Why do diseases of the liver and biliary tract occur. Scheme of effective treatment of the liver and gallbladder Treatment of the liver and biliary tract

Many human diseases have their manifestations - symptoms. Several combined symptoms are called a syndrome. Symptoms can be both the same for various organs, and specific - characteristic only for the pathology of a particular organ or for a particular disease. Symptoms allow you to recognize the disease in its diagnosis. They can be bright, permanent. This is characteristic of acute diseases.

Smoother symptoms are a sign of a chronic disease

The ability to distinguish, notice the manifestations of the disease is very important for the doctor and the patient himself. A person may not pay attention to any symptoms and not suspect that he is developing an ailment until he sees a doctor, perhaps for a completely different reason. Therefore, knowledge of the elementary manifestations of diseases is the necessary basic basics for people who care about their health. However, having discovered a symptom of a particular disease, you should not immediately diagnose yourself, lose heart, and even more so start self-treatment. You need to clearly understand that, having suspected a violation of the function of some organ, you must immediately go to the doctor. Only he can objectively identify the symptoms, analyze them and proceed to adequate treatment or prescribe additional studies.

Joke. Late in the evening - a knock on the door of the doctor's house. The doctor opens the door and sees a skeleton in front of him.

“Well, first they bring themselves to such a state, and then they come to the reception,” the doctor grumbles.

Indeed, there is a great deal of truth in this. People often do not pay attention to other symptoms of serious diseases. The neglect of the disease is not only serious suffering for the patient, but also a difficult path to recovery. Sometimes this inevitably leads to disability or even death.

Symptoms are divided into objective and subjective

Subjective ones are connected with the sensations of a person and do not have manifestations that others can see. For example, complaints of pain. Objective symptoms have real manifestations that another person can see. For example, yellowing of the skin or enlargement of the liver, felt on palpation. Objective signs of diseases are more reliable, and therefore more informative.

Naturally, liver diseases, like diseases of many other organs, have their specific and non-specific, objective and non-objective manifestations.

In diseases of the liver, weakness, fatigue are common. This is a fairly common symptom for the pathology of many organs and diseases, and it is subjective. Sometimes it may not be related to a disease of the liver or another organ at all. Man is a living being, and he is characterized by fluctuations in the physical and spiritual state. Therefore, if you experience weakness or increased fatigue, do not immediately blame the liver for this. Perhaps this is due to unusually high physical or emotional stress. In such cases, recovery occurs with proper rest, taking vitamins. If you feel increased fatigue for no reason or it is unusually strong, then you can suspect something is wrong.

In liver diseases, weakness and fatigue are associated with intoxication.

However, if in infectious diseases intoxication is caused by the pathogen itself or its toxins, then in liver pathology this occurs due to a violation of its detoxification function. The body accumulates toxins formed as a result of its vital activity, since they are not destroyed in the liver. In case of violation of the patency of the biliary tract, the reverse absorption of its components from the bile occurs, which also leads to intoxication. Weakness and fatigue in liver disease also occur due to violations of protein, carbohydrate, vitamin metabolism.

The liver plays a huge role in digestion, therefore, with its diseases, the digestive function will certainly suffer. In chronic hepatitis, cirrhosis, chronic cholecystitis, this will be less noticeable than in acute diseases of the liver and biliary tract. In chronic liver diseases, digestive manifestations are nonspecific. They are characteristic of chronic pancreatitis, chronic enterocolitis, etc. One of the manifestations is dyspeptic phenomena, which can manifest themselves as unformed stools, as well as constipation, flatulence (bloating), belching, heaviness in the epigastrium (upper abdomen between costal corners). The quality of the stool changes. It becomes fatty consistency - steatorrhea, which is associated with impaired absorption and breakdown of fats. Bile performs a regulatory function for the intestines, improves the absorption of fats and proteins by the cells of the intestinal walls. Therefore, in diseases of the liver and biliary tract, peristalsis, the secretory function of the intestine are disturbed, the absorption of nutrients worsens - all this leads to weight loss. At the same time, the bacteriostatic effect of bile is minimized, which contributes to the settlement of the small intestine with excess flora. This leads to the occurrence of enterocolitis with its characteristic symptoms. A long-term pathological process in the gallbladder steadily leads to a disorder in the function of the pancreas. As a result, the picture of chronic pancreatitis joins. Based on the foregoing, it becomes clear that in chronic liver diseases, the symptoms are diverse, other organs are involved in the pathological process, and therefore it is difficult to recognize manifestations that are characteristic only of the liver.

Acute diseases such as acute hepatitis, acute cholecystitis, choledocholithiasis (blockage of the common bile duct with a stone) have more pronounced manifestations in the digestive tract. There may be severe nausea, vomiting, including bile. A special feature specific to hepatitis and bile duct obstruction is complete or partial discoloration of the feces. In hepatitis, the flow of bile is impaired due to dead cells that block the bile ducts inside the liver. This condition is temporary and characterizes a certain stage of hepatitis. With cholelithiasis, a block occurs due to a stone that has entered the bile duct. In this case, fecal discoloration may occur suddenly or increase. There are valve stones, which, rotating, either block the duct completely, or release it. Then the discoloration may periodically change to the normal color of the stool. Violation of the outflow of bile is a frequent companion of tumors of the biliary tract; then the discoloration of the feces occurs gradually and irreversibly.

Most diseases of the liver and biliary tract are accompanied by pain

The pain in this case is felt in the right hypochondrium. There are no pain receptors in the liver tissue, so pain in liver diseases occurs due to stretching of the fibrous capsule that covers the liver. With the inflammatory process in it, stagnation of blood, tumor growth, the volume of the liver increases accordingly. This leads to slow expansion of the capsule.

Pain is a special reaction of the body to a stimulus that threatens the normal functioning of the body. The sensation of pain is a signal to eliminate the stimulus that causes it. Pain is a necessary component that allows a living organism to adapt to nature. She, or rather, her character and localization help the doctor to make the correct diagnosis.

The fibrous capsule of the liver is dense, and therefore reacts slowly to stretching. This explains the nature of the pain. When the pathological focus is localized directly in the liver, it has a aching dull character, that is, it is not intense, it continues for a long time; a feeling of heaviness is possible. This type of pain accompanies hepatitis, the initial stages of cirrhosis, tumor diseases of the liver. If the pathological process occurs in the biliary tract, then the pain is intense, sharp, cramping. This is due to the occurrence of spasms caused by smooth muscles, or, conversely, stretching of the bile ducts and bladder. Very intense acute pain occurs with inflammatory diseases of the biliary tract, such as acute purulent cholecystitis or cholangitis. When tapping along the costal arch, the pain increases sharply. This type of pain is a sure sign to go to the doctor or call the emergency room.

Must be remembered! It is strictly forbidden to take painkillers in case of severe pain in the abdomen before a doctor's examination! This is especially true for strong or narcotic drugs. Analgesics eliminate pain and smooth out the clinical picture, possibly a very serious disease, in which the only way to save is immediate surgery. Antispasmodics are allowed, but if you are not strong in pharmacology, leave this idea and call "03".

Often, liver disease is accompanied by a rise in body temperature - fever

It is a protective reaction of the body to a pathogenic factor. At elevated temperatures, immune reactions are better aimed at exterminating the infectious agent. When a disease occurs, a fever of up to 38 ° C is considered normal for the body, provided that it is well tolerated and lasts up to five days. In this case, the use of antipyretics is not justified.

With hepatitis, cirrhosis, the body temperature usually does not rise above 38 ° C, it remains at 37-37.5 ° C. It can be at normal figures of 36.6 ° C during the day, and rise only in the evening. For acute diseases, especially purulent ones - cholecystitis and cholangitis, a rise in temperature to 39 ° C and above is characteristic. Such conditions may be accompanied by twitches of skeletal muscles, including facial ones. The popular name for this condition is "shaking". This is another good reason to see a doctor immediately.

Liver diseases, especially chronic, long-term cirrhosis and hepatitis, are accompanied by pallor of the skin, which is a component of the "unhealthy appearance". The reasons for this are disorders of metabolic (metabolic) processes in the body, disturbances in normal hematopoiesis, and conditions after bleeding.

Occurs in liver diseases pigmentation disorders

New pigment spots appear or the skin takes on a bronze or smoky gray tint in the armpits and on the palms.

Spider veins - small areas of skin with dilated capillaries - are also characteristic of chronic liver diseases. They arise due to the depletion of the capillary wall against the background of metabolic disorders. More often localized on the back and cheeks.

Chronic cirrhosis is accompanied by a violation of blood clotting, fragility of capillaries, the occurrence of hemorrhagic diathesis. With gentle touches, bruises may remain.

"Liver palms" - symmetrical spotty redness of the palms and soles, especially pronounced in the area along the edges of the palms on the hills, sometimes - the palmar surfaces of the fingers. The spots become paler on pressure and quickly redden when the pressure is removed. The mechanism of their occurrence is not well understood. Characteristic for cirrhosis and chronic hepatitis.

Xanthomas are intradermal yellow plaques located on the eyelids (xanthelasma), elbows, hands, feet, buttocks, knees and armpits.

Occurs with violations of the outflow of bile, an increased content of fats in the blood

Sometimes the only symptom of a violation of the outflow of bile from the liver is persistent itching. It can persist for years, accompanied by abrasions and scratching. It was assumed that the cause of its occurrence is in the reaction of the skin to an increase in the level of bile acids in the blood, but there are refutations of this hypothesis.

Jaundice (icterus) is one of the specific signs of liver suffering. Jaundice - yellowing of the skin, sclera, mucous membranes due to the accumulation of excess bilirubin in the blood. There are three types of jaundice depending on the origin: suprahepatic, hepatic and subhepatic. The suprahepatic is associated with increased breakdown of red blood cells and, as a result, with an increase in the level of bilirubin in the blood. Occurs in case of poisoning with hemolytic poisons, Rhesus conflicts, etc. Hepatic jaundice is caused by impaired liver function to bind bilirubin and excrete it with bile. It is characteristic of hepatitis, cirrhosis. Subhepatic jaundice occurs when the bile ducts are blocked and bilirubin from the bile back into the blood. It occurs in cholelithiasis, tumors of the bile ducts and the head of the pancreas. Depending on the type of jaundice, the corresponding fraction of bilirubin prevails in the body, which determines the shade of jaundice. With suprahepatic it is lemon yellow, with hepatic it is saffron yellow, with subhepatic it is green or dark olive. Jaundice is often accompanied by discoloration of feces and urine.

Due to the hormonal imbalance that accompanies chronic liver disease, hair loss in the armpits and pubis is possible. In men, against this background, there may be an increase in the mammary glands - gynecomastia.

A prognostically unfavorable sign of chronic hepatitis and, as a result, cirrhosis or self-induced cirrhosis is an increase in skin veins on the abdomen. This is due to a violation of the venous outflow through the portal vein through the liver. Therefore, blood from the abdominal organs flows through the veins of the anterior abdominal wall, which, as a result, increase. This is often accompanied by dilatation of the veins of the esophagus, which leads to fatal bleeding. The venous network that appears on the abdomen, for its resemblance to the original, was called the "head of a jellyfish." Expansion of the veins of the abdomen is rarely seen without an increase in its volume - ascites - due to the accumulation of free fluid in the abdominal cavity.

Sometimes you can hear the expression "liver smell"

It has a sweetish aroma, similar to the smell of fresh liver or overripe fruit. It is felt when the patient breathes, from his vomit and sweat. This smell is due to a violation of the metabolism of amino acids and aromatic compounds.

Summarizing all of the above, it can be noted that the symptoms give a vivid, but incomplete picture of the disease. We must not forget that we live in an age of technological progress. This allows the use of a huge range of laboratory and instrumental examinations in the diagnosis. One of the informative modern methods of examination of the liver and biliary tract is ultrasound. Of the laboratory methods, a biochemical blood test is indicative. If you suspect liver disease, see your doctor. He will prescribe the necessary studies, indicate the necessary treatment and tell you what folk recipes can be used for this pathology.

Inna Lavrenko

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The gallbladder and liver are very important organs in the human body. If their work is disturbed, there are pains, problems with digestion, and general well-being also worsens. These organs are a kind of "filters" that purify the blood of toxins and toxic substances. Effective treatment of the liver and gallbladder is possible when drug therapy is combined with diet.

During the rehabilitation and recovery period, the load on the affected organs should be reduced as much as possible. In the complex for the treatment of diseases of the liver and gallbladder, along with traditional medicines, folk medicines are often introduced, as well as therapeutic exercises and sanatoriums.

The main functions that the liver and gallbladder perform in the body

The work of these organs is closely related to each other; it is not for nothing that these two organs are called the biliary system. Both of them are participants in the digestive process. Bile is secreted by the liver cells, through the hepatic duct system enters the gallbladder, and then delivered to the small intestine, which increases motility. Bile also takes part in the process of splitting fats, increases the level of enzyme activity, and helps to neutralize the acids contained in the stomach.

It is the action of this secret that allows you to better absorb amino acids, calcium salts, vitamins and cholesterol, and also inhibits the development of bacteria.

The liver takes part in almost all metabolic processes, namely:

in the process of protein metabolism, proteins are broken down and converted in it, amino acids become a reserve source of energy and raw materials for the body to build its own tissues and cells;
during carbohydrate metabolism, the liver forms and accumulates glycogen, which is a reserve energy substrate;
in fat metabolism, the liver, together with the gallbladder, breaks down lipids into fatty acids and ketone bodies, and also produces cholesterol.

An important function of the liver is to maintain the correct balance of essential nutrients in the body. In other words, if there are few carbohydrates with food, then the deficiency is replenished by their synthesis from proteins. When you eat too much sweets, excess sugar is converted into fats.

In addition, this organ is involved in hormonal synthesis, and also helps to synthesize anticoagulants, regulates the metabolism of microelements, gives the body protection from toxins and maintains homeostasis. The bile produced by the liver is stored in that organ. like the gallbladder, and therefore, as a rule, the treatment of these internal organs is interconnected.

Liver disease

All lesions of this organ can be classified as follows:

diseases of an infectious nature, when tissue damage is caused by fungi, viruses, helminths, bacteria or protozoan pathogens (leptoprirosis, ascariasis, echinococcosis, and so on);
autoimmune diseases, which include certain specific types of hepatitis, autoimmune cholangiopathy, primary biliary cirrhosis, and other ailments);
damage to the liver tissues under the influence of various toxic substances, such as alcohol, drugs and drugs (cause fibrosis, steatosis, cirrhosis, toxic-type hepatitis, and so on);
vascular lesions (liver vein thrombosis, pylephlebitis, portal hypertension and other vascular diseases);
tumor diseases (cancer of liver cells or its internal ducts, hemangioma, sarcoma, and so on);
metabolic diseases (glycogenosis, acanthocytosis, fatty hepatosis, and so on);
hereditary diseases (liver fermentopathy, aplasia and hypoplasia, hemochromatosis and other similar ailments).

In addition, the causes of disruption of the normal functioning of this organ can be injuries: ruptures, bruises, blows.

Sometimes the functions of the liver are violated in the process of diseases of other organs and systems of the body (for example, in the case of heart failure). Also harmful to this organ is prolonged exposure to ionizing radiation, as well as carcinogenic substances of a physical and chemical nature.

Most of the diseases of this organ are accompanied by pain and a feeling of heaviness in the right hypochondrium.

These disturbing signs of a person are constant, intensify with increased physical exertion, their intensity increases in the case of eating fatty or fried foods. As a rule, these symptoms subside with passive rest. The pain syndrome is often manifested in conjunction with a deterioration in appetite, belching, bitterness in the oral cavity, nausea, heartburn and vomiting.

In addition, hepatic lesions are characterized by:

yellowing of the eye sclera and skin;
darker color of urine;
gradual discoloration of feces.
skin itching;
apathy;
general weakness;
fast fatiguability;
persistent headache;
fainting.

The sexual sphere also suffers - the menstrual cycle of women is disturbed, and men experience sexual impotence.

If such symptoms occur, you should immediately contact a gastroenterologist who will prescribe the necessary diagnostics in order to accurately determine the disease and subsequently prescribe effective therapy. The main diagnostic methods for such diseases are ultrasound and a biochemical blood test, but the doctor, after reviewing and collecting anamnesis, may also prescribe immunological tests, genetic studies, CT, MRI, biopsy, blood tests for hepatitis and cancer.

Medicines for the liver and gallbladder. Basic treatment methods

In many cases, patients seek help belatedly, as the symptoms appear gradually and may not be particularly disturbing for a long time.

The treatment regimen for the liver and gallbladder involves drug therapy in combination with physiotherapy and diet. Particularly neglected cases are treated with surgery.

Treatment with medicines should take place under mandatory medical supervision. Depending on the type of disease, hepatoprotectors, antibiotics, antiviral, antimicrobial and anthelmintic drugs, B vitamins, as well as some types of organic acids are used.

The most versatile means for treating the liver are hepatoprotectors.

Although they are not able to eliminate the cause of the pathology that has arisen, however, with their help, the functions of this organ are restored and protection from damage to the liver cells is provided. The basis of their composition can be ursodeoxycholic acid (drugs Exhol, Ursosan, Livodex), phospholipids (Rezalyut pro, Essentiale forte), ademethionine (Heptral, Heptor), ornithine (Hepa-Merz). The use of medicines based on natural ingredients is practiced (Liv-52, Sibektan, Gepabene). Such drugs are especially needed when treatment of the liver is necessary after removal of the gallbladder.

Physiotherapy procedures help restore damaged liver tissue after an illness. Microwave, UHF, galvanic mud procedures, galvanic currents and electrosleep are used.

Surgery is used in cases of severe irreversible liver damage. Such an intervention allows you to eliminate complex types of abscesses, formed cysts, as well as restore tissue damaged as a result of injuries. Removal of this organ (complete or partial) followed by transplantation of a donor organ, as a rule, is practiced in cases of severe cirrhosis, cancerous tumors and blockage of the liver veins.

Traditional medicine (herbal treatment)

Such liver therapy, as a rule, begins with the cleansing of this organ. The most affordable option is to drink a small amount of virgin vegetable oil in the morning for five weeks.

The first week - half a teaspoon. the second - a full teaspoon. the third - two teaspoons, the fourth - a tablespoon, the fifth - again two teaspoons.

№	Useful information
1	a mixture of a tablespoon of oat grains, three tablespoons of lingonberry leaves, a tablespoon of birch buds pour four liters of water and put in a cool place for 20 hours; in parallel, a decoction is prepared from wild rose berries (one glass), two tablespoons of knotweed and two hundred milliliters of boiling water, which after cooking is infused for 45 minutes; both prepared infusions are mixed and stored in the refrigerator; regimen - 150 milliliters half an hour before meals for ten days
2	freshly squeezed beetroot juice - a third of a glass three times a day for two weeks
3	instead of tea, drink a decoction of boiled corn stigmas for two weeks (one tablespoon per glass)
4	juice prepared from 210 grams of carrots, 60 grams of parsley and 150 grams of celery, drink in the morning on an empty stomach for a month

Any traditional medicine can be used only after consulting a doctor.

Diet

Diet in such diseases is very important. It is necessary to remove strong tea, coffee, alcohol, tomato and grape juice, fatty broths, fish and meat, carbonated drinks, rich and fresh bakery products from your diet. You can not do anything fried, spicy, too salty and smoked. Extremely harmful in such cases, cocoa and chocolate, sauces, eggs, fresh berries, fruits and mushrooms. As for vegetables, it is necessary to exclude Brussels sprouts and white cabbage, garlic, turnips, