In the bodies of the vertebrae foci of fatty degeneration. Fatty degeneration of the spine. Treatment of fatty degeneration of the bone marrow - briefly

Rhythm of life modern man dictates its terms. The average resident of a large city does not have the opportunity to set aside several hours a day for eating: our contemporary is too busy. In order to somehow satisfy the need for food, a person resorts to fast food, small snacks, etc. As you know, "bitching" never leads to good. The lack of a rational and thoughtful diet will certainly lead to various diseases gastrointestinal tract. Less than you can get rid of - gastritis, but there are more serious diseases. One of them is fatty liver disease.

Fatty hepatosis of the liver is a degenerative disease of the organ with the gradual destruction of hepatocyte cells. Instead of hepatocytes in the liver, fat cells - lipocytes - take their place. Over time, lipocytes are destroyed, liver fibrosis begins, and this is already a direct path to cirrhosis and lethal outcome.

What you need to know about fatty liver hepatosis, so as not to miss the trouble?

Fatty hepatosis of the liver: causes

In the vast majority of cases, the reasons fatty hepatosis liver lie in the alimentary factor. This means that the disease itself develops for reasons not proper nutrition. However, not always. Among the factors that cause the disease, there are:

Alcohol abuse. Approximately 80% of all patients with hepatosis are persons who do not knowing measures in the use of alcohol. Especially often the problem of alcoholism occurs in men, so they are the main patients of the gastroenterologist. In women, hepatosis develops more rapidly and has a worse prognosis, especially against the background of alcoholism.

The use of narcotic and psychoactive substances. This includes not only drugs, but also the notorious energy drinks, caffeine in general, and even tea, due to the content of tannins in it (tea can be drunk without fear, we are talking about isolated cases).

Another risk group is people with poor nutrition. In this case, we are talking about a shortage of normal food. This includes vegetarians, anorexics. The body is not adapted for such extreme loads. With prolonged malnutrition, the body begins to think that the "hungry year" has come and it's time to stock up on fat. This is extremely harmful not only to the liver, but also to the heart.

Lung and heart disorders can lead to hepatosis.

Diseases associated with impaired lipid metabolism in the body. The main culprit of hepatosis, among diseases, is diabetes mellitus (especially type 2). It causes both external and internal obesity affecting the organs.

The effect of toxins on the body.

There are many causes of fatty liver disease. Almost always, the person himself is to blame for violations of her work.

Fatty hepatosis of the liver: the first symptoms

Hepatosis of the liver is a silent disease. Often, until the process becomes running, a person develops cirrhosis of the liver, nothing is noticeable. However, this is only an appearance. If you listen carefully to own body, you can see something that was not observed before. The first symptoms of fatty liver disease include:

Slight pain in the right side under the ribs. This is where the liver is located. At initial stages damage, hepatocyte cells die. This is accompanied by inflammation and the manifestation of pain. The pains are of a dull aching nature and are almost imperceptible, unless hepatitis or cholecystitis is added in parallel to hepatosis.

peptic phenomena. Frequent signs fatty hepatosis of the liver. Since the liver ceases to function normally, there is a high risk of developing problems with other organs of the gastrointestinal tract: nausea, vomiting, abdominal pain, heartburn, belching. There may be pain in the side on the left, in the center of the abdomen in the epigastric region.

The manifestations of dysbacteriosis. Usually manifested in the form of constipation, diarrhea, or their alternation. The stool becomes greenish.

Dry skin. The skin with hepatosis becomes dry, hot and flabby. If it's about late stages disease, it even turns yellow from the release of bile into the bloodstream.

Sensory disturbances, in particular blurred vision.

All this - non-specific signs fatty hepatosis of the liver. You can put an end to it only after passing a complete diagnosis.

Diagnosis of fatty hepatosis of the liver

At the first suspicion of the development of hepatosis, it is urgent to consult a doctor. Problems with the organs of the gastrointestinal tract are dealt with by gastroenterologists. On the initial appointment the doctor conducts a patient survey on the subject of complaints, their nature and prescription. So the specialist draws up a diagnostic strategy.

To the list necessary activities for staging accurate diagnosis includes:

Ultrasound of the liver. Traditionally, ultrasound procedure liver helps to identify its increase, and this almost always indicates problems with the organ.

Tomographic study. MRI allows you to evaluate the structure of the liver. If fat is deposited in the organ, this will be visible on an MRI.

Blood chemistry. The indicators of ALT and AST are evaluated. With their increase, we are talking about liver disease.

Biopsy. It doesn't happen that often. Allows you to find out if there is fat in the structure of the body.

In most cases, doctors do not encounter hepatosis, but hepatitis or cholecystitis. However, you cannot diagnose yourself. The doctor will take care of this. The patient's task is to clearly and consistently talk about their complaints.

Treatment of fatty hepatosis of the liver

Treatment of fatty hepatosis of the liver presents many difficulties. To resolve the issue once and for all, A complex approach. Treatment includes a number of important aspects:

Elimination of the root cause of fat deposition in the liver. Critical step, without which the treatment will have no effect. The first thing to do is to identify the root cause. It may be alcoholism, then you can not do without a complete rejection of alcohol, according to at least, for the period of treatment, may be malnutrition, then you should abandon fatty, fried and overly salty. At this stage, the main role is played by the willpower and discipline of the patient.

Compliance with diet, diet and physical activity. If the fat is broken down, it will not be deposited in the liver. But in order for fat to break down, effort is required. First, you need to renounce fatty foods and foods rich in "bad" cholesterol. This includes fatty varieties meat, sausages, pastries, etc. Secondly, it is necessary that the reserves that have entered the body are broken down. Therefore, hypodynamia should be avoided.

Reception medications. The main group of drugs used to treat hepatosis is the so-called hepatoprotectors.

In addition to avoiding factors that cause fatty degeneration of the liver and following a specialized diet, it is possible to take hepatoprotectors. Among them, preparations based on silymarin (milk thistle flavonoid) enjoy great confidence. For example, Legalon, an original German preparation containing milk thistle flavonoids (silymarin), special procedure purification and standardization.

