseases associated with metabolic disorders

Diseases associated with circulatory disorders:

• Heart failure

  Blockage of the hepatic veins

Exchange disorders:

• Hemochromatosis

  Fat Metabolism Disorders

The appearance of neoplasms:

• benign tumors

  Cancer tumors

Exposure to toxins:

• Alcohol defeat

  drug lesion

Cholelithiasis

Defeat by helminths

An enlarged liver can be determined independently when the following symptoms appear:

Feeling of discomfort in the right hypochondrium, a feeling of heaviness

Dyspeptic disorders - nausea, heartburn, stool changes, belching, accompanied by an unpleasant odor.

Change in the color of the skin - jaundice, characteristic of hepatomegaly.

Changes in behavior - nervousness, irritability, drowsiness or insomnia.

Since the above signs may indicate other disorders in the body, for an accurate diagnosis, you need to contact a specialist. There is no need to delay the visit to the doctor - timely measures taken will help to avoid serious consequences.

Enlarged liver in a child

In infants, liver enlargement may be associated with neonatal jaundice. She does not need treatment, as it passes within a month. The causes of this condition can be birth trauma, diabetes and other disorders in work. endocrine system at mother.

In a child under the age of 7, hepatomegaly is quite normal physiological phenomenon. It is considered normal if the baby's liver slightly protrudes beyond the edges of the ribs (by 1–2 cm). As the child grows, the liver becomes normal in size. In any case, the doctor will most accurately determine whether the child needs treatment.

In children, an enlarged liver may indicate the following diseases:

Inflammatory processes in the body.

Congenital TORCH infections

Damage to the liver by toxins or drugs.

Pathology of metabolism

Disorders of the biliary tract, blockage of the bile ducts

Metastases or tumors

A cause for concern is an enlarged liver in children in combination with other "danger signals": fever, venous network on the abdomen, vomiting, skin rashes, weight loss, loss of appetite, yellowness of the mucous membranes. When these signs appear, the pediatrician prescribes a consultation with a hepatologist, infectious disease specialist, gastroenterologist. To identify exact reason liver enlargement requires a number of tests and ultrasound.

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Diet with an enlarged liver

A properly organized diet will help the liver cope with hepatomegaly. Diet with an increase in the liver excludes spicy, salty, fatty foods. The diet must contain proteins, vitamins, minerals and fiber. Food should be ingested in small portions so as not to overload the diseased liver. Fractional meals (6-7 times a day) are recommended for better digestion. Read more about what you can eat and what you can not with liver diseases.

Sample menu for liver enlargement for a week

Monday.

1 reception - Milk rice porridge without the addition of butter and sugar, green tea with honey or rosehip broth.

2 reception - A glass of freshly squeezed apple juice, oatmeal cookies

3 reception - Boiled river fish

4 reception - Boiled carrots, grated

5 reception - Steamed vegetable dish (without salt and spices)

6 reception - Fresh fruit

Tuesday

1 meal - Omelette from one egg (without yolk), rosehip broth or green tea, diet biscuit cookies

2 reception - Dried fruits (dried apricots, prunes, raisins), previously filled with boiling water.

4 reception - Freshly squeezed carrot juice, oatmeal cookies

5 reception - Low-fat cottage cheese

6 reception - Salad of greens and cucumbers

Wednesday

1 reception - Low-fat kefir or cottage cheese

2 reception - Rosehip broth with honey, oatmeal cookies

3 reception - Steam meatballs

4 reception - Pumpkin puree, herbal tea

5 reception - Baked cheesecakes with the addition of dried fruits

Meal 6 - Freshly squeezed fruit juice, oatmeal cookies

Thursday

1 meal - Oatmeal with milk, green tea with honey and lemon

2 reception - Compote with dried fruits, diet biscuit cookies

3 reception - Steamed river fish, bran bread

Meal 4 - Fresh fruit juice, oatmeal cookies

5 reception - Vegetable casserole, bran bread

6 reception - Herbal tea

Friday

1 reception - Boiled pasta in a small amount

2 reception - A glass of freshly squeezed apple juice, biscuit cookies

3 reception - Dietary buckwheat soup, bran bread

4 reception - Dried fruits soaked in boiling water

5 reception - Milk porridge, diet biscuit cookies

6 reception - Green tea with honey, oatmeal cookies

Saturday

1 meal - Buckwheat porridge boiled in water without salt and sugar, herbal tea

2 reception - Fruit platter

3rd reception - Veal or chicken broth, bran bread

4 reception - Salad of sauerkraut

5 reception - Marshmallow or fruit marmalade

Sunday

1 meal - Cheesecakes with dried fruits cooked in the oven, green tea with honey and lemon

2 reception - Fruit or vegetable juice, biscuit biscuits

3 reception - Veal or turkey, boiled and mashed with the addition of boiled carrots or pumpkin

4 reception - Rosehip broth, bran bread

5 reception - Kefir or cottage cheese, oatmeal cookies

6 reception - Salad of fruits or vegetables

It is also necessary to observe equal intervals of time between meals. Any diet must be discussed with a doctor who will give everything necessary recommendations. With an enlarged liver, nutrition should be optimally balanced. Therefore, it is periodically necessary to adjust and diversify the diet. With a strong increase in the liver, fruit and vegetable juices it is desirable to dilute with boiled water in a ratio of 1:1. Alcohol, coffee, chocolate, confectionery, salt, pepper, vinegar are the main enemies of the liver. For any liver disease, legumes in any form, nuts, carbonated drinks are contraindicated.

Sometimes this symptom is not a sign of a pathological process, for example, with excessive physical exertion. If a feeling of heaviness in the right hypochondrium is observed constantly and there are additional symptoms, you should consult a doctor for qualified medical help. Self-medication or ignoring the symptoms is unacceptable.

Etiology

Heaviness in the right hypochondrium may be present in the clinical picture of the following pathological processes:

In addition, heaviness under the right rib can be triggered by external negative factors:

• hypothermia;
• excessive physical activity;
• malnutrition - the manifestation of this symptom is likely after a heavy meal;
• severe injury.

If the heaviness in the right hypochondrium is not due to a pathological process, then the symptom disappears when the provoking factor is eliminated. However, it must be understood that prolonged exposure some causes can lead to the development of diseases with this symptom.

Symptoms

If the heaviness and pain in the right hypochondrium is not justified by the pathological process, then additional symptoms are usually absent.

In gastroenterological diseases, heaviness in the right hypochondrium may be accompanied by the following symptoms:

• bloating;
• change in the frequency and consistency of stools, feces may be watery, contain particles undigested food. Attacks of diarrhea can be up to 10 times a day;
• loss of appetite;
• rumbling in the stomach, flatulence;
• heartburn, belching with an unpleasant odor.

In liver diseases, heaviness and pain in the right hypochondrium in front are accompanied by such signs:

Often, heaviness in the right hypochondrium can be a sign of the onset of the inflammatory process of the appendix, which manifests itself in the form of the following clinical picture:

• nausea with vomiting;
• increased, as the pathological process worsens, heat body;
• sharp, cramping pain in the abdomen;
• profuse sweating;
• increased blood pressure.

This human condition is characterized high risk lethal outcome.

If the cause of the development of this symptom is lumbar osteochondrosis, then heaviness in the right hypochondrium is almost always accompanied by pain and such symptoms:

As the pathological process worsens, the clinical picture may be accompanied by symptoms. hepatic colic. Heaviness in the right hypochondrium is permanent, which increases with minimal physical exertion.

If this symptom is a manifestation of cardiovascular pathologies, then the manifestation of such specific signs is likely:

• dyspnea;
• heaviness in the hypochondrium, which is accompanied by pain;
• unstable blood pressure;
• feeling of tightness in the chest area;
• nausea, rarely with bouts of vomiting;
• increased sweating.

The presence of any of the above clinical pictures requires immediate medical attention, as timely diagnosis significantly increases the effectiveness of treatment and the chances of a full recovery. Self-medication is unacceptable.

Diagnostics

In order to establish the cause of the manifestation of such a symptom, it is necessary to conduct an examination of the patient, which includes laboratory and instrumental methods. Preliminary physical examination with palpation painful area, collection of complaints, anamnesis of illness and life.

Laboratory diagnostic methods include:

• general clinical analysis of blood, urine and feces;
• blood chemistry;
• liver tests;
• tests for the presence of viral hepatitis;
• fecal analysis for occult blood and etc.

Instrumental diagnostic methods for this symptom include:

• Ultrasound of the abdominal organs;
• CT and MRI;
• x-ray of the stomach with a contrast agent;
• coprogram;
• gastroduodenography;
• cholecystopancreatography;
• microscopic examination of a liver biopsy.

Based on the results of the examination, the etiology of this symptom is established and the optimal treatment tactics is chosen.

Treatment

Basic therapy will depend on the underlying factor. Medical treatment may include taking the following medications:

• antispasmodics;
• painkillers;
• non-steroidal anti-inflammatory;
• hepatoprotectors;
• to improve gastric motility;
• probiotics;
• vitamin and mineral complexes.

Be sure to follow a sparing diet, which implies the complete exclusion of fatty, fried foods, alcohol. The patient's diet should be frequent, but in small portions, with an interval between meals of 2-3 hours. In chronic diseases, dieting should be constant, even in the stage of persistent remission.

Prevention

For prevention, the following recommendations should be followed:

• eat properly balanced;
• undergo annual preventive medical examination;
• treat all diseases in a timely manner.

Thus, it is possible, if not to exclude, then to minimize the risk of developing diseases with this symptom in the clinical picture.

"Heaviness in the right hypochondrium" is observed in diseases:

Aortic insufficiency is a pathological process in the heart, which is characterized by incomplete occlusion of the aortic opening by the leaflets of the mitral valve. This means that a gap is formed between them, which, in turn, leads to overflow of the left ventricle with blood. It stretches, which makes it worse to perform its functions. This disease is the second most common heart disease and is often accompanied by narrowing of the aorta. Aortic valve insufficiency is more commonly diagnosed in males than in females. Depending on the factors of occurrence, this disorder can be primary and secondary. That is why development factors are congenital pathologies or past illnesses.

Autoimmune hepatitis is a pathological lesion of the main hematopoietic organ, the liver, which has unclear etiology and leads to the destruction of liver cells with the subsequent development of liver failure. Among all hepatic pathologies, autoimmune hepatitis occupies about 25%, and both children and adults suffer from it. Women are affected by this pathology 8 times more often than men.

Biliary cirrhosis is a pathology of the liver that occurs as a result of a long-term violation of the outflow of bile due to cholestasis or damage to the biliary tract. This is a process of chronic inflammation that has an autoimmune origin. Pathology is secondary and primary. It should be noted that primary biliary cirrhosis of the liver is observed predominantly in people with this pathology.

Viral hepatitis B - viral disease inflammatory nature, which affects mainly the liver tissue. After a person recovers from this disease, he develops a strong lifelong immunity. But the transition of an acute form of hepatitis B into a chronic progressive one is possible. It is also possible that the carrier of the virus.

Hepatosplenomegaly - pathological condition, which is characterized by a simultaneous increase in the spleen and liver. These two organs are closely connected to each other by lymphatic pathways, nerves (common innervation), and they are also connected to the portal vein system. This condition can develop in both children and adults. It also has no gender restrictions.

Cholelithiasis, which is also commonly defined as cholelithiasis or cholelithiasis is a disease in which stones form in the gallbladder or in the bile ducts. Cholelithiasis, the symptoms of which are observed in patients, as shown by the results of medical practice, is ineffective in treatment with the use of conservative therapy and various types of techniques, therefore the only way to cure the disease is surgery.

Calculous cholecystitis is one of the manifestations of cholelithiasis, in which deposits of stones appear in the affected organ. The disease does not manifest itself for a long time, but during the period of exacerbation, when one or more stones begin to move along the duct, and sometimes completely clog it, symptoms of biliary colic appear. Most often, people with this pathology are prescribed surgery and the most preferred option for surgery is laparoscopic.

Gallbladder stones form due to metabolic problems in the body. They are the cause of the occurrence of GSD. Calculi formed in the organ can be located anywhere - both in the bladder itself and in its ducts, and even in the liver, while their shape and size vary from very small (sand) to very large.

Leukemia (syn. leukemia, lymphosarcoma or blood cancer) is a group of tumor diseases with characteristic uncontrolled growth and various etiologies. Leukemia, the symptoms of which are determined based on its specific form, proceeds with the gradual replacement of normal cells with leukemic cells, against which serious complications develop (bleeding, anemia, etc.).

Drug-induced hepatitis is an inflammatory process in the liver, provoked by certain medications. If the treatment of the disease is not started in a timely manner, then the onset of necrotic processes in the affected organ and cirrhosis is quite possible. In advanced stages, death is no exception. According to statistics, drug-induced hepatitis is three times more likely to be diagnosed in women than in men. This circumstance has no scientific explanation yet.

Lymphoma is not one specific disease. This is a whole group of hematological ailments that seriously affect the lymphatic tissue. Since this type of tissue is located in almost the entire human body, a malignant pathology can form in any area. Even internal organs may be damaged.

Waldenström's macroglobulinemia (syn. primary macroglobulinemia, macroglobulinemic reticulosis) is an extremely rare disease in which a tumor is formed in the bone marrow, consisting of lymphocytic and plasmacytic cells.

Mitral valve insufficiency is a secondary heart disease characterized by incomplete closure leaflets, due to which there is a reverse flow of blood from the left ventricle to the left atrium. In this case, the volume of blood increases, which leads to a thickening of the valve itself (hypertrophy). At the same time, the fibrous ring is stretched and, as a result, weakens. A similar process occurs in the left ventricle, causing it to receive too much blood.

A disease that is characterized by a violation of the integrity of the liver tissues due to their acute or chronic damage is called liver failure. This disease is considered complex, due to the fact that after liver damage, a violation occurs metabolic processes. If you do not take appropriate measures to cure the disease, then under certain conditions, liver failure can quickly and rapidly develop and lead to death.

Heart defects are anomalies and deformations of individual functional parts of the heart: valves, septa, openings between vessels and chambers. Due to their improper functioning, blood circulation is disturbed, and the heart ceases to fully fulfill its function. main function- supply of oxygen to all organs and tissues.

The pancreas is a unique multifunctional organ in its essence, at the same time it also acts as the only gland in our body in which its endocrine and exocrine functions are performed. Pancreatic cancer, the symptoms of which are manifested due to damage to the tissues of the gland by a malignant tumor, ranks sixth among the most common cancers.

Reactive hepatitis is a pathological process that leads to dystrophic-inflammatory processes in the liver. Most often, such a disease develops against the background of gastroenterological ailments of a chronic nature, systemic and other diseases. It should be noted that nonspecific reactive hepatitis, in contrast to viral, toxic and other forms of this disease, responds well to treatment.

Liver steatosis is a pathological process that is associated with the accumulation of fats in the cells of this organ. The disease can be both independent and can develop against the background of other disorders. Along with such an ailment, pancreatic steatosis is quite common. In addition, the disease can be focal, i.e., fat deposits are concentrated in one place, and diffuse - when fat spreads over the entire surface of a particular organ.

Fibrosis is a disease that is characterized by an accelerated process of collagen production and the growth of connective tissues in any organs of the body due to inflammation. The disease leads to thickening of tissues and the formation of scars in them. When fibrosis of a certain organ develops, its functionality can deteriorate significantly. As a result, this disease leads to the development of all kinds of pathologies.

One of the most common diseases gastrointestinal tract cholecystopancreatitis is a disease in which there is simultaneous inflammation of the pancreas and gallbladder. According to ICD 10, the code for this disease is K87.0.

Through exercise and abstinence most of people can do without medicine.

Causes of heaviness and pain in the region of the right hypochondrium

Almost every adult at least once in his life felt pain in the right hypochondrium. Sometimes discomfort passes quickly enough, without causing much discomfort. But there are times when such pains become systematic or permanent.

Such pain can be both aching and quite acute in nature. In this case, it not only prevents a person from fully functioning, but can also serve as a signal that there are certain diseases in the body.

Non-dangerous pain in the right hypochondrium

Even in perfectly healthy people, from time to time, there may be an uncomfortable feeling of heaviness or aching pain in the hypochondrium on the right. The most common conditions of the body that provoke such unpleasant sensations include:

1. Pregnancy, because during this period the woman's uterus is significantly stretched and increases in size. Accordingly, over time, it begins to put pressure on nearby organs, such as the gallbladder, intestines and liver. Increased production of progesterone during this period can provoke the expansion of the biliary tract. These factors lead to the fact that quite often, women, especially in the last stages, may feel heaviness, as well as unpleasant, mild pain with right side under the ribs.
2. Physical exhaustion or simply a state of the body with excessive physical activity. Very often, a person can feel heaviness or tingling in the right hypochondrium while running or brisk walking. This is due to the fact that during physical activity in the body, blood circulation is greatly accelerated. The blood supply to the liver also increases, the hepatic capsule stretches and begins to put pressure on the lower right row of ribs. In turn, this causes pain in the right hypochondrium. Also, the release of adrenaline, which is accompanied by physical activity, can provoke a decrease in tone in the bile ducts. This can lead to temporary stretching of the stagnant bile, causing the person to feel heaviness, discomfort, and pain in the right side.
3. Menstruation in women in rare cases also causes pain in the right hypochondrium. This is due to the fact that during the menstrual cycle there can be a sharp imbalance between the levels of progesterone and estrogen. Such a hormonal failure can cause a spasm of the biliary tract and cause discomfort in the area in question.

As a rule, pain in the right hypochondrium, arising from these reasons, disappear immediately after the factor of their appearance is eliminated. They do not pose a particular threat to the health of the body and human life.

Pain in the right hypochondrium - a signal of a problem

Since the right hypochondrium is in contact with many internal organs, frequent pain or a feeling of discomfort can signal a problem in the work of such organs as:

Also in this area, pain from the bile ducts, the inferior vena cava and sometimes from the pancreas can be reflected. This area may suffer from diseases of the spine, osteochondrosis, or inflammation of the intercostal muscles. The dislocation of pain in the right hypochondrium may indicate with which particular organ problems are observed.

Pain in the right hypochondrium, radiating to the back

Such a dislocation of discomfort, when pain is felt from behind, closer to the back, can signal existing kidney diseases, problems with the spine, and pathological changes in the vena cava. The most common diseases that provoke acute or aching pain in the right hypochondrium are:

• Thrombosis of the vena cava - may manifest as pain in the right hypochondrium, lower back and in the region right scapula.
• Intercostal neuralgia, which is characterized by the fact that, along with severe, shooting pain, it limits the movement of a person during sharp bends and turns.
• Fractures either severe bruises ribs can be manifested by severe, constant pain in the area of ​​\u200b\u200bthe right hypochondrium. Such injuries are characterized by increased pain with a deep breath or cough.
• Osteochondrosis, which affects the lumbar region. With this disease, pain in the region of the right hypochondrium may be accompanied by pulling sensations along the spine and sharp sharp shootings.
• Pyelonephritis is quite common kidney disease and most often it can be accompanied by fever, swelling on the face, pain when urinating, and, in addition to the right hypochondrium, the lower back in the kidney area can hurt.
• Acute upper paranephritis occurs as a result of inflammation of fatty tissue near the kidney. This disease is characterized by the fact that there is a strong increase in temperature, painful sensations occur in the lumbar region, and only on the 2nd or 3rd day after the onset of the disease, they move to the right hypochondrium.
• Kidney cancer or a tumor of the adrenal gland is characterized by mild and sluggish pain, which is most often localized in the lower back. But sometimes, this pain can also appear in the right hypochondrium.
• Urolithiasis, which affects the right kidney, can also be manifested by pain in the hypochondrium on the corresponding side. The promotion of stones and sand through the urinary canals can cause acute severe pain colic, which are localized in the right hypochondrium, lower back and lower abdomen.

Pain in the right hypochondrium, radiating to the side or into the abdominal cavity

In the case when the pain under the ribs on the right side radiates to the stomach or to the side, it is highly likely that this is a symptom of a malfunction of the abdominal organs, or problems in the cardiovascular system.

Quite often, the cause of discomfort and pain are diseases such as:

• Chronic pancreatitis. This disease means persistent inflammation pancreas. As a rule, such pain sensations have a dull, aching form and quite often they occur after eating. Along the way, pancreatitis can be accompanied not only by discomfort on the right side, but also by bloating of the entire abdomen, nausea and vomiting.
• Cholecystitis, which occurs along with cholelithiasis. In this case, the disease appears due to the fact that the resulting stones constantly injure and injure the inner wall of the bladder. As a result, chronic inflammatory processes develop. Further, there is a deterioration in the outflow and stagnation of bile. All this leads to constant discomfort in the region of the gallbladder and under the ribs on the right. Such symptoms may be aggravated after eating fatty and heavy foods.
• Chronic duodenitis can be one of the causes of pain in the area under consideration. If in the right upper lobe In the abdomen, inflammation of the duodenum and its mucosa occurs, then the pain in this area will be dull in nature. They can be accompanied by heartburn, diarrhea, decreased appetite, and in some cases, vomiting of bile.

The liver is a common cause of such pains.

Since the liver is localized on the right side, very often, the problem in question can become a symptom of a malfunction of this organ. There are a number of liver diseases that can cause constant heaviness or discomfort on the right side. The most common diseases in this group include:

Sharp, sharp pain on the right side under the ribs can be a signal that a serious problem has arisen in the body. This pain should not be ignored, since it can be a signal of myocardial infarction, or rather, its abdominal form.

In this case, it is sharp, sharp and intense. It can give to the right shoulder blade and does not go away even after taking nitroglycerin. Usually accompanied sharp drop pressure and pale skin. With such manifestations, a person must be hospitalized without fail to rule out a heart attack.

Women shouldn't be ignored either. detailed pain, because they can signal the presence of problems such as:

• torsion of an ovarian cyst;
• acute adnexid;
• ectopic pregnancy.

Necessary diagnostics

Systematic pain in the right hypochondrium, the causes of which can be quite diverse, should not be ignored. For timely diagnosis possible diseases, which may be manifested by pain or discomfort in this area, it is necessary to consult a doctor in a timely manner. As a rule, with such complaints, the specialist may prescribe the following studies:

• Ultrasound of the kidneys, pelvic organs or abdominal cavity;
• liver tests;
• x-ray of the spine and lungs;
• ECG and ultrasound of the heart;
• hemogram.

What can mean a feeling of heaviness under the ribs on the right

Sometimes discomfort in the region of the right hypochondrium can occur in any person, for example, after a plentiful feast or playing sports.

If the severity in the right hypochondrium recurs frequently (more than 3-5 times per month), it is recommended to consult a specialist and conduct a comprehensive comprehensive diagnostic examination.

Types of pain in the hypochondrium

Specialists currently classify various types of pain in the region of the ribs on the right:

• Feelings of a dull nature can occur in a chronic inflammatory process that occurs in pathologies such as:
  • Diverticulosis
  • chronic hepatitis
  • cirrhosis
  • Malignant neoplasm of the liver
  • helminthic infestations
  • Cholangitis and cholecystitis
  • Pyelonephritis
• Acute pain in the hypochondrium on the right is a clear sign of a negative condition, called by experts " acute abdomen"(the state of the human body, which has suffered damage to the internal organs in the abdominal cavity and irritation of the peritoneum). This condition requires immediate consultation with a surgeon to rule out:
  • Appendicitis
  • Acute pancreatitis
  • Injuries with torn bowel loops
  • peritonitis
  • Acute obstruction
  • Blockages of the bile ducts
• Cramping pain sensations are characteristic of such pathologies as renal and biliary colic. Their intensity is so pronounced that patients lose consciousness. Requires emergency medical intervention.
• Heaviness in the right hypochondrium can also form in chronic heart failure, accompanying swelling of the hepatic structures, hepatitis, hypomotor variant of biliary dyskinesia.
• Painful impulses under the ribs on the right can occur after physical overexertion. In this case, they are more often aching and stabbing.

Each of possible causes the appearance of heaviness and pain in the right hypochondrium should be carefully studied by a specialist.

Physiological causes

Periodically, even a completely healthy person may experience discomfort under the ribs.

The causes of heaviness in the right hypochondrium are quite diverse:

• The period of menstrual flow in the female half of humanity, which is accompanied by fluctuations in hormone parameters and the spasm provoked by it.
• Long-term use of oral contraceptives aggravates premenstrual syndrome, disrupts the passage of bile. In this case, there is a feeling of heaviness in the right hypochondrium, pain of a stabbing nature, flatulence.
• A person who decides to do physical exercises without appropriate training also runs the risk of discomfort in the hypochondrium on the right. A surge of adrenaline provokes stretching of the bile ducts, provoking stagnation and a decrease in tone in them. At the same time, there is an overflow of blood in the structures of the liver, its capsule is stretched, and pain impulses arise.
• After a week of bearing a baby, the enlarged uterus begins to significantly put pressure on the surrounding organs, provoking a characteristic heaviness in the right hypochondrium during pregnancy.

After carefully analyzing their own discomfort, a person can independently establish the cause that provoked them, and its elimination will contribute to the normalization of well-being.

Pathological causes

In the region of the right hypochondrium there are various organs, deviations in the activity of which, provoked by various pathologies, will cause a feeling of heaviness under the ribs on the right:

In addition to the above pathologies, other reasons can also provoke the appearance of discomfort in the area of ​​\u200b\u200bthe ribs on the right:

• Traumatization. With an unsuccessful fall, car accident, participation in a fight, a person develops a sharp soreness in the area of ​​\u200b\u200bthe right ribs. The pain syndrome may not be sufficiently pronounced and is described by a person as severity, It's a dull pain in the right hypochondrium. X-ray imaging contributes to an adequate diagnosis.
• The inflammatory process in the kidneys (pyelonephritis) is also quite disease state, one of the signs of which is the occurrence, due to a number of predisposing factors, of a feeling of heaviness in the right hypochondrium, radiating to the back. Accompanied by fever, frequent and painful urination.
• The abdominal form of myocardial infarction also causes burning pain in the right hypochondrium, sometimes with their return to the region of the right shoulder blade, shoulder and the appearance of nausea and vomiting. Pain is combined with various arrhythmias, pain shock, skin pallor, cold torrential sweat. Symptoms of this pathology are very similar to acute pancreatitis. Carrying out an ECG and ECHO KG helps the specialist to make a differential diagnosis.
• Inflammatory processes in the pancreas (pancreatitis) will be manifested by heaviness in the right and left hypochondrium, severe flatulence, alternating constipation and diarrhea, loss of appetite, belching. A person notes the relationship of increased discomfort with food intake. In the acute variant of the pathology, the pain can be intense, girdle in nature. Complex medical measures help to cope with pain in a short time.
• Exacerbation of herpetic pathology (shingles) can proceed in different ways. If rashes have formed in the region of the ribs on the right, then a person with a mild course notes dull pain and heaviness in the right hypochondrium, the presence of single bubbles with homogeneous contents. Treatment must be carried out comprehensively, with the inclusion of physiotherapy, antiviral drugs.

Feeling of fullness and pain under the ribs on the right - causes and treatment

Discomfort, pain and heaviness in the right side make you think about the source of these sensations. Most often, such manifestations make themselves felt some gastroenterological diseases.

Causes and symptoms

Regularly occurring unpleasant sensations of heaviness and pain on the right side of the body can occur for several reasons. The nature of such manifestations depends on their origin.

Physiological

Symptoms usually appear during strenuous sports or during strenuous work. In these cases, the severity and pain are short-lived.

They occur due to the fact that a high load activates blood flow. The hepatic veins overflow, provoking bursting and heaviness in the liver. Its fibrous membrane has many nerve endings and pain receptors. Stretching causes pain.

ADVICE! After the blood flow returns to normal, the symptoms stop immediately.

Food

Pain after eating, belching and bloating may occur with the consumption of large amounts of alcoholic beverages or fatty foods heavily spiced. The causes of such symptoms are a malfunction in the liver, gallbladder, gastrointestinal tract, which occur as a result of overeating and drinking alcohol.

Development of diseases

If the right side regularly hurts, the reason most likely lies in the pathological changes in the internal organs. The manifestation of unpleasant painful sensations, in this case, is of two types - constant sluggish or periodic acute. There are many diseases that can cause heaviness in the right side or hypochondrium.

Liver pathologies

The resulting feeling of fullness, heaviness and pain in the liver and right hypochondrium can be signs of serious problems in the liver and related organs. Such symptoms can be caused by:

1. Problems with the gallbladder and bile ducts:

Such pathologies are characterized by nausea and spasmodic pain.

Basically, liver diseases are of a viral or physiological nature. As a result of their development, stagnation of bile is formed, the functional activity of the organ is disrupted. Its complete failure leads to death.

All negative processes in the liver have similar symptoms. These include pain under the ribs, which is most often localized in front, bitterness in the mouth. If the cause of discomfort lies in liver disease, this can be found out by palpation. The affected organ is usually enlarged.

Pathological changes in the liver tissues may be asymptomatic. Pronounced signs appear more often with chronic forms or when acute course illness.

Gastrointestinal organs

Some diseases of the gastrointestinal tract may have a course that causes unpleasant symptoms in the right side. They can be expressed as a feeling of bloating, heaviness under the right rib, girdle pain around the entire hypochondrium (characteristic of inflammation of the pancreas).

These diseases include:

Diseases of the gastrointestinal tract have symptoms similar to those of liver pathologies. To determine exactly what causes heaviness and pain, you need a special diagnosis.

kidneys

In cases where prolonged discomfort, heaviness in the right side and pain syndrome are localized behind, one can suspect the presence of pathologies in the kidneys.

Such symptoms occur in the following diseases:

• Urolithiasis disease;
• Pyelonephritis;
• Acute upper paranephritis;
• Cancer of the kidney and right adrenal gland.

The most common symptoms in renal negative processes are acute pain and a feeling of swelling in the right side.

Neurological disorders

Various neurological dysfunctions can cause symptoms similar to signs of liver disease. Sterno-lumbar degenerative changes are characterized by the presence of pulling or spasmodic pains. There may also be a feeling of tightness, heaviness and burning on the right, often from the back. Usually, heaviness in the right side of the body provokes intercostal neuralgia, the symptoms of which are similar to cholecystitis.

One of the causes of heaviness on the right side of the body can be stress and increased nervous activity, which give impetus to the development of various diseases.

Circulatory disorders

Chronic venous hyperemia with fibrosis, and collateral venous plethora with cirrhosis of the liver, arising from heart failure. Since the vessels are squeezed by the nodular formations of the affected liver, blood accumulates in the organ. It expands causing unpleasant feeling heaviness and swelling.

Pregnancy

AT III trimester During pregnancy, the size of the uterus increases so much that the rest of the organs are under constant pressure. Because of this, constant aching pain and heaviness can occur.

Diabetes mellitus, which affects many organs, is one of the causes of heaviness and pain in the liver and kidneys.

For all diseases of the liver, kidneys and gastrointestinal tract, nausea, vomiting, and stool disorders are characteristic. In the acute stage, the temperature may rise, profuse sweating may appear. How local reaction, a rash may appear.

Diagnostics

The affected liver most often increases in size and presses on adjacent tissues, causing a feeling of heaviness. Constant heaviness in the right side is the basis for urgent medical attention. If there is discomfort in the right hypochondrium, the causes and treatment should be evaluated and prescribed by a specialist.

With the help of a comprehensive examination, the doctor will determine which organ damage causes symptoms and make a diagnosis, revealing the pathology. The diagnosis includes laboratory tests of blood, urine, tissue samples taken with a biopsy. Instrumental and hardware diagnostic methods are also needed. Ultrasound, CT, MRI allow not only to make a diagnosis, but also to accurately localize the place of development of the negative process.

The sooner you see a doctor, the less likely development of the disease into a chronic form.

Treatment

A complex of therapeutic measures is prescribed only after establishing the source of the pathology. Depending on the type and severity, it can be:

• Medicamentous, with the use of drugs;
• Physiotherapy;
• operational.

In no case should you self-medicate. Taking drugs without a doctor's prescription can aggravate the condition or cause a toxic complication, especially with liver pathologies.

To maintain the body during the rehabilitation period, preventive or maintenance treatment is prescribed. Folk remedies and herbal medicine, used in parallel with other types of therapy, increase the effectiveness of treatment. You can independently prepare decoctions and teas, observing all the requirements and recipes. There are also ready herbal preparations and balms, which can be purchased at the pharmacy. Traditional medicine should not contain alcohol.

Prevention

During the period of examination and treatment, as well as after them, it is necessary to adhere to proper nutrition. Some diseases involve the use of special diets (table No. 5, 9). The use of pickled, spicy and fried foods during the course of the disease is unacceptable. Preventive measures include the periodic use of vitamin-mineral complexes and hepatoprotectors.

In liver disease, drinking alcohol is strictly not recommended. Alcoholic beverages exacerbate pathologies and can lead to the development of incurable cirrhosis, which is an irreversible and fatal disease.

Heaviness in the right side is rarely spontaneous. It appears as the first symptom of some diseases and is a signal of violations in the body. When it appears, even if this symptom is painless, it is worth contacting a specialist and preventing possible complications.

The appearance of any ailment and physical discomfort requires close attention - it can serve as a sign chronic changes in the work of the body. Heaviness in the right side under the ribs, which is systematically repeated, requires a mandatory visit to the doctor, as it may indicate pathological conditions of vital organs.

Heaviness in the right side under the ribs in front

Non-pathogenic causes of heaviness in the right side

Discomfort in the right hypochondrium can also occur in completely healthy people. It is characterized by a lack of systematicity and manifests itself with certain changes in the body itself. Most common causes the following can be named:

• dietary disorders;
• hormonal changes during menstruation;
• pregnancy;
• stress.

Anatomy of the biliary tract

Irrational nutrition

When eating a large amount of fried or fatty foods, a large amount of bile is released. Bile contains special enzymes that break down fats into easily digestible fatty acids. The regulation of bile emissions is carried out by the sphincters of Oddi, Mirizzi and Lutkens.

With an increase in the volume of secreted bile, discomfort and dull aching pain in the right hypochondrium may occur. Also, the cause may be an increase in the activity of the pancreas. Therefore, after eating a large amount of “heavy” food, it is recommended to take Pancreatin to alleviate the condition of the gastrointestinal tract.

Eating a lot of fried or fatty foods can cause heaviness in the right side

Exercise stress

One of the main functions of the liver is to maintain a reserve supply of blood. When a person experiences intense physical activity, blood from the liver enters the general circulation so that tissues and organs can receive more oxygen. Such a sharp release can cause discomfort in the right hypochondrium and even pain.

Menstrual cycle

During menstruation, a woman's body experiences a hormonal imbalance caused by a decrease in progesterone levels and a sharp jump in the amount of estrogen. Due to such a violation of the hormonal background, a spasm of the biliary tract can occur, which is felt as heaviness or even colic.

Pregnancy

With constant squeezing of the liver during pregnancy, the normal outflow of bile from the liver can be disrupted, which leads to a feeling of heaviness

During pregnancy, the growing uterus gradually displaces the organs, which causes heartburn in women and problems with bowel function. With constant squeezing, the normal outflow of bile from the liver can be disrupted, which leads to a feeling of heaviness. If a pregnant woman feels systematic heaviness in the area under the ribs on the right, she needs to consult a doctor regarding the use of hepatoprotectors and means to improve the outflow of bile.

Psycho-emotional load

At nervous strain and prolonged stress may cause discomfort in the right side. They usually go away after good rest. Such painful sensations are due to a sharp release of hormones, which is accompanied by a reflex contraction of the bile ducts, which causes discomfort.

Unpleasant sensations in the right side can occur with nervous strain and prolonged stress

Important! If the feeling of heaviness persists for a long time, it is necessary to consult a doctor for examination and finding out the reasons.

Pathological causes

Pathologies that can be manifested by severity include the following:

Location of organs in the abdominal cavity

All these pathologies have a different origin, but the symptoms of some may be identical. Therefore, to make a diagnosis, the doctor must conduct a complete examination of the body.

Pancreatitis

Inflammation of the pancreas is characterized by heaviness in the abdomen on the right and the appearance of characteristic girdle pains. This disease progresses rapidly and easily becomes chronic in the absence of specific treatment.

What is pancreatitis

Symptoms of pancreatitis include the following:

• stool disorders;
• feeling of heaviness, aggravated after eating;
• feeling of weakness;
• nausea;
• vomit;
• dizziness.

Therapy of pancreatitis is carried out using several groups of drugs:

• antispasmodics (Drotaverine, No-shpa, Spazmol);
• painkillers (Ibuprofen, Paracetamol);
• preparations containing enzymes (Pancreatin, Mezim);
• antiemetic drugs (Cerukal, Domperidone).

In addition, the patient is prescribed a strict diet according to the 5th table, which completely excludes the use of fatty, fried foods, pickles, smoked meats and spices. Patients with pancreatitis can only eat boiled and baked low-fat foods, without a lot of salt and spices.

Chronic cholecystitis

Cholecystitis is an inflammation of the gallbladder that occurs as a result of the multiplication of bacteria in its cavity. This is possible with congestion, when bile thickens, stones form. Cholecystitis is dangerous because it can cause a rupture of the gallbladder, and therefore it requires constant monitoring and treatment.

The main symptoms of cholecystitis include the following:

• the appearance of a feeling of bitterness in the mouth;
• nausea;
• vomiting with bile;
• feeling of heaviness;
• loss of appetite;
• yellowness of the mucous membranes;
• belching with the smell of a rotten egg;
• aching pains radiating to the scapula.

Pain in chronic cholecystitis

Symptoms of chronic cholecystitis

The severity of cholecystitis appears at the initial stages of the development of the disease. If at the same time discomfort is accompanied by the above symptoms, you should immediately contact a gastroenterologist.

Therapy is carried out with the use of medications and special procedures:

• duodenal sounding to facilitate the outflow of bile;
• taking special choleretic drugs (Omeprazole, Kvamatel);
• taking antibiotics and antimicrobial agents to suppress the inflammatory process (Tetracycline, Ampicillin);
• washing of the bile ducts;
• physiotherapy procedures.

Treatment of chronic cholecystitis

A patient with cholecystitis must comply with strict diet on table 5. At the time of exacerbation, the diet involves the use of the most light food, after 3-5 weeks, a gradual return to the usual diet is possible. But the dishes fast food, semi-finished products, excessively fatty foods should be completely excluded from the menu.

Calculous cholecystitis

Calculous cholecystitis is characterized by the formation of stones in the gallbladder. Stones are formed during prolonged congestion, the accumulation of a large amount of bile and its gradual thickening.

Calculous cholecystitis is characterized by the following symptoms:

• pain in the right hypochondrium;
• feeling of bitterness in the mouth;
• yellowing of the skin and mucous membranes;
• nausea;
• vomiting with bile content;
• belching with the smell of rotten eggs;
• when pressed, there is acute pain in the region of the right lower ribs.

Nutrition for cholecystitis

Therapy for calculous cholecystitis is different from the treatment of ordinary cholecystitis. With small sizes of stones, their crushing with a special laser is possible. If the stones are large, then their extraction is carried out surgically. In this case, the gallbladder can be completely removed if its walls have been damaged. The rest of the therapy is carried out using the same drugs as in conventional cholecystitis.

Video - How to prevent the formation of stones in the gallbladder

Biliary dyskinesia

Biliary dyskinesia (JVP) is a violation of the outflow of bile from the gallbladder. Such a violation is of two types: hypokinetic and hyperkinetic. With the hypokinetic type, congestion occurs, which leads to an increase in the size of the gallbladder and can provoke cholecystitis. With the hyperkinetic type, bile emissions are uneven, which leads to painful sensations and can adversely affect the condition of the intestine.

What is biliary dyskinesia

Symptoms of JVP include the following:

• heaviness;
• nausea;
• vomiting with elements of bile;
• discomfort in the right side of the abdomen;
• feeling of bitterness in the mouth;
• the appearance of belching air.

Therapy for DZHVP is carried out mainly with medication. It is possible to use physiotherapeutic procedures, as well as duodenal sounding - it not only contributes to the outflow of bile, but also has diagnostic value. From medicines such means are used:

• choleretic (Omeprazole, Allochol);
• antispasmodics (Drotaverine, No-shpa, Papaverine);
• drugs to improve gallbladder motility (Flamin, Berberine).

Nutrition for JVP

Additionally, patients are prescribed a diet for a period of 4-8 weeks.

cirrhosis

Cirrhosis is called a change in specialized liver cells - hepatocytes and their replacement with connective and adipose tissue. This violation is characterized by a change in the size of the liver, squeezing of the bile ducts and blood vessels. Cirrhosis can be provoked by hepatitis, regular alcohol abuse, and non-compliance with the necessary diet.

The characteristic signs of cirrhosis include the following:

• pain and heaviness in the area under the ribs on the right;
• yellowness of the skin;
• sleep disturbance;
• nausea;
• vomiting with bile;
• an increase in the size of the liver, which is accompanied by a feeling of fullness;
• exacerbation of allergic reactions.

Treatment for cirrhosis is quite long. Its success directly depends on the stage of the disease at the time of the start of treatment and the patient's compliance with the doctor's recommendations. Patients with cirrhosis are prescribed a strict diet, taking hepatoprotectors (Karsil, LIV-52, Essentiale) and drugs to restore liver function (Heptral, Ovesol). In the late stages of the disease, traditional therapy is ineffective, and therefore the question is raised about possible transplant liver.

Hepatitis

In patients with hepatitis, there is a gradual fading of liver activity. This leads to the fact that it ceases to fulfill its function of purifying the blood and the body begins to suffer from extensive intoxication.

Stages of liver damage

Hepatitis is characterized by the appearance of such signs:

• general weakness of the body;
• decrease in working capacity;
• feeling of heaviness;
• nausea;
• vomit;
• yellowness of the mucous membranes and skin;
• loss of appetite;
• urine becomes bright yellow;
• stool becomes light.

Treatment of hepatitis includes taking hepatoprotectors (Karsil, LIV-52, Essentiale), choleretic agents (Allohol, Sorbitol, Xylitol) and drugs to restore liver function (Heptral, Ovesol). Patients with hepatitis must follow a special diet.

Colon pathologies

Crohn's disease and its localization

In the area under the ribs on the right is a part of the large intestine, which is called the colon. Therefore, violations normal operation intestines can also manifest themselves as heaviness in the right hypochondrium. Patients may experience the following disorders:

• nonspecific ulcerative colitis;
• Crohn's disease;
• the appearance of neoplasms.

To the main signs of diseases colon include the following:

• violations of intestinal patency;
• stomach ache;
• stool disorders - both diarrhea and constipation;
• the appearance of pus and mucus in the feces;
• pain is similar to spasms.

Symptoms of colon disease

Therapy involves taking anti-inflammatory drugs (Ibuprofen, Paracetamol, Nimesil), drugs to restore microflora (Acipol, Bion-3, Bifidumbacterin) and normalize intestinal activity (Lactulose, Domperidone, Laktitol). Upon detection malignant neoplasms held specific therapy, which includes procedures that inhibit tumor growth (chemotherapy, radiotherapy) and surgical removal.

Heart failure

In case of circulatory disorders big circle in patients there is an increase in the size of the liver, and systemic blood flow is disturbed.

Heart in chronic heart failure

Congestive heart failure is characterized by the following symptoms:

• an increase in the size of the liver;
• swelling of the hands and feet;
• feeling of heaviness in the right hypochondrium.

Manifestation of heart failure

Treatment is carried out after determining the exact cause of the appearance of congestion. Usually, patients are prescribed antispasmodics (No-shpa, Drotaverine, Papaverine), agents to improve fluid outflow (Lasix, Furosemide) and special drugs to normalize the work of the heart (Metoprolol, Atorvastatin, Veroshpiron).

Liver enlargement is commonly referred to as hepatomegaly in clinical practice. This pathological condition can be a manifestation of various diseases not only of this organ, but also of others. important systems organism. Normally, the edge of the liver in an adult, as a rule, is at the level of the right costal arch, but when it protrudes from under it, then we are talking about its increase.

Classification

There are various classifications of this disease. The degree of liver enlargement is initially determined during a routine examination of the patient and his percussion (tapping of the anterior abdominal wall) and palpation (palpation of the internal organs). In this case, depending on how many centimeters the lower edge of this organ protrudes, they distinguish:

• a small degree (1 cm);
• moderate degree (2 cm);
• pronounced degree (3 cm or more).

With hepatomegaly, this organ can increase in size as a whole (diffuse process), or each lobe individually. In the latter case, we are talking about a local pathological process, for example, about or echinococcosis of the left lobe.

The reasons

All the reasons why the liver can increase are conditionally divided into three groups:

1. Liver diseases.
2. Accumulation diseases.
3. Diseases of the cardiovascular system.

Liver diseases

Almost any pathology of the liver tissue leads to an increase in the size of the organ. In this case, the most common causes are the following conditions:

Since the liver is the central organ responsible for the metabolism of various substances in the body, if any cleavage processes are disturbed, its tissue can increase in size. Storage diseases include:

• hepatolenticular degeneration;
• amyloidosis.

At the same time, a large amount of non-split substances (iron, fats, glycogen) accumulate in the liver cells.

Diseases of the cardiovascular system

Almost any pathology of the cardiovascular system, leading to the development of congestive insufficiency, can cause an enlarged liver. This is due to the accumulation of a large number venous blood in the hepatic sinuses and further secondary tissue restructuring. Most often, the development of hepatomegaly is accompanied by:

• postinfarction cardiosclerosis;
• permanent form of atrial fibrillation;
• heart defects (acquired and congenital);
• postmyocarditis syndrome;
• hypertonic heart.

Symptoms

At the initial stages, the enlarged liver does not manifest itself in any way. However, since the capsule that covers this organ from the outside is not extensible and contains a large number of pain receptors, even with a slight increase in tissue volume, discomfort or a feeling of heaviness in the epigastrium and right hypochondrium may occur. In the future, a rather pronounced pain syndrome joins. In addition, there will be signs of that primary disease, as well as symptoms of liver failure:

• (indigestion, stool);
• yellowness of the skin;
• an increase in the veins of the esophagus, as well as the anterior abdominal wall (jellyfish head) due to portal hypertension;
• violation of the blood coagulation system, in which the appearance of a petechial rash and frequent bleeding, including uterine and nasal bleeding, is noted;
• and swelling.

Course of the disease

Since an enlarged liver is only a manifestation of various diseases, its course is primarily determined by the primary pathology. However, there are risk factors that can aggravate the course of the disease. These include:

• the use of alcohol, as well as other toxic substances;
• taking excessive amounts of dietary supplements and drugs;
• herbal medicine using some active plant components;
• any infectious diseases, which reduce immunity and make liver cells more susceptible;
• excess body weight;
• eating excess preservatives, animal fats and semi-finished products.

Diagnostics

In some cases, it is possible to diagnose an enlarged liver with a standard examination of the patient and a manual examination. However, in order to clarify the state of this organ, methods of instrumental and laboratory diagnostics are used.

Among instrumental methods usually do:

If the doctor suspects a cardiac pathology, then the patient is examined for a disease of the cardiovascular system (ECG, ECHO-cardiography).

Treatment

With hepatomegaly, it is very important to find out the cause of the increase in this organ, since the treatment for various diseases will be quite different.

Medical treatment

Medicines can be used to relieve the symptoms of the disease. At the same time, drugs called hepatoprotectors are prescribed. They improve the condition of the liver cells and normalize the function of the organ. However, special attention should be paid to the treatment of primary pathology:

• at viral hepatitis prescribe interferon;
• autoimmune processes can slow down the intake of glucocorticosteroid hormones;
• in congestive heart failure, cardiac drugs (diuretics, ACE inhibitors) are prescribed.

Surgery

With malignant tumors, echinococcosis and cysts, the most effective is the surgical method of treatment. At the same time, it is possible to open surgery with the removal of a segment or share of an organ. The amount of intervention depends on the prevalence of the process.

Recently, the so-called embolization of vessels that supply the tumor with blood has been increasingly used. At the same time, the blood flow in it stops, and the neoplasm itself is gradually destroyed due to a lack of oxygen. This manipulation is performed through a puncture of the vessel under x-ray control.

In advanced cases of diffuse lesions of the liver tissue, the only way out is transplantation. Since this organ is capable of regeneration, that is, of growth, it is enough to transplant a part of the liver. Therefore, any relative who meets a number of criteria can be a donor.

Diet

All patients with liver enlargement, regardless of the underlying disease, must adhere to a special diet. At the same time, it is necessary to exclude from the diet products that have a toxic effect on the liver tissue (alcohol, spicy), as well as hard-to-digest and fatty foods.

In storage diseases, it is necessary to limit the use of foods that the liver is not able to metabolize as much as possible. For example, with hemochromatosis, it is necessary to exclude dishes containing iron (meat, fish, eggs).

ethnoscience

Alternative methods of treatment can be used only after consulting a therapist or gastroenterologist. However, the most effective use of initial stages diseases. It is very effective to take an infusion made from equal parts of motherwort herb and sage, dandelion roots, chicory and peony. It is necessary to drink it at 450 ml per day for two weeks. Also useful for cleansing the liver may be the use of beetroot and pumpkin salad seasoned with vegetable oil.

Consequences and prognosis

The consequences and prognosis of an enlarged liver are entirely determined by the primary pathology, as well as the stage of the process and the severity of liver failure.