Hepatocytes with signs of protein degeneration. How to treat fatty liver and pancreas? Causes of hepatosis of the liver

Fatty degeneration liver (steatosis, hepatosis) is a disease caused by the accumulation of lipids (a large group of natural organic compounds, including fats and fat-like substances). Organ cells eventually begin to degenerate into fat cells. Disease can be prevented by traditional medicine and only in the first two stages of the disease. Knowing all the symptoms will not allow you to miss the beginning of the development of the disease.

Symptoms

The first and second stages are characterized by the reversibility of the pathological process, but the disease proceeds without obvious symptoms which makes it difficult to detect. The first bright signs will begin to appear along with the development of the disease.

What you need to pay attention to:

• loss of appetite;
• abdominal pain;
• bitter taste in the mouth;
• fatigue;
• malaise;
• nausea, vomiting;
• intestinal dysbacteriosis;
• blurred vision;
• pale and dull skin;
• yellow coating on the tongue.

When the third stage comes, the brightness of the signs increases dramatically, and it is simply impossible not to pay attention to them. Symptoms worsen, and the patient notices such manifestations:

• trouble remembering information
• yellowing of the skin;
• severe weakness;
• depression or constant irritation;
• the abdomen increases in size (due to the accumulation of fluid);
• sleep mode failure;
• pain in the liver (poorly relieved by analgesics).

The third stage is considered a harbinger of the development of cirrhosis. The tissues of the most important organ begin to slowly collapse. Connective tissue grows in their place. This pathological process leads to a serious disruption of the liver and bile excretion.

Fatty degeneration of the liver, the symptoms of which, when neglected, are complicated by tissue necrosis, is manifested by a sweetish liver smell from oral cavity, temperature increase, strong weight loss(sharp), impaired breathing and heart rate.

Important! Steatosis can be dangerous because the rapid development of the disease (in some cases) threatens the destruction of liver tissue and other serious complications that are fatal.

Risk factors for stenosis

The causes of fatty liver disease are varied. The main one is considered malnutrition, in which a person consumes a lot of fatty, spicy, smoked. An improper diet becomes a prerequisite for a malfunction in the work of hepatocytes (cells that are responsible for the synthesis of cholesterol and the transformation of carbohydrates).

Other reasons

In addition to malnutrition, there are several other reasons that can contribute to the development of the disease:

• excessive consumption of alcoholic beverages;
• use of steroids for muscle building;
• exposure to mercury salts;
• overweight;
• diabetes second type;
• hyperlipidemia;
• smoking;
• bad ecology;
• abdominal surgery (surgery to remove sections of the small intestine);
• genetic predisposition;
• Wilson's disease.

In addition, the pathological process can be caused in a sedentary manner life and activities at enterprises with increased hazard.

Stages of stenosis

There are two stages of fatty degeneration of the liver. Each of them has its own symptoms and causes of development. Let's consider them in more detail.

Acute stage

Occurs suddenly and is different rapid development, which in the end can lead to severe complications, and cirrhosis is no exception. Most often, this course of the disease can serve food poisoning, intoxication, alcoholism, latent hepatitis. The patient is in critical condition. He suffers from constant nausea, abdominal pain, heat and stool disorder. In addition, the liver significantly increases in size, which can be seen from the rounded belly on the right. Acute liver dystrophy should be treated as soon as possible.

chronic stage

This stage is not characterized by such vivid symptoms. Everything will depend on how quickly fat droplets begin to accumulate in the cytoplasm of liver cells. Over time, these microscopic clusters merge into larger ones. fatty formations, shifting the core to the edge, located in the center. Without treatment, the cells of the organ, which are filled with fat, begin to break down over time, forming a cyst.

When pathological changes affect neighboring organs, not only fatty degeneration of the liver is diagnosed, but also malfunctions of the pancreas. Pathology is accompanied serious violation work of the digestive system.

If acute fatty degeneration of the liver develops in pregnant women, it can threaten the death of the mother or child. Moreover, the child can die in utero, both starting from the 22nd week of gestation, and after childbirth within 7 days. This pathology is extremely rare. Most often, development is infectious diseases. The disease is manifested by nausea, vomiting, lethargy, heartburn, lack of appetite, pain in the right hypochondrium, yellowing of the skin. It is important to immediately contact your gynecologist if you experience such symptoms.

Forms of the disease

The liver is the organ that is responsible for neutralizing toxic substances that enter the human body. Frequent use of alcoholic beverages will sooner or later lead to a malfunction of the body. As a result, a disease such as alcoholic liver dystrophy begins to develop. However, it should be noted that there are other forms of the disease. Let's take a closer look.

Alcoholic fatty liver disease: when the body is exposed to chronic intoxication, which leads to structural changes in the organ. Symptoms appear suddenly. They are pronounced and give a person pain and discomfort. Alcohol intoxication leads to a rare form - Zieve's syndrome. The central nervous system is affected, the patient becomes drowsy, depressive. There is a bitter taste in the mouth, often dizziness and pain in the liver.

Toxic dystrophy of the liver: this form is characterized by extensive damage to the tissues of the organ, called necrosis. Along with this, liver failure develops. Alcohol poisoning, mushrooms, chemicals, taking some medicines- all this can serve the development of the disease. Acute period begins from 3 to 8 weeks of the course of the disease. Sleep is disturbed, vomiting, dizziness, weakness appear.

Focal dystrophy of the liver: the development process occurs against the background of intoxication of the whole organism with alcohol, taking medications (for example, tetracyclines, corticosteroids, estrogens). In addition, focal liver disease can begin to develop as a result of obesity and type 2 diabetes. There is fatigue, shortness of breath, loss of appetite. The intensity of symptoms increases during movement.

Granular dystrophy of the liver. During the diagnosis of pathology, protein inclusions will be noticeable in the liver cells. This process occurs due to a violation of colloidal properties. It is possible even in infancy when the child does not receive proper nutrition. In adulthood Infectious diseases, intoxication, impaired lymph flow and blood circulation can contribute to the development of liver disease.

Protein degeneration of the liver. This form is characterized by a significant violation of protein metabolic processes. When diagnosed, it resembles a granular form. Protein inclusions are combined into a single whole and fill the entire cellular space. Without treatment, such a pathological process leads to the destruction of the liver cell.

With the progression of any of the forms, serious structural changes in the tissues of the organ will develop. The patient's condition will noticeably worsen.

Drug treatment

In cases where the patient has fatty hepatosis, it is necessary to start treatment in a timely manner. The main task drugs will be to improve the condition of liver tissues and restore normal functioning organ.

Since it is not enough just to take medication, the patient will need to completely review and change their living habits. So, how to treat fatty liver?

Drug therapy is carried out with the following drugs:

• Essliver, Essentiale (hepatoprotectors);
• vitamins of groups A, B, E;
• Methyluracil, Methionine (drugs of metabolic action);
• No-shpa, Papaverine (antispasmodics for severe pain).

In addition, in complex cases of the disease, it is sometimes prescribed hormone therapy. The treatment takes about 6 months, and then recovery procedures (treatment in sanatoriums) are recommended.

Therapeutic Diet

To avoid overloading the liver, food should be consumed several times a day, in small quantities, with careful chewing. Smoked meats, fried, very spicy - such dishes should be completely excluded from the diet.

1. vegetables can be eaten boiled or baked;
2. sea ​​fish, chicken breast only boiled or steamed;
3. porridge should be cooked in water or skimmed milk(oatmeal is especially recommended);
4. salads from vegetables should be seasoned only with oil.

With this liver disease, it is necessary to control the drunk liquid. The patient should drink at least two liters of pure water without gas. Eliminating alcohol completely is the most important point in treatment.

Products and dishes for compiling the menu:

• boiled, steamed or fresh vegetables (pumpkin, cucumber, carrots, cabbage, beets);
• milk soups;
• lean fish (boiled or steamed);
• non-spicy and fat-free cheese;
• boiled eggs or steamed scrambled eggs (1 time per day);
• buckwheat, rice, oatmeal, as well as semolina;
• soups and borscht without fatty meat;
• fat-free yogurt, cottage cheese and milk.

In order to properly compose a diet, and most importantly - determine the weight of a serving, it is better to contact a nutritionist.

The following products should be completely eliminated:

• fatty fish, meat;
• onion garlic;
• mushrooms;
• salted and pickled foods;
• fatty dairy products;
• confectionery;
• pasta;
• sparkling water;
• sweet and alcoholic drinks.

The diet for fatty liver is to control the intake fatty foods. Only by changing the diet, and with it the lifestyle, can this disease be cured. It is necessary to increase activity, for example, to include in everyday life about 30 minutes of intensive walking or cycling.

Fatty liver disease is a rather dangerous disease. digestive tract. It is characterized by the replacement of liver cells with adipose tissue, due to which the functionality of this organ decreases. The danger of fatty degeneration lies in the fact that the disease for a long time may not manifest itself in any symptoms, due to which the liver begins to rapidly collapse.

Over time, a person begins to constantly feel nausea, vomiting, heaviness and pain in the right hypochondrium, is faced with a violation of the chair and fatigue. Due to the formation of fat cells, the size of the liver begins to increase rapidly, while the organ loses its natural defense mechanisms.

Against the background of this disease, complications often occur in the form of or hepatitis.

With fatty degeneration in the liver, various structural changes occur, which lead to disruption of the functioning of this organ.

Experts distinguish the following forms of the course of this disease:

• Focal disseminated- a pathology in which numerous accumulations of fat cells are located on the liver. This form of the disease is asymptomatic for a long time.
• Expressed disseminated- a disease of the liver, in which fatty inclusions are located on the entire area of ​​\u200b\u200bthe liver. It quickly manifests itself with specific signs.
• diffuse- liver disease, in which adipose tissue fills all the lobes. With this form, the symptoms are clear and well expressed.
• Zonal- damage to the liver tissue, in which fatty inclusions in the cells are distributed in certain lobes.
• Alcoholic – rare form disease in which Ziwe's syndrome manifests itself. It occurs as a result of alcohol, drug and other addictions.

Causes of the disease

Metabolic syndrome, or metabolic and hormonal disorders, is the most common cause of fatty liver disease. This disease is accompanied by an increase in the level of lipids in the blood and the development of diabetes mellitus. Because of this, there serious danger cardiovascular complications.

The following factors can provoke this disease:

Fatty degeneration of the liver occurs against the background of insulin resistance by cells, as well as due to a violation of lipid and carbohydrate metabolism. Also, such a disease can develop due to excessive intake of fatty acids in the liver with increased lipolysis or due to food consumed.

Symptoms of the disease

Symptoms of fatty degeneration depend on the degree of liver damage and the degree of development of this process. At the first stage, the disease does not manifest itself by any signs; it is possible to diagnose the pathology only with a comprehensive examination.

Grade 2 of this disease is accompanied by the following symptoms:

In stage 3 fatty degeneration, more serious manifestations occur, such as:

The thermal stage is characterized by the occurrence of complications such as renal failure and cirrhosis. Also, shortness of breath, nosebleeds, bad breath, loss of appetite, fever are added to this.

Fatty degeneration in pregnant women

Acute fatty degeneration in pregnant women is extremely dangerous complication which can occur in any pregnant woman. Despite the fact that it occurs extremely rarely, the consequences of such a violation will be deplorable for both the mother and the child.

The following reasons can provoke liver degeneration in a pregnant woman:

• Constant bouts of vomiting.
• Acute form of fatty hepatosis.
• Hepatosis with cholestasis.
• Inflammation of the liver with renal syndrome.

It is possible to identify the first manifestations of this disorder already at 30-38 weeks, earlier they occur in extremely rare cases.

The woman begins to complain of a feeling of lethargy, weakness, constant nausea and vomiting, pain in the abdomen.

After some time, heartburn joins everything, ulcers appear on the surface of the esophagus, which cause pain when swallowing. At the next stage of development, the disease is supplemented by brown vomit, jaundice, ascites and anemia.

Diagnostics

First step diagnostic measures is a detailed history taking and visual inspection specialist. After that, palpation of the liver, abdomen, tapping abdominal cavity.

To determine the functioning of the body is assigned general study and biochemical analysis blood, analysis for markers of liver disease, general analysis of urine and feces.

All this is accompanied holding instrumental methods diagnostics:

Nutrition for liver dystrophy

With fatty liver disease, it is very important to follow a special diet. It will help reduce the load on this organ, as well as restore all its basic functions. It is important to remember that you can consume no more than 50 grams of fat per day.

Also eliminate from the diet foods that are high in cholesterol. It is best to cook food for a couple, but you can stew and boil.

Don't forget to follow following rules diets:

• Increase the amount of protein in your diet.
• Completely refrain from drinking alcoholic beverages.
• Completely exclude spicy, fried, salty foods.
• Drink at least 2 liters of pure water a day.
• Reduce the amount of animal fats.
• Eliminate simple carbohydrates.

Treatment of fatty degeneration of the liver

There is no single and only correct treatment regimen for fatty liver disease. Therapy depends on the individual characteristics of the organism and the degree of manifestation of the disorder. Usually medical measures require the patient to exclude all provoking factors.

After that, drug therapy is carried out to restore the liver tissue, stabilize metabolic processes, and eliminate toxic effects. Also, the patient needs to reconsider his lifestyle and start eating right.

You should not self-medicate - a qualified specialist should deal with the therapy of IDP.

Do not ignore this disease or try to cure it yourself. Such a defeat requires the most complete and responsible approach, constant control by the doctor. Treatment of fatty degeneration consists in taking a number of medications. It usually consists of therapy with antioxidants and membrane stabilizers.

Drugs for the treatment of IBD can be divided into the following groups:

• Preparations based on essential phospholipids. These include funds from phosphatidylcholine, due to which liver cells receive a protective layer. Among such drugs, Essliver, Essentiale, Hepabos and their analogues can be distinguished.
• Preparations from the group of sulfoamino acids - Dibicor, Heptral and others.
• Herbal preparations that normalize liver function - LIV 52, artichoke extract, Karsil and others.

To reduce the toxic effects on the liver and reduce intoxication, it is very important to drink vitamin complexes. For these purposes, it is permissible to use Niacin, ascorbic acid, vitamin B or E.

Effects

Chronic fatty degeneration of the liver with the right approach to drug therapy has a very favorable prognosis. Of course, if such a problem is ignored for a long time, such a disease is complicated by cirrhosis of the liver - the organ begins to change its size, structure and shape.

It usually haunts the elderly as well as people who suffer from overweight body or diabetes. Such an ailment is of particular danger to pregnant women, since with a recurrence of cholestasis, the risk of fetal death increases.

With a complete approach to the treatment of IDP, a person can live a long and fulfilling life.

Fatty junk food or alcoholic beverages will lead to a sharp development of the disease. Because of this, the quality and duration of life is significantly reduced and reduced. In many cases, fatty degeneration flows into, which leads to the formation of stones in the ducts and the organ itself. Try to have regular check-ups with your doctor and follow all his prescriptions.

Prevention of fatty degeneration of the liver

In order to prevent the formation of prerequisites for fatty degeneration of the liver, it is enough to conduct healthy lifestyle life. The most important thing is correct and good nutrition. Your diet should always contain dishes with a high content of useful elements and vitamins. You also need to eat often and in small portions so as not to overload your liver.

Proper nutrition - best prevention fatty degeneration of the liver.

Preventive measures include regular visits to the attending physician for a detailed medical examination. It will help to identify any abnormalities in the early stages and prescribe appropriate treatment in a timely manner.

Lead an active lifestyle that normalizes the movement of food through the gastrointestinal tract and prevents congestion. Do not forget to regularly drink vitamin complexes, treat any viral diseases in a timely manner.

Video

Judging by the fact that you are now reading these lines, victory in the fight against liver diseases is not on your side yet ...

Have you thought about surgery yet? It is understandable, because the liver is very important organ and its proper functioning is the key to health and well-being. Nausea and vomiting, yellowish skin tone, bitterness in the mouth and bad smell, dark urine and diarrhea... All these symptoms are familiar to you firsthand.

But perhaps it is more correct to treat not the consequence, but the cause? We recommend reading the story of Olga Krichevskaya, how she cured her liver...

Lecture 4. Fatty degeneration

1. Types of fats in the body

1. Types of fats in the body

Fats found in the body of animals and humans are designated by a general, collective term - lipids, which are of two types:

a) neutral fats;

b) lipoids (fat-like substances).

Neutral Fats form the basis of fat depots, are deposited in the subcutaneous tissue, mesentery, omentum, under the serous cover of the abdominal wall, under the epicardium, near the kidneys and in other places.

Neutral fats are called labile (or expendable), since their amount is variable, they provide energy reserves organism. Lipoids are classified according to chemical composition: this includes phosphotides, sterols and sterides, sphingolipoids and wax. Lipoids are part of cytoplasmic fat, where they are associated with proteins and form complex unstable fat-protein complexes (lipoproteins). Together with proteins, they are a building material and an integral part of cellular structures, therefore they are relatively stable and change little quantitatively.

In cells and tissues, fats are found in the form of droplets and grains. These droplets and grains do not dissolve in water (unlike glycogen) and in acetic acid(unlike proteins), soluble in alcohol, ether, xylene, chloroform, therefore, for the detection of fats, a material fixed in formalin is used, and sections are prepared on a freezing microtome.

To prove the presence of fat in tissues and organs, special stains and reactions are used. The most commonly used are sudan III and scarlet, which stain the fat droplets orange-red. When exposed to osmic acid, the drops turn black. Nile blue sulfate (nilblau sulfate) colors neutral fats red, and fatty acid- in dark blue.

2. Mesenchymal and parenchymal fatty degenerations

In case of violation of fat metabolism, pathological anatomy considers separately the changes that occur in fatty tissue and in the parenchyma of internal organs.

Violations of the metabolism of neutral fat adipose tissue

A. Fat reduction

A general decrease in fat content in fiber can occur as a result of overexploitation of animals, with chronic infectious diseases, tumors, endocrine disorders, etc.

The amount of fat in fiber is reduced, it is impregnated serous fluid(serous atrophy of fat). At the same time, fiber sometimes acquires a gelatinous character (mucous degeneration) and a yellowish-gray color. Such states of the body are referred to as exhaustion, or cachexia.

Macroscopically, it is found that the fat cells are wrinkled due to the decrease or complete disappearance of fat. Fat reduction in fiber may be local. In the subcutaneous fat layer, sometimes there is a breakdown of fat cells: with inflammation, with trauma, with improper use of drugs injected subcutaneously.

B. Increasing the amount of fat

Obesity is characterized by excessive deposition of fat in fiber throughout the body: subcutaneously, intermuscularly, in the mesentery and omentums, in the interstitium parenchymal organs. General obesity is caused various reasons: overfeeding, especially in combination with a weakening of muscle activity, endocrine disorders etc. At the same time, excess fat deposits are observed not only in fat depots, but also in the liver, kidneys, muscle, connective tissue and in the interstitium of other organs. Of particular importance is pericardial obesity when it spreads to the myocardium, as this causes atrophic and degenerative changes in muscle fibers.

Local excessive deposition of fat (lipomatosis) is observed in organs and tissues undergoing atrophy (kidneys, individual lymph nodes, areas skeletal muscles and etc.).

Violation of the exchange of cytoplasmic fat in certain tissues and organs

Fatty degeneration

The reasons may be: general obesity, protein starvation, infections and intoxications, heart and lung diseases, chronic anemia, local circulatory disorders, beriberi, etc.

The accumulation of fat in cells occurs mainly by infiltration, i.e. penetration from the outside - from various fat depots. The second way is also considered possible - decomposition; at the same time, the disintegration of fat-protein complexes occurs inside the cytoplasm and the release of fatty substances, which are collected in drops.

With a weak degree of fatty degeneration, drops are detected in limited areas of the hepatic lobules, but with an intensification of the process, obesity spreads to the entire lobule. Usually, small droplets of fat appear first, occupying almost the entire cytoplasm. The nucleus moves to the periphery of the cell and is compressed.

Liver cells then resemble fat cells. With a pronounced dystrophy, the beam arrangement of the liver cells (discomplexation) is disturbed. If the harmful principle acts very strongly, dystrophy can turn into necrobiosis and necrosis. Liver cells either die in the designated areas, or spread to entire lobules. Sometimes significant or most of the entire hepatic parenchyma (toxic liver dystrophy).

Macroscopically, it is found that with diffuse obesity, the liver is enlarged, yellowish, clay-like; its consistency is doughy. On the blade of the knife, when cut, a fatty coating is visible, and droplets of fat often protrude on the surface of the cut. If at the same time there is venous plethora of the liver, variegation is noticeable on its surface and on the cut. The periphery of the lobules is stained yellowish color, and the red center is the extended central vein. The pattern of the parenchyma becomes similar to a cut nutmeg("nutmeg liver").

Microscopy shows that there are deposits of small and large drops of fat in the interstitium, in the epithelium of the convoluted tubules, loops of Henle and collecting ducts. In severe fatty degeneration, necrobiosis and necrosis of the epithelium of the renal tubules can occur. The cortical layer is thickened, gray-yellow or ocher-yellow. Medulla red or yellowish gray. The consistency of the kidney is flabby. The cut surface is oily and sticky.

Sometimes the changes are diffuse character, the heart muscle becomes flabby and clayey. Microscopy reveals a large number of small fat droplets in all muscle fibers.

More often dystrophic process It has focal character when changes occur only in a group of muscle fibers located near small veins. In such cases, stripes and spots of gray-yellow color are visible in the myocardium. The pattern resembles the skin of a tiger ("tiger heart").

With an increase in the process of fatty degeneration in muscle cells, nuclei can die by lysis or pycnosis.

Outcomes and significance of disorders of fat metabolism

The outcomes of fatty degeneration depend largely on the cause that caused it. With minor metabolic disturbances, there may occur full recovery functions and structures of affected cells. Sometimes, even with very significant obesity, the cells remain viable. After passing the conditions that caused obesity, the fat droplets are assimilated, and the cells return to their normal state.

With a deep and prolonged violation of lipid metabolism, fatty degeneration progresses, which leads to cell death and decay.

The defeat of parenchymal elements results in a weakening of their function, and sometimes its complete cessation. For example, in infectious diseases, death often occurs due to the decline and cessation of heart activity associated with fatty degeneration of the heart muscle. In rare cases, a rupture of the altered wall of the heart may occur.

Fatty degeneration of the muscle fibers of the walls blood vessels can lead to rupture of the walls.

author Evgeny Ivanovich Gusev

24.2.3. Hepatocerebral dystrophy

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Hepatocerebral degeneration

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Many people, faced with the diagnosis of liver dystrophy, panic. Meanwhile, in no case should you be afraid, but, on the contrary, you must mobilize and make every effort to preserve your health and life. Indeed, liver dystrophy is a very dangerous disease, so try to follow all the prescriptions prescribed by your doctor and you will be healthy.

In the classical sense, liver dystrophy is a disease accompanied by a coma associated with a malfunction of the main human filtering organ - the liver. To hepatic coma lead the most various reasons, however, in most cases, this phenomenon occurs due to necrosis of the tissues of the organ and their replacement with others that are unable to function properly. However, there are several forms of the disease, in which degradation occurs gradually, at the cellular level.

ICD-10 code

The International Classification of Diseases (ICD-10) is a large reference book that lists the most well-known diseases today. It is designed to simplify the process of transferring a patient from one hospital to another as much as possible. In this case, the patient does not need to re-pass all the examinations and take tests. This is done only if there is a suspicion that the previously diagnosed diagnosis is incorrect.

In the ICD-10 classification, liver dystrophy is described in chapter K76 " fatty degeneration liver, not elsewhere classified", which, in turn, is also an integral part of section K70-K77 "Disorders of the liver". The largest subsection, which includes all the others, is called "Diseases of the digestive system" and is indicated by the code K00-K93.

The reasons

The main cause of liver dystrophy is a decrease in the response of its cells to the action of insulin, the hormone responsible for transporting glucose into the cells of our body. The result of this is a deficiency of glucose in hepatocytes (liver cells). Further development events are not difficult to predict: experiencing a constant lack of the substance they need, liver cells die, being replaced after some time by adipose tissue, which causes dysfunction of the diseased organ.

Why might such a failure occur? The cause of the pathological reaction of hepatocytes can be:

• genetic pathology;
• Violation of metabolic processes.
• If a the immune system begins to show aggression to insulin, this can manifest itself in the form of immunity of hepatocytes to this hormone.

Other causes of hepatic dystrophy can be:

• Improper nutrition - the predominance of fats and carbohydrates in the daily diet;
• Abuse of alcohol and cigarettes;
• Lack of sufficient physical activity.

These, at first glance, insignificant factors - the vast majority of us sin this to a greater or lesser extent - adversely affect the state of the liver, triggering pathological processes. If we continue to lead a passive existence and ignore the first SOS signals that the liver gives us, the changes taking place in it can become irreversible.

Symptoms

In the early stages of development, signs of pathological changes in the liver are so insignificant that a person may not notice them at all or, having noticed, not correlate with the onset of a serious illness. Due to the very slow development of the process, the body gets used to the changes and patients at first do not experience any noticeable discomfort.

Over time, hepatic dystrophy begins to remind of itself:

Occasionally, the pathological process may be accompanied by yellowing (to a greater or lesser extent) of the skin, mucous membranes and eye proteins, sharp pains in the abdomen, rapid weight loss. In this case, a person can be pursued severe itching- so pronounced that the patient scratches himself until the blood.

If there is toxic dystrophy of the organ, in which necrosis of the parenchyma occurs, the liver cells located nearby portal vein spleen and lymph nodes begin to divide intensively. A number of dystrophic and necrotic changes occur in the tissues of the pancreas and cardiac muscle, multiple bleeding occurs, affecting both internal and serous membranes, and skin. The chronic form of toxic liver dystrophy can lead to the development of large-nodular cirrhosis and, as a result, the imminent death of the patient due to a functional disorder of the diseased organ or acute renal failure. To extend your life for at least a few years, you need to see a doctor as soon as possible, undergo comprehensive treatment and start treatment.

Where does it hurt?

If someone complains to you about pain in the liver, or you yourself use a similar expression in a private conversation, remember: this is impossible. The liver itself cannot get sick, because there are no nerve endings. Significant pain sensations radiating to the right half of the back, epigastric region, under the shoulder blade or to the neck (also on the right), do not occur in the organ itself, but only in its sheath, where the nerve endings are well developed.

If the liver is greatly enlarged (this may occur due to the flow in the diseased organ inflammatory process), adjacent organs are under pressure, which can also cause pain in the right hypochondrium. In the early stages of liver dystrophy, the patient experiences an unpleasant sensation in the right side, as if something is bothering him there, and sometimes reflexively tries to get rid of this by making characteristic body movements. At the very beginning of the disease, these sensations occur periodically, but over time become permanent.

Pain may become stronger or almost disappear. With intense physical exertion and heavy sports training, pain in the right hypochondrium intensifies in the same way as from drinking alcohol, taking certain medications, or eating too much.

If the pains on the right in the hypochondrium appear in the form of attacks or, in particular, become permanent, it is necessary to see a doctor as soon as possible: timely treatment will help prevent the transition of the pathology into an irreversible process.

Forms

With toxic dystrophy of the liver, a necrotic process develops very quickly, destroying the normal structure of this organ. As a rule, physicians deal with acute course diseases, however, in some cases the process becomes chronic, as a result of which the liver gradually ceases to function normally.

Extensive necrosis can develop as a result of exposure to the patient's body of powerful toxins contained in certain products - for example, mushrooms - that is, external factors influenced its appearance

Symptoms of toxic liver dystrophy can also appear due to internal factors - for example, toxicosis in women during pregnancy or excessive hormone production. thyroid gland(hyperthyroidism). Hepatic dystrophy can also appear against the background of a fulminant form of hepatitis.

The characteristic signs of toxic liver dystrophy are:

• An increase in the size of the diseased organ;
• Flabbiness or, conversely, excessive tissue density;
• Yellowish organ.

If treatment is not started on time, the size of the liver gradually decreases. Wrinkles form on the capsular membrane. The gland itself changes from yellowish to gray and appearance- similar to clay. Liver shrinkage continues for three weeks. By the end of this period, it acquires a hue that can be described as something between gray and reddish.

Gradually, the reticular stroma of the gland is exposed. The capillaries become clearly visible, which have become wider due to the blood overflowing them. Hepatocytes are getting smaller. They can only be found in certain places. This pathological process is called red dystrophy.

The chronic form of hepatic dystrophy is quite rare and in most cases ends in the death of the patient as a result of the rapid development of dysfunction of the affected organ.

Acute liver dystrophy

As an independent pathology, acute liver dystrophy is rare. As a rule, this is a complication of severe hepatitis A.

This pathology has not been fully studied, so experts still find it difficult to answer exactly how it develops. In addition, it has not yet been possible to find out which factors influence the development of the pathological process and how the hepatitis A virus is associated with it.

To provoke the development of acute parenchymal hepatitis can:

• Syphilis;
• Brucellosis;
• Tick-borne relapsing fever.

The possibility of developing complications in women during pregnancy or who have had an abortion is significantly increased - in both cases, there is a weakening defensive forces organism. All this negatively affects the state of hepatocytes and provokes the development of severe hepatic dystrophy.

The initial stage of acute hepatic dystrophy is very similar to the symptoms of hepatitis A. The patient's condition deteriorates sharply. A disorder develops brain activity resulting from damage to the nervous system. The patient becomes restless, delirious, has convulsions and severe vomiting. At similar symptoms he needs urgent treatment in a psychiatric ward.

It is worse if, instead of anxiety and excitement, the patient is in the opposite state: he becomes lethargic, apathetic, indifferent to everything. Other symptoms include depression, constant drowsiness, decrease in vitality. Along with an increase in symptoms, the patient periodically faints, during one of which he may fall into a hepatic coma.

Alcoholic degeneration of the liver

The cause of alcoholic liver dystrophy is revealed in the very name of this disease: alcohol abuse. Penetrating into human body, ethanol destroys hepatocytes. If a person systematically consumes alcohol (it is not at all necessary to go into long binges for this, two or three bottles of beer every day are enough), ten years later he is diagnosed with hepatic dystrophy. This can happen much earlier if the introduction to alcohol occurred in adolescence, and somewhat later if an elderly and previously non-drinker suddenly became addicted to alcohol.

The development of alcoholic liver dystrophy is preceded by:

• alcoholic hepatitis;
• Hepatosis;
• Cirrhosis of the liver.

most common cause dystrophic changes becomes hepatitis. Symptoms in this case are mild and manifest in:

• Reddish hue of the palms and feet;
• Contracture of the fingers on the hands;
• Magnification salivary glands located near the ears.

Fortunately, in the early stages of the development of the disease, the process is reversible: it is enough to refrain from drinking alcohol for one or one and a half months, switch to a diet and drink more water, as improvement will not keep itself waiting. And with a complete rejection of alcohol for a longer period, the diseased gland is completely restored.

In more complex cases, it may be necessary to take essential phospholipids and corticosteroid drugs. If the patient has been diagnosed with the last stage of the disease, only a liver transplant can help.

Diffuse dystrophy of the liver

An extremely dangerous condition that occurs with diffuse-dystrophic changes in the liver parenchyma. The reason for its appearance is that hepatocytes cannot independently get rid of toxins entering the body. Liver cells, unable to cope with the load, begin to die. Instead, fibrous connective tissue is formed. If the process is not stopped in time, the disease will progress and eventually lead to liver failure. This is the manifestation of diffuse dystrophy.

These changes can cause a similar phenomenon in the pancreas. This is due to the fact that these two organs constantly interact with each other.

The main danger of focal liver dystrophy is that it is extremely difficult to diagnose in the laboratory. most full information can be obtained using computed tomography and magnetic resonance therapy, other methods are practically useless.

The cause of focal liver dystrophy is excessive consumption of alcohol and alcoholic beverages. Signs of its manifestation:

• Decrease either complete absence appetite
• Dyspnea;
• In some cases - pain in the right hypochondrium.

The symptoms practically disappear when the patient is motionless, and are greatly aggravated during movement.

Granular dystrophy of the liver

This pathology belongs to the most common types of liver protein dystrophy. With this disease, the colloidal properties of the cell cytoplasm are violated, which leads to the appearance of a grain-like protein in it.

The development of granular degeneration of the liver can be triggered by:

• Inadequate feeding of the newborn;
• drug poisoning;
• infection;
• Violations of blood and lymph circulation;
• Oxygen starvation.

Granular dystrophy develops gradually. In the later stages of the disease, pathological changes may begin. The change in protein metabolism is disturbed, the cytoplasm becomes cloudy and swells. The tissues of the bile-forming gland become flabby and swell. There is a lack of blood flow.

When diagnosing, it should be borne in mind that normal protein synthesis also has signs similar to granularity.

Despite the reversibility of the pathology, it can cause severe complications. So, in some patients, in the absence of proper treatment, intracellular hyalinosis, dropsy and necrosis were observed.

Protein degeneration of the liver

This form of hepatic dystrophy occurs due to a violation of protein metabolism. The disease itself cannot develop, however, it can occur due to amyloidosis, and also outgrow from hyaline or granular degeneration of the liver.

Amyloidosis is characterized by the fact that in the tissues of the liver begins to synthesize and deposit the protein-polysaccharide complex amyloid.

Hyalinosis is a type of protein degeneration in which atherosclerosis develops. The disease manifests itself at the site of formation of a vascular thrombus. In this case, protein deposits are formed, resembling cartilage in structure.

With protein degeneration of the liver, the structure of the organ becomes granular. This is due to the fact that drop- or grain-like clots are formed in the protoplasm of cells. However, unlike the granular form of dystrophy, they can combine with each other, fill the space between cells. Affected tissue usually dies.

Hydropic dystrophy of the liver

With this form of liver dystrophy, additional vacuoles filled with cytoplasm begin to form in each cell. As a result, the cells of the parenchyma of the organ increase in size. The affected surface is slightly wrinkled. As the disease progresses, the liver becomes increasingly filled with fluid and at some point may begin to decompose. In this case, the cell is a cavity completely filled with water, in which the bubble-nucleus is located.

The disease can be detected only by examining a particle of the liver under a microscope. All methods of non-invasive examination are not able to detect diseases.

Unfortunately, this form begins to appear only when extensive cell necrosis begins. Treatment at this stage is not possible, only a liver transplant can save the patient.

Yellow dystrophy of the liver

This form of hepatic dystrophy develops as a complication of pregnancy. There is a disease due to intoxication of the body, during the treatment of infection. Also, jaundice in pregnant women can be caused by previously present liver dystrophy of any form or the presence of stones, as well as inflammation of the gallbladder.

For yellow liver dystrophy, the following symptoms are inherent:

• The skin and mucous membranes turn yellow;
• Profuse vomiting begins;
• Consciousness may periodically be disturbed;
• The body temperature rises (this phenomenon is often accompanied by delirium and increased excitability);
• Hemorrhagic rash (subcutaneous diseases);
• The amount of urine excreted during the day increases.

When examined in the urine of a patient, cyrosine and lecithin can be detected. An external examination may reveal a decrease in hepatic dullness. If you don't start within a few days intensive treatment the patient will die quickly.

Parenchymal dystrophy of the liver

Similar to other forms of the disease and may combine their symptoms. Parenchyma cells in this form begin to suffer first, pouring water. This may lead to various violations metabolism and even denaturation (destruction) of proteins.

Subspecies of parenchymal dystrophy are classified as follows:

• Hyaline drip;
• hydropic;
• Horny dystrophy.

The disease often turns into a granular form of dystrophy.

Diagnostics

It is possible to identify the disease as such only during a biopsy. All other methods of examination are ineffective. The most that can be found out during non-invasive checks is to find out that the liver is enlarged. Biopsy is resorted to in the very last resort, since for this test it is necessary to make an incision under the patient general anesthesia, insert a special probe and pick up a piece of organ tissue. In the future, the resulting micropreparation will be examined under a microscope, after which we can talk about making a final diagnosis.

What needs to be examined?

The diseased organ itself is examined. In addition, the patient takes some tests - urine and blood (the latter - twice). Also, the patient must undergo at least one non-invasive examination (for example, ultrasound). If, based on the results of the examinations, there is a suspicion that the patient is ill with liver dystrophy, he will be offered to go to the surgeon for a biopsy.

How to investigate?

Self-diagnosis of the disease is not possible, since it does not have pronounced symptomatic signs.

Tests cannot indicate exactly what disease the patient suffers from, they only generally indicate damage to the organ.

Treatment

Conservative therapy

Prevention of the disease consists in a change in lifestyle and taking drugs that help the liver cope with the disease.

Treatment with folk methods

Liver dystrophy is too dangerous a disease to treat on its own. Any drug that affects the liver can cause serious damage to it. If the patient has a desire to resort to traditional medicine, he should definitely consult with a specialist.

Who to contact?

If liver dystrophy is suspected, the patient may contact a therapist to receive an appointment to continue treatment. Further examination and treatment is performed by a gastroenterologist.

Medications

Most often, for rehabilitation after such a disease and for the prevention of its occurrence, the drug "Lesfal" is prescribed. This drug is universal remedy, which stimulates the rapid renewal of liver tissues.

The medicine is produced in Ukraine, in the Kyiv region, however, it can be purchased in Russia and Belarus.

The cost of the drug in Moscow is about 300 rubles.

Prevention

In order for the liver to old age pleased you with the absence of reminders of yourself, properly performing its functions, you need very little:

Monitor your weight and try to keep it within the normal range;

refrain from daily use sweet rolls and buns, fatty fried meat, smoked sausages, canned food and fast food;

Do not prescribe medication to yourself - if you suffer from constant headaches, aching joints or pain in the lower back, this the serious reason in order to see a doctor, and not to buy up half of the pharmacy in the hope that “at least something will help”;

Do not keep emotions in yourself - they say that long-suppressed anger, resentment or anger hits the liver. Apparently, without a miss, since all these feelings are literally written on the patient's face, while he himself is invariably restrained and correct. Allow yourself to verbally knock out the offender from time to time - or just take up boxing;

Participate in sports, such as swimming or walking;

Active rest - spending the weekend lying on the couch with your favorite laptop on your stomach, perhaps nice, but completely useless. Take the whole family to the zoo, local history museum or cat show, build a kennel for a dog or an aviary for betnamok hens ... Are you lonely? Make a list of challenges and once a week do one item from the plan. You will see, soon your life will sparkle with new colors!

Forecast

Provided that liver dystrophy is not accompanied by other diseases, the prognosis is usually quite favorable. If there are complications, due to which the resistance is weakened pathogenic bacteria, the latter, freely entering the body, undermine the already small strength of the patient. It is much harder to come out of anesthesia, he does not tolerate surgical intervention, the recovery period after which is significantly lengthened.

A radical lifestyle change complete failure from alcohol, strict observance diets and compliance with all the prescriptions of the attending physician can save not only health, but also the life of a person with liver dystrophy. On the contrary, continuing to lead a passive lifestyle, neglecting treatment, the patient runs the risk of "earning" steatohepatitis, and even cirrhosis of the liver.

Diet for sickness

In liver dystrophy, a significant role is played proper nutrition. The daily diet should contain foods containing the optimal amount of:

• vitamins;
• Belkov;
• Fiber;
• Pectin.

But you need to be careful with fats - the less they are on the menu, the better.

With liver dystrophy it is necessary:

• Exclude from the use of alcoholic beverages;
• Strictly monitor the amount of fat - they should be no more than 20% of the daily volume of food;
• Reduce the consumption of protein foods - its amount should not exceed 100-150 grams per day;
• Eat fractionally and drink at least 2 liters of non-carbonated water per day;
• Avoid using artificial food additives and other harmful substances.

For the basis daily menu you can take a dietary table N5.

Do not forget about annual preventive medical examinations. The sooner the initial signs of liver dystrophy are detected, the easier it is to cure it.

Fatty degeneration of the liver, also called fatty liver, occurs as a result of the accumulation of adipose tissue in its cells. As a result, the liver can no longer function normally and eliminate toxic substances.

Stages of the disease

Based on the degree of damage to liver cells and the accumulation of simple fats in them, three stages of the disease are distinguished. With fatty hepatosis of the I degree, foci of accumulation of cells with a high concentration of fat are formed. When, due to an increase in the area of ​​​​these accumulations, connective tissue begins to grow between the cells, we can say that the pathological process has passed to the II degree. Fatty degeneration of the liver III degree characterized by a significant accumulation of fat cells and the appearance of pronounced bands of connective tissue, ending with strands of fibroblasts.

Causes of the disease

The transformation of normal cells into fat cells can occur by different reasons. Pathologies associated with impaired lipid metabolism lead to this: obesity, type 2 diabetes mellitus, hypertriglyceridemia. Exposure of toxins to the liver can also eventually lead to fatty degeneration. The liver is prescribed the function of a kind of filter: it neutralizes toxic and foreign substances in the body. But if the toxic effect on the organ becomes permanent (for example, with regular alcohol intake), at some point it will no longer be able to cope with it. The probability of developing fatty hepatosis in people living in areas with high radiation is quite high. In addition, malnutrition leads to the disease (irregular food intake, lack of protein in the diet, starvation), as a result of which lipid metabolism is disturbed. Fatty liver disease can also result from long-term use antibiotics. Endocrine diseases lead to pathological process in the liver due to excess or, on the contrary, insufficient action of certain hormones.

Fatty degeneration of the liver: symptoms

As the cells are affected, symptoms begin to appear. They become most pronounced at stage III of the disease, when treatment is no longer possible. In this case, only one thing can help a person - a liver transplant. So, the main symptoms of fatty hepatosis are: heaviness in the abdomen from above (in the area where the liver is located), dysbacteriosis, decreased visual acuity, tarnishing of the skin, nausea, and vomiting. These symptoms appear when acute form disease, while the chronic one proceeds without any pronounced symptoms.

Fatty degeneration of the liver: treatment

The basis of treatment is the observance of a special diet aimed at maximum limit intake of fat. Due to this, it is possible to ensure that the fat that has already accumulated will begin to be actively used, which will allow the liver to get rid of it. Should be excluded from the diet fatty fish and meat, meat broths, beans and beans, mushrooms, tomatoes, onions and garlic (fresh), radishes, sour cream and cottage cheese with a high percentage of fat, canned food, smoked meats, carbonated drinks. Coffee should be replaced with unsweetened tea. Compliance with such a diet is mandatory, it is the basis of all treatment!