Compared to analogues, Legalon has high content active component. It helps the liver cope with the load, strengthens its structure and prevents destruction by stabilizing cell membranes and additional synthesis of phospholipids. Legalon is actively fighting against toxic substances without giving them excess harm the liver and the whole body.

In addition to the protective effect, hepatoprotector Legalon has a restorative effect and helps reduce inflammation factors. Also, Legalon is suitable for the prevention of liver dysfunction, since it significantly reduces the load on the organ when taking medicines, fatty foods and alcohol. In addition, the drug helps prevent the occurrence of fibrosis and other degenerative changes liver.

These drugs stop the destructive processes in the liver and help restore already dead cells. Antioxidant drugs have also proven themselves well, preventing liver cells from dying and being replaced by scar or fatty tissue.

Contrary to the opinion replicated on the Internet, hepatosis should be treated with herbs with great care. Only milk thistle is suitable. The reason lies in the fact that often this disease is accompanied by cholecystitis: choleretic drugs can cause gallbladder rupture.

Prevention of fatty hepatosis of the liver

Prevention of fatty hepatosis of the liver is not difficult. It is enough to follow the following recommendations:

Eat often and fractionally, in small portions. So the liver will not be overstressed.

Minimize your intake of animal fats. Complete failure from them is also unacceptable.

Use alcohol with caution, in no case abuse it.

Maintain at least a minimum level of physical activity: physical inactivity has an extremely negative effect on liver function.

All these tips will help you avoid liver problems in the future.

Fatty liver disease is characterized high danger due to the risk of degeneration into cirrhosis. To prevent problems, you should rationalize your diet and physical activity. And if trouble does occur, it is urgent to consult a doctor for advice. It is much easier to treat hepatosis in the initial stages. So the patient will help both himself and the doctor.

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Diet for fatty liver

One of the factors in the development of fatty degeneration of the liver is a sedentary lifestyle combined with overeating. Therefore, it is very important to monitor your diet and maintain normal weight. If the patient is obese, then he is advised to follow a diet (but not strict) with a weight loss of about 0.5 kg per week. Moderate physical activity is welcome: exercise bike, swimming, walking.

Diet in fatty liver is not just important - it plays a leading role in the effectiveness of treatment of patients. Medical institutions usually prescribe diet table No. 5, with the use of protein foods up to 120 g per day, limiting animal fat, as well as enough products useful for the liver - cottage cheese, cereals (oatmeal, buckwheat, millet, wild rice). Vegetarian food is welcome - fruits and vegetables, greens, all types of cabbage.

Instead of meat products It is recommended to eat fish and seafood. It is advisable to avoid fried foods - steam, boil or bake, with the minimum amount butter (it is better to replace with vegetable).

We must not forget about drinking mode: in the absence of contraindications, you should drink at least 2 liters of water per day, mainly in the morning.

It is necessary to limit or exclude fatty dairy products: whole milk, sour cream, cheeses. Allowed to use low-fat kefir, ryazhenka, yogurt.

Alcoholic drinks will have to be completely excluded! In addition to alcohol, carbonated drinks are banned.

It is also recommended to give up sweets, white pastries, store-bought and fatty sauces, margarine, sausages, fatty meat and lard. Try to eat only natural fresh products, with a minimum amount of sugar.

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Causes of fatty degeneration of the liver

Various causes can lead to fatty degeneration of the liver: alcohol abuse, improper and malnutrition, and especially protein starvation; endocrine disorders (damage to the diencephalic-pituitary system, islet apparatus of the pancreas), prolonged infections (tuberculosis) and intoxication (phosphorus, chloroform, carbon tetrachloride, etc.), treatment with corticosteroids and antibiotics.

Symptoms and signs of fatty liver

On the early stage the disease is asymptomatic; possible hepatomegaly without noticeable functional abnormalities. The liver is smooth and soft to the touch. In this still reversible period, the elimination of the cause leads to the normalization of the size of the liver. With the progression of the disease, the liver becomes sensitive, dense. Determined high level choline in the blood serum, the activity of acetylcholinesterase increases. The content of total fats in the blood serum is often increased, and the first stage of the polarographic wave shows a tendency to increase. emphasize hypersensitivity and vulnerability of the liver in fatty degeneration, a decrease in the content of glycogen in it.

In the terminal period of the disease, it is possible severe complications: fat embolism, vascular thrombosis, hemorrhagic diathesis, hepatic coma. There is no convincing evidence that stenosis can lead to cirrhosis in humans.

Diagnosis. One should think about fatty degeneration of the liver in cases of detection of an enlarged liver of a soft consistency, in the absence of noticeable functional disorders especially when it comes to alcoholics, diabetics, ulcerative colitis, tuberculosis or nutritional disorders, etc. For pathology fat metabolism and the presence of fatty degeneration of the liver indicate a high level of choline in the blood serum, increased activity acetylcholinesterase, high total fat, and elevated first stage of the polarographic wave. Reliable diagnosis can be set by histological examination of biopsy material from the liver.

Fatty degeneration of the liver is differentiated from prolapse of the liver, chronic hepatitis and compensated inactive cirrhosis.

Treatment of fatty degeneration of the liver

First of all, the cause that led to fatty liver should be eliminated. The diet should be rich in animal proteins, vitamins, lipotropic substances with limited number fats. Vitamin B6 can be prescribed due to the unconditional dapotropic action characteristic of the drug, as well as choline chloride, lipocaine, folic acid, empirically methionine and choline (the use of the latter in the clinic has been disappointing).

Fatty degeneration of the liver of non-alcoholic etiology

Fatty degeneration of the liver of non-alcoholic etiology is called liver damage of varying severity, histologically resembling alcoholic liver damage, but occurring in those who do not abuse alcohol. It includes the actual fatty degeneration of the liver, damage to hepatocytes, necrosis and fibrosis; cirrhosis of the liver with portal hypertension and other complications, including hepatocellular carcinoma. Life expectancy in fatty liver is lower than in the general population.

In practice, the diagnosis of fatty degeneration of the liver of non-alcoholic etiology is made by the method of exclusion. It should be suspected in a patient with chronic liver disease who does not abuse alcohol if the results are negative. serological studies on the viral hepatitis and the absence of congenital or acquired liver disease.

Associated diseases and conditions

Fatty degeneration of the liver of non-alcoholic etiology is often found in type 2 diabetes mellitus, obesity and dyslipoproteinemia, which, in turn, are closely associated with the presence of metabolic syndrome.

Obesity. It is obesity that most often accompanies fatty degeneration of the liver, not associated with alcohol consumption. The presence of obesity is noted in 40-100% of cases of fatty liver with signs of hepatitis, and fatty degeneration liver with signs of hepatitis is detected in 9-36% of obese individuals. In addition, the type of obesity matters.

Hyperlipoproteinemia(hypertriglyceridemia, hypercholesterolemia, or both) is detected in 20-80% of cases of fatty liver with signs of hepatitis.

As a rule, with fatty liver with signs of hepatitis there are several risk factors.

In addition, risk factors include female gender, rapid weight loss, acute starvation, diverticulosis of the small intestine.

To hereditary diseases in which fatty degeneration of the liver develops, include Wilson's disease, homocystinuria, tyrosinemia, abetalipoproteinemia and hypobetalipoproteinemia, as well as spontaneous Weber-Christian panniculitis.

To fatty degeneration of the liver (especially with signs of hepatitis) can lead surgical interventions eg gastroplasty, jejunoileoanastomosis, biliopancreatic shunting.

Medicines and other substances. Fatty liver disease can be caused by a number of drugs and other chemical compounds. These include glucocorticoids, amiodarone, synthetic estrogens, tamoxifen, dietifen (a former cardiovascular drug), isoniazid, methotrexate, perhexilin, tetracycline, puromycin, bleomycin, dichloroethylene, ethionine, hydrazine, hypoglycine A, asparaginase, azacitidine, azauridine, azaserine . Constant contact with petroleum products at work is also a risk factor for fatty liver disease.

Symptoms. Most often, fatty degeneration of the liver is asymptomatic; sometimes patients complain of weakness, malaise, mild pain.

Physical examination. Almost three-quarters of patients have hepatomegaly, and a quarter have splenomegaly.

Laboratory research. In the absence of signs of hepatitis, laboratory studies are uninformative. In their presence, the main change in the biochemical parameters of liver function is an increase in the activity of ALT and AST. Usually these deviations are detected at the next medical examination or when you see a doctor for another reason. There is no clear relationship between enzyme activity, on the one hand, and histological parameters and the severity of inflammation or fibrosis, on the other. The activity of AlAT is often higher than the activity of AsAT, which distinguishes fatty degeneration of the liver of non-alcoholic etiology from liver damage in alcoholism, when the activity of AsAT is higher than AlAT, and the activity of alkaline phosphatase may be slightly increased; serum bilirubin and albumin levels are usually normal. Prolongation of the PV indicates decompensated liver failure. In some patients, a low titer of antinuclear antibodies is determined. However, there are no antimitochondrial antibodies, antibodies to the hepatitis C virus and HBsAg in the blood, and the serum levels of ceruloplasmin and α 1 -antitrypsin do not go beyond the normal range. Elevated serum ferritin levels and increased transferrin saturation are often observed. In men, excess iron in the body is more pronounced than in women. In a third of patients with fatty liver with signs of hepatitis, a homozygous or heterozygous mutation in the HFE gene is detected, leading to the replacement of cysteine in position 282 with tyrosine (a genetic marker of hemochromatosis). Liver fibrosis in the presence of this mutation is usually more pronounced.

Instrumental Research. For the diagnosis of fatty degeneration of the liver, various non-invasive methods of radiation diagnostics are used, including ultrasound. abdominal cavity, CT and MRI of the abdomen. None of them is sensitive enough to detect liver inflammation and fibrosis. CT and MRI can detect only extrahepatic manifestations of cirrhosis and portal hypertension. Thus, these methods lack both sensitivity and specificity to reliably diagnose fatty liver with signs of hepatitis and determine its severity.

Liver biopsy- a method to confirm the diagnosis of fatty liver, with or without signs of hepatitis, to assess the activity of hepatitis and the degree of fibrosis. It is still unclear whether to perform a biopsy in all patients, since the results do not always affect the treatment. A biopsy is indicated in the presence of metabolic syndrome in patients and with constantly elevated, despite proper treatment, activity of liver enzymes.

Histological picture with fatty degeneration of the liver of alcoholic and non-alcoholic etiology is the same. Histologically, there are 3 stages of fatty degeneration of the liver. First stage - fatty infiltration hepatocytes without inflammation and destruction. At the same time, fat accumulates in large drops in hepatocytes. The second stage is fatty infiltration of hepatocytes with signs of necrosis and inflammation. Fatty degeneration can be diffuse, and can be concentrated in the central zones of the hepatic lobules. There is always inflammation of the parenchyma of one degree or another; the cellular infiltrate in this case consists of neutrophils, macrophages and lymphocytes. Possible necrosis of hepatocytes with areas of devastation of the parenchyma; Mallory and Councilman's bodies may be found.

Iron deposits in hepatocytes are detected in 15-65% of patients. In fatty degeneration with signs of hepatitis in 35-85% of cases, fibrosis is found around individual hepatocytes, around sinusoids and portal tracts. The degree of fibrosis can vary greatly, from mild fibrosis around small veins and cell groups to severe, extensive fibrosis. In 7-16% of patients with fatty degeneration of the liver with signs of hepatitis, cirrhosis of the liver is detected at the first biopsy; histologically, it is indistinguishable from portal cirrhosis.

Causes of liver dystrophy of non-alcoholic etiology

The pathogenesis of fatty degeneration of the liver of non-alcoholic etiology is complex; apparently, it involves not only the liver, but also adipose, muscle and other tissues. Adipose tissue and insulin resistance play a leading role in the pathogenesis of the disease. Fats are known to be stored in adipose tissue. internal organs. With excess calorie content of food, the process of normal storage of fats is disturbed, which affects the rate of both lipogenesis and lipolysis and leads to an increased intake of free fatty acids from adipose tissue into the blood. This, in turn, contributes to the accumulation of fats in the liver and striated muscles. At the same time, cytokines are released, which disrupts intracellular signaling when insulin binds to receptors and reduces insulin-mediated glucose uptake into muscles. At the same time, utilization is suppressed and production of glucose in the liver is stimulated. In addition, the availability of fatty acids in the liver stimulates their esterification and de novo lipogenesis. This increases the level of apoprotein B 100l VLDL. All this together leads to the accumulation and oxidation of fats in the liver, stimulates free radical oxidation, release of inflammatory cytokines and activation of Ito cells.

In general, although the specific mechanisms for the development of inflammation and necrosis of hepatocytes in fatty liver are not fully understood, it is most likely that two processes underlie at once: fatty infiltration of the liver, on the one hand, and free radical oxidation and release of pro-inflammatory cytokines, which cause progressive damage. liver, on the other. There is increasing evidence that the second mechanism of pathogenesis of fatty liver is mediated by adipokines released from adipose tissue.

Adiponectin is an adipokine with anti-inflammatory properties. A network of significant associations between low levels of adiponectin and an increase in the amount of fatty tissue in the internal organs, hyperlipoproteinemia and insulin resistance. Another adipokine, leptin, in contrast, has a pro-inflammatory effect. It promotes liver fibrosis by increasing expression of transforming growth factor beta and stimulating Ito cell activation. Pro-inflammatory cytokines produced by adipose tissue of internal organs also include PIO and IL-6. They play a leading role in the development of insulin resistance, as they disrupt intracellular signaling when insulin binds to receptors and promote inflammation. In addition, they provide negative impact on the immune system.

The course and prognosis of liver dystrophy of non-alcoholic etiology

The course of the disease depends on the histological picture. If there is no inflammation and destruction of hepatocytes, the disease usually does not progress, but in the presence of signs of hepatitis, approximately 20% of patients develop cirrhosis over time. In the presence of signs of hepatitis, fatty degeneration of the liver in most cases is considered stable state, but in a number of patients it progresses and leads to severe cirrhosis of the liver. The risk factors for cirrhosis are elderly age, the presence of metabolic syndrome, obesity, diabetes mellitus, higher activity of AST than ALT.

There is currently no treatment for fatty liver of non-alcoholic etiology; the available methods are aimed at eliminating the factors associated with the development of the disease. Patients are advised to lose weight and refrain from alcohol, correct hyperglycemia and hyperlipoproteinemia, cancel hepatotoxic drugs (glucocorticoids, estrogens, amiodarone, perhexilin). In severe obesity, surgical treatment is indicated. In a number of small, short-term studies, ursodeoxycholic acid, vitamin E, gemfibrozil, betaine (a metabolite of choline), acetylcysteine, and metformin improved biochemical indicators liver function and reduced the severity of its fatty infiltration, but did not have a noticeable effect on the activity of inflammation or the severity of fibrosis.

Thiazolidinedione derivatives (pioglitazone and rosiglitazone) increase the sensitivity of fatty and muscle tissue to insulin and improve glucose uptake by their cells.

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Liver pathology

Symptoms

As a rule, patients with fatty degeneration or hepatosis in the liver do not complain about the deterioration of their health. The disease has an erased course, but at the same time continues to slowly progress. Subsequently, persistent dull pain develops in right side hypochondrium, accompanied by nausea with vomiting and stool disorders.

AT rare cases develops fatty degeneration of the liver of various etiologies with bright severe symptoms- severe abdominal pain, weight loss, jaundice and itching of the skin.

The reasons

«> main reason damage to the body is the immunity of liver cells to the effects of insulin on them. The main function of this hormone is to transport glucose into cells from tissue fluid and blood. In the formation of insulin resistance, cells in the liver do not receive vital glucose and die, and subsequently their place is taken by adipose useless tissue.

Insulin resistance can develop as a hereditary pathology, and also often occurs due to improper metabolism and can be triggered by improper immune aggression towards the hormone insulin.

To contributing factors that have a beneficial effect on the development of the disease are: intoxication, high concentration fat in foods and lack of physical activity.

Treatment

For treatment, patients are shown taking multivitamins, drugs that protect the liver. It is also recommended that sufficient physical activity. Treatment of fatty liver degeneration is usually long-term and takes at least two to three months. Subsequently, in without fail an ultrasound of the peritoneum and a biochemical blood test are performed.

As for food, it should include vegetable oils with their non-vegetable fatty acids. With the accompanying development diabetes and obesity requires limiting the amount of carbohydrates consumed.

Courses of treatment of pathology must be carried out at least twice a year. This disease indicates a metabolic disorder, which provokes the accumulation of excess fat in the cells in the form of drops.

If the treatment of the causes of the pathology is not carried out on time, then fatty degeneration will lead to the complete loss of damaged organs and, as a result, to death. In this regard, one should not ignore the recommendations of a specialist and strictly adhere to the course of treatment.

Pathology of the pancreas

“> Regardless of the location of the lesion, the pathology disrupts the normal functioning of the organ. It also happens in the pancreas, where fat cells begin to push out healthy structures and prevent the remaining ones from working properly. Fatty infiltration in the pancreas indicates a violation of metabolic processes in the human body.

Most often, fatty degeneration of the pancreas occurs in patients with acute or chronic form pancreatitis due to alcohol abuse. Usually in these situations this pathology combined with infiltration in the liver. At the same time, during the course of ultrasound examination iron practically does not change its size, has even contours. The launch of pathology can lead to serious and unpleasant consequences.

The reasons

Often, fatty infiltration in the pancreas develops due to improper organization of treatment or non-compliance with nutrition in patients with chronic pancreatitis. Against the background of obesity, all the negative manifestations of the disease are amplified several times, as there is a violation of normal functioning, healthy tissues are replaced by fat, and the process itself is considered irreversible.

Degeneration does not necessarily develop against the background inflammatory pathology, and not always the process of inflammation in the pancreas will cause degeneration in it. Usually such pathological changes are exposed to people with overweight, elderly patients.

Treatment

Degeneration in the pancreas can only be treated conservative ways or through surgical intervention. Conservative treatment It is carried out on the condition that small fat cells are distributed throughout the gland and do not compress its ducts. When fat cells begin to merge into groups, compress the ducts and interfere with secretion production, a surgical intervention- namely, the removal of lipomatous nodes.

The essence of conservative treatment is to organize the following activities:

strict diet with limited consumption fats.
Weight loss in the presence of excess body fat. According to statistics, most people who suffer from fatty degeneration also suffer from overweight body. That's why this measure will allow you to remove excess fats from the lipid layer in the pancreas.

“> Due to the fact that fatty degeneration is considered an irreversible process, it will no longer be possible to cure damaged parts of the organ, and the main goal of therapeutic treatment remains to prevent the subsequent progression of the spread of fat cells. At this stage of treatment, proper nutrition plays an important role, because the right diet, which is strictly observed by the patient, helps to avoid surgical intervention in case of progression of the disease process.

Diet is based on rules fractional nutrition. This is not just the basis of a diet, but an indisputable algorithm for proper nutrition in general. Unfortunately, in modern world even such an inalienable norm becomes an exception.

You need to eat four to five times a day. The nutrition itself is based on diet number 5, which must be followed by all patients affected by pancreatic pathologies. Patients are required to stop eating fried foods, smoked and salty foods, sweets, muffins, alcoholic beverages and chocolate. Doctors recommend steaming or steaming all meals. And it is especially useful to eat dairy products and cereals.

As for meat, it is better to give preference low-fat varieties poultry, but to the extent possible, replace them with vegetables. It is also useful to drink pre-prepared infusions from medicinal herbs such as chamomile, mint, St. John's wort, blueberry leaves, and cranberries.

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Why does pathology develop

Most often, the pathology develops after 46-50 years.

A disturbed metabolism leads to the fact that the liver cannot excrete right amount enzymes for processing fats.

As a result, they begin to accumulate in the organ cavity.

Such changes can occur under the influence of the following factors:

Eating disorder. Sweets, convenience foods and fast foods, preservatives, dyes and other toxins are especially detrimental to the liver.
Prolonged fasting or, conversely, constant overeating. Starvation diets or an incorrectly composed diet, vegetarianism are the enemies of the liver. They lead to body fat.
hereditary factor. If there were relatives with liver diseases in the family, then a person will develop dystrophic pathology in 89%.
Uncontrolled and prolonged use of medications.
Drinking too much alcohol (alcoholic fatty liver disease).
Drug use.
Professional activity involving work in industrial enterprises where they produce different kinds chemicals.
Passive lifestyle.
Failure of the hormonal system.
Neoplasms affecting the pituitary gland.

The mechanism of formation of fatty degeneration is actually very simple. Fats enter the gastrointestinal tract (gastrointestinal tract) and are amenable to the process of splitting. If there are a lot of these components entering the liver, and there are disposing factors, fats undergo synthesis and accumulate in the liver cells. The same thing happens under the action of carbohydrate-containing substances that enter the liver in large quantities.

Fatty degeneration can be classified as follows:

Type I - fatty inclusions are single character, they are randomly located in the liver. There are no clinical manifestations.

Type II - fat molecules are densely packed. A person feels worse, there is pain in the liver.

Type III - there is a local arrangement of fat capsules, they are located in certain areas of the body. The symptoms are pronounced.

Type IV - fatty molecules are located almost throughout the liver or occupy one of the lobes. Symptoms are bright.

Fatty degeneration can also be classified depending on the stage:

I - in liver cells contains a small amount of fat molecules, but they do not affect the functioning of the organ, although the destructive mechanism has already been launched.

II - fat completely fills the cells, they are destroyed, an inflammatory process can develop around each cell.

III - the processes are irreversible, necrosis develops, in most cases it is impossible to restore liver function at this stage.

How the disease manifests itself

Symptoms of the disease appear already in the second stage:

pulling, It's a dull pain in the area of the liver, which becomes stronger after eating fatty foods, smoked meats, spicy dishes and alcoholic beverages. The pain may be constant or intermittent.
Bitterness in the mouth, belching with a bitter taste.
Nausea, almost always ending in vomiting.
Flatulence.
Enlargement of the liver in size.
appears on the tongue yellow plaque, it is dense.
Constipation followed by diarrhoea. They are permanent.

Signs of the third stage of the lesion cause very great discomfort and are expressed in:

increased irritability;
sleep disturbance;
fatigue;
memory impairment;
tendencies to depression;
accumulation of a large amount (up to 25 l) of free fluid (the abdomen becomes very large);
pain cannot be relieved with analgesics;
yellowness of the skin;
in rare cases, itching develops.

If fatty degeneration leads to necrosis of liver tissues, such additional signs and symptoms:

an unpleasant smell of the liver on the bed and from the oral cavity;
a significant increase in temperature;
nose bleed;
anorexia;
cardiac arrhythmias and shortness of breath.

It should be noted that as soon as the first symptoms appear, you should immediately go to the hospital so that the doctor prescribes a course of treatment. In no case can you treat fatty degeneration on your own. This can lead to death. Another point is that the disease develops quite quickly, so treatment should be prescribed as soon as possible.

Today at timely handling in a hospital, the treatment is effective, thanks to innovative methods and new generation drugs.

Apply folk ways treatment is not prohibited, but it is necessary to consult a doctor before drinking decoctions.

How is diagnostic testing and treatment carried out?

Diagnostics includes the following types of examination:

ultrasound procedure;
CT scan;
laparoscopic technique;
biopsy to identify fatty inclusions, their number, size and localization;
blood tests.

When the symptoms are examined, and also on the basis diagnostic examination treatment will be prescribed, the scheme of which will be developed in each individual case.

Treatment of fatty degeneration is carried out in a complex. In this case, a prerequisite is a diet.

Only by observing all the prescriptions of doctors, it will be possible to get rid of fatty degeneration. To treat dystrophy, doctors prescribe drugs to restore liver cells, drugs that normalize metabolism, drugs and a vitamin complex to increase immunity. If an inflammatory drug is present, treatment involves taking anti-inflammatory drugs.

Treatment with folk remedies

Treatment of liver dystrophy can be carried out with a pumpkin.

It is very rich in vitamins and minerals, which help in the shortest possible time to restore cells and normalize the metabolic balance.

Cut off the top of the pumpkin, remove the seeds, fill the cavity with honey and put in a cold place for 8-10 days. After that, drain the honey into a container and refrigerate. Take 1 tbsp. l. 2 times a day. If you are allergic to bee products this method prohibited.

It is possible to treat dystrophy herbal collection. The following components are taken in equal amounts: string, wormwood, sage, raspberry leaves, birch, chamomile, yarrow, linden. Grind and mix ingredients. Pour boiling water in the ratio of 1 part of the collection, 2 parts of water. Infuse for 3 hours, strain and take during the day as a tea.

You can treat dystrophy with the help of such a decoction: birch leaves, wild rose, hawthorn, red-fruited mountain ash, nettle leaves, lingonberries, bearberry, dandelion roots, fennel fruits, St. John's wort. Grind the components and pour water in a ratio of 1: 3. Boil on steam bath mix 20 min. Strain and drink as a tea throughout the day.

Diet for liver dystrophy

Basic rules of the diet:

increase the amount of foods rich in protein ( dairy products, lean meats);
cut out carbs White bread, sugar, rice, potatoes);
minimize the amount of animal fats (butter, oily fish and oil);
be sure to include in the diet at least 2.5 liters of water per day;
exclude alcohol;
refuse fried, spicy, salty foods.

How dystrophy will be treated depends on the person. If present excess weight, a person leads a sedentary lifestyle, you should completely get rid of such factors - go in for sports, but without much physical exertion. You can ask your doctor about how to treat dystrophy with physical gymnastics.

The main tasks of dietary nutrition in dystrophy are the normalization of the main functions of the organ and the resumption of cholesterol and fat metabolism; stimulation of bile production.

The amount of fat consumed during the day should not exceed 50 g! This is a very important condition.

In addition, it is necessary to exclude foods that are rich in cholesterol. In this case, it will be possible not only to help the liver cells recover, but also to avoid thrombophlebitis.

Another important rule is that dishes are best steamed or eaten boiled, baked. In this case, they will not only be useful for the liver, but also retain all the vitamins.

What must be included in the diet:

soups on vegetable broth with cereals, borscht;
vegetables;
vegetable salads;
mild cheese, ham;
boiled egg or steam omelette;
oatmeal, buckwheat, semolina;
low fat dairy products.

What to exclude:

fatty foods, mushroom broths and mushrooms;
seafood;
onion in fresh, garlic, tomatoes, radishes, legumes;

pickles and marinades;
dried products;
conservation;
coffee, cold or carbonated drinks.

It is very important not only to treat the disease, but also to take all measures to prevent it.

Prevention methods include: healthy lifestyle life, control of alcohol intake, increase immunity, health care, sports. Only in this case it will be possible to prevent such a disease as fatty degeneration of the liver. It should be remembered that if the disease is not treated, it will lead to death.

Bone marrow normally consists of myeloid tissue. It fills the cavity of the bone. it hematopoietic organ which produces erythrocytes, leukocytes and platelets. He takes an active part in the formation of immunity. Under the influence of various adverse factors myeloid tissue may be replaced by fat. In this case, doctors talk about fatty degeneration. bone marrow. Why are such changes dangerous? And how to treat such a pathology? We will consider these questions in the article.

Why is it dangerous

Most often, patients have fatty degeneration of the bone marrow of the vertebrae. Dystrophic changes in this organ negatively affect the process of blood formation and the state of the musculoskeletal system. In humans, the number of erythrocytes, leukocytes and platelets decreases. This can lead to the following consequences:

A drop in the number of red blood cells causes anemia.
Violation of the formation of leukocytes. This leads to a deterioration in immunity. The patient's resistance to infection decreases.
because of low quantity platelets in humans, blood clotting is impaired.

This leads to a deterioration in the supply of oxygen to the organs and can cause a violation of their function. AT advanced cases are happening pathological changes in vessels due to reduced blood flow.

Further dystrophic changes extend to ligaments spinal column. This can lead to its narrowing and compression of the spinal cord.

The reasons

The most common cause of myeloid tissue degeneration is age-related changes in the body. Areas of fatty degeneration of the bone marrow are observed in many patients over 65 years of age. At this age, dystrophic processes develop rapidly in the body.

In older patients, approximately half of the myeloid tissue is replaced by fat. This is considered natural process and is not pathological.

If foci of fatty degeneration in the bone marrow are observed at a young age, then most often this is due to a disease or intoxication. Can be distinguished the following reasons pathological changes:

oncological diseases;
metabolic disorders;
chronic infections;
osteochondrosis;
(decreased secretion of pituitary hormones);
intoxication with benzene and arsenic;
long-term medication: non-steroidal anti-inflammatory drugs, antihypertensive drugs, sleeping pills of the barbiturate group, cytostatics, antibiotics and sulfonamides.

Symptoms

Fatty degeneration of the bone marrow for a long time be asymptomatic. On the early stages there is a decrease in immunity and susceptibility to infections. Often observed prolonged bleeding even from small wounds. Patients complain about fatigue and weakness.

Patients do not always associate these manifestations with pathology. However, such symptoms indicate a violation of the formation of blood cells in the bone marrow. Often they are found only at the stage of occurrence of complications.

If a fat changes in the bone marrow are associated with osteochondrosis, then patients complain of discomfort and back pain, muscle stiffness in the morning, and asthenia.

Complications

In advanced cases, fatty degeneration of the bone marrow can lead to the following complications:

Hypoplastic and aplastic anemia. This condition is accompanied by a sharp inhibition of the formation of blood cells. The blood test shows significant reduction indicators of erythrocytes, leukocytes and platelets. The patient has frequent bleeding and manifestations of anemia (weakness, dizziness, fatigue). Without treatment, this pathology can be fatal.
Osteoporosis. Due to fatty deposits in the bone marrow, collagen production and calcium absorption are disrupted. This leads to increased bone fragility. Patients have pain in the spine, scoliosis, stoop.
Spinal stenosis. With fatty degeneration, degeneration of ligaments and cartilage develops. As a result, the spinal canal narrows and compresses spinal cord. This threatens with paresis and paralysis.

Diagnostics

The main method for diagnosing this pathology is MRI of the spine. The picture shows the bone marrow with signs of fatty degeneration. In addition, appoint clinical trial blood. A decrease in the number of erythrocytes, platelets and leukocytes may indicate fatty degeneration of the hematopoietic organ.

Conservative treatment

If fatty degeneration of the bone marrow develops in old age, then this pathology cannot be fully cured. Such changes are irreversible. You can only stop the progression of dystrophy.

If pathological changes are caused by intoxication, infections, tumors and endocrine ailments, then it is necessary to treat the underlying disease.

As we have already mentioned, most often foci of fatty degeneration are formed in the vertebral bodies. Such pathological changes are accompanied by pain and discomfort in the back. In this case, treatment should be aimed at relieving pain and improving the condition of cartilage and ligaments. The following groups of drugs are prescribed:

Nonsteroidal drugs anti-inflammatory action: "Diclofenac", "Ibuprofen". They help relieve back pain.
Blockade with Novocaine. This method of treatment is used for severe pain syndrome.
Muscle relaxants: Sirdalud, Mydocalm. Drugs help relieve muscle spasms.
Chondroprotectors: "Chondrolon", "Chondrex", "Teraflex". These medicines contribute to the restoration of affected cartilage.
Calcium preparations. Administered to patients with severe osteoporosis.
Medicines that stimulate the process of hematopoiesis: "Maltofer", "Sorbifer Durules", "Folacin", "Ferretab comp". They are prescribed for signs of anemia.

The doctor selects an individual diet for the patient. It is recommended to consume foods rich in gelatin, iron and vitamin B12.

After stopping the pain syndrome, therapeutic exercises are prescribed. Treatment is supplemented with physiotherapy: massage, electrophoresis, acupuncture, magnetotherapy.

Surgical methods

Surgical treatment is rarely used. The operation is indicated only for stenosis of the spinal canal. In this case, the surgeon cuts off those parts of the spinal discs that compress the nerves.

However, most often fatty degeneration is subject to conservative therapy. Reestablish normal tissue bone marrow is possible only in the initial stages of the disease in young patients. In old age, timely treatment can stop the spread of pathology.

Bone marrow is a mass that occupies those spaces in the bone cavity that are not filled with bone tissue. He is the most important body hematopoiesis, constantly creates new blood cells that replace dead ones. The bone marrow plays an important role in the formation and maintenance of immunity.

Problems that arise in the bone marrow inevitably affect hematopoiesis, blood composition, the state of blood circulation, blood vessels, and soon the whole organism. In violation of the functions of the bone marrow in the blood, the number of leukocytes, platelets, erythrocytes decreases. The composition of the blood changes, and hence the nutrition of the organs, that is, their functions also suffer. Due to changes in the composition of the blood, the nature of its movement through the vessels also changes, which also causes many unpleasant consequences.

Degenerative processes sooner or later begin in any organism. Such processes also take place in the bone marrow. To a certain extent they are normal physiological processes, of course, if they start on time. In degenerative-dystrophic processes, normal (myeloid) bone marrow tissue is gradually replaced by connective and adipose tissue. Moreover, it is fat substitution that prevails.

With age, these processes increase and accelerate. So, by the age of 65, about half of the bone marrow in a person is replaced by adipose tissue. At an older age, fat cells can occupy half of its volume. Fatty degeneration of the bone marrow today is the object of attention medical science. An earlier and more intensive process of such replacement of one tissue by another causes the development of various diseases.

Where do fat cells come from

When scientists studied fat precursor cells, the first suspects were myeloid cells in the bone marrow. These cells give rise to blood cells (except lymphocytes), cells from which muscles are formed, liver cells, and can also be the progenitors of fat. Thus, perhaps due to the low "specialization" of myeloid cells in the bone marrow, their significant replacement with fat cells occurs.

Pathological replacement of myeloid tissue with adipose tissue may occur due to a violation metabolic processes in the body, bone marrow lesions by metastases, infectious processes especially chronic ones.

What diseases are accompanied by fatty degeneration of the bone marrow?

Simmonds-Schien Syndrome,
Hypoplastic and aplastic anemias,
Osteoporosis.

This is a list of diseases in which a link has been established between bone marrow degeneration and symptoms or causes of disease.

Simmonds-Schien syndrome

Another name for this disease is hypothalamic-pituitary cachexia. It affects most often women aged 30-40 years. Initially pathological process occurs in the adenohypophysis and hypothalamus. Further, the secretion of hormones, including growth hormone, is disrupted. This causes degenerative-dystrophic and atrophic processes in tissues and organs and a wide variety of symptoms.

Hypoplastic and aplastic anemias

This group of anemias develops as a result of hematopoiesis suppression, which, in turn, is caused by the replacement of the myeloid tissue of the bone marrow with adipose tissue. The reasons for this may be toxic or infectious and viral effects.

Among the substances that negatively affect the state of the bone marrow, arsenic, benzene, and some drugs are called. This is one of the arguments that you should not self-medicate, any medicine should be prescribed by a doctor. He does this with the potential consequences in mind.

Medicines that can cause or accelerate bone marrow degeneration:

cytotoxic agents,
Non-steroidal anti-inflammatory drugs such as acetylsalicylic acid, analgin,
Sleeping pills (barbiturates),
Blood pressure lowering agents such as captopril
Thyrostatics,
anti-tuberculosis drugs,
Sulfonamides,
Some antibiotics, in particular, chloramphenicol,
Antiarrhythmic drugs.

The main manifestation of hypoplastic and aplastic anemia is thrombocytopenia, manifested by hemorrhagic syndrome. Bleeding, bleeding of the skin and mucous membranes, hemorrhagic eruptions - these are the most common symptoms this type of anemia.

Osteoporosis

Until recently, it was believed that a large amount of adipose tissue protects the body from osteoporosis, since it compensates for the missing hormones. However latest research found that this is not entirely true. Excess fat cells prevent the body from producing collagen and absorbing calcium. This leads to a weakening of the bone tissue, to degenerative processes in it, that is, to bone fragility - the main manifestation of osteoporosis.

What threatens fatty degeneration of the bone marrow?

Bone marrow is a mass that occupies those spaces in the bone cavity that are not filled with bone tissue. It is the most important organ of hematopoiesis, constantly creating new blood cells that replace dead ones. The bone marrow plays an important role in the formation and maintenance of immunity.

bone marrow degeneration

Degenerative processes sooner or later begin in any organism. Such processes also take place in the bone marrow. To a certain extent, they are normal physiological processes, of course, if they begin on time. In degenerative-dystrophic processes, normal (myeloid) bone marrow tissue is gradually replaced by connective and adipose tissue. Moreover, it is fat substitution that prevails.

With age, these processes increase and accelerate. So, by the age of 65, about half of the bone marrow in a person is replaced by adipose tissue. At an older age, fat cells can occupy half of its volume. Fatty degeneration of the bone marrow today is the object of attention of medical science. An earlier and more intensive process of such replacement of one tissue by another causes the development of various diseases.

Where do fat cells come from

When scientists studied fat precursor cells, the first suspects were myeloid cells in the bone marrow. These cells give rise to blood cells (except lymphocytes), cells from which muscles are formed, liver cells, and can also be the progenitors of fat. Thus, perhaps due to the low specialization of myeloid cells in the bone marrow, their significant replacement with fat cells occurs.

Pathological replacement of myeloid tissue with adipose tissue can occur due to a violation of metabolic processes in the body, bone marrow lesions with metastases, infectious processes, especially chronic ones.

What diseases are accompanied by fatty degeneration of the bone marrow?

Simmonds-Schien Syndrome,
Hypoplastic and aplastic anemias,
Osteoporosis.

This is a list of diseases in which a link has been established between bone marrow degeneration and symptoms or causes of disease.

Simmonds-Schien syndrome

Another name for this disease is hypothalamic-pituitary cachexia. It affects most often women aged 30-40 years. Initially, the pathological process occurs in the adenohypophysis and hypothalamus. Further, the secretion of hormones, including growth hormone, is disrupted. This causes degenerative-dystrophic and atrophic processes in tissues and organs and a wide variety of symptoms.

Hypoplastic and aplastic anemias

Medicines that can cause or accelerate bone marrow degeneration:

cytotoxic agents,
Non-steroidal anti-inflammatory drugs, for example, acetylsalicylic acid, analgin,
Sleeping pills (barbiturates),
Blood pressure lowering agents such as captopril
Thyrostatics,
anti-tuberculosis drugs,
Sulfonamides,
Some antibiotics, in particular, chloramphenicol,
Antiarrhythmic drugs.

The main manifestation of hypoplastic and aplastic anemia is thrombocytopenia, manifested by hemorrhagic syndrome. Bleeding, bleeding of the skin and mucous membranes, hemorrhagic rashes are the most common symptoms of this type of anemia.

Osteoporosis

Until recently, it was believed that a large amount of adipose tissue protects the body from osteoporosis, since it compensates for the missing hormones. However, recent studies have shown that this is not entirely true. Excess fat cells prevent the body from producing collagen and absorbing calcium. This leads to weakening of the bone tissue, to degenerative processes in it, that is, to bone fragility - the main manifestation of osteoporosis.

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Doctors say that the state of the whole organism largely depends on the health of the spine. But a person often does not follow his own musculoskeletal system, exposing it heavy loads leading an inactive lifestyle, long time sitting at the computer. As a result, degenerative-dystrophic changes in the spine occur, subsequently causing osteochondrosis.

Fatty degeneration of the bone marrow of the vertebral bodies is a change in tissues, accompanied by the fact that a lot of fat accumulates in the cells. At the same time, the protoplasm of the cell can be transformed into it due to the fact that fat grains get inside it. Such violations cause the death of the cell nucleus, in the future it dies.

In most cases, fatty degeneration occurs in the liver and blood vessels, but can be detected in other parts of the body. When fat replaces the cartilage of the intervertebral discs, they lose their ability to provide flexibility and springiness to the spine.

Even human bones can be replaced by fat. As a result, the vertebrae become less durable, which adversely affects the health of the spine as a whole. The vertebrae acquire excessive mobility, that is, they become unstable. These pathological abnormalities are perfectly visible to doctors during magnetic resonance imaging.

Based on the nature of pathological changes, the forms of degeneration can be different. If the spine has undergone this pathology, then there is a high probability of developing osteochondrosis.

Classification of degenerative-dystrophic changes in the spine

The course of pathology is divided by specialists into several stages, each of which is characterized in its own way. Thus, the following stages of dystrophy in the vertebrae are distinguished:

First stage. On it, changes in the intervertebral disc are not yet observed, but during the examination it is already possible to see that there are small gaps inside the layers of the fibrous ring.
Second stage. At this stage, the layers of the annulus on the outside are still preserved and can prevent the disc from protruding. But the patient already feels pain in the back area, which can radiate to the leg and knee.
Third stage. Extensive ruptures of the fibrous ring occur on it, as a result of which a protrusion occurs intervertebral disc. Pain in lumbar become even stronger.

Reasons for the development of the disease

The main cause of fatty degeneration is poor nutrition vertebral cells. It is they who are most sensitive to the fact that a small amount of oxygen, glucose is supplied and changes occur. acid-base balance in blood. All this provokes the development of disorders in the disk.

Deterioration of the activity of the circulatory system may occur due to different reasons, for example, due to anemia, spinal overload and poor nutrition. Also, deviations can develop due to age.

Changes can even occur as a result of poisoning with a substance, such as alcohol. Also, certain infectious pathologies can become the cause of fatty degeneration.

Methods of treatment of fatty degeneration of the bone marrow of the vertebral bodies

Fatty degeneration of the vertebrae is treated with both conservative and operational method. If the pathology appeared due to the aging of the body, then the process cannot be cured, since it is irreversible.

If unpleasant symptoms, inflammation processes and nerve compression occur, specialists prescribe the following medications:

non-steroidal anti-inflammatory drugs aimed at relieving inflammation and relieving pain;
muscle relaxants to eliminate spasm of muscle tissue;
blockade with novocaine in the form of injections;
chondroprotectors that help restore damaged cartilage.

In addition to drugs, patients are prescribed physiotherapeutic procedures, for example, magnetotherapy and electrophoresis. Also great help physiotherapy, but it can only be used during remission. Good methods of treatment are massage and acupuncture.

Surgical intervention is performed only if there is a narrowing of the spinal canal. In this case, without the help of a doctor, the patient risks losing sensitivity and acquiring paralysis.

Reestablish bone tissues in this case It is possible only in the first stages of the disease, but basically therapy can only stop the development of the pathological process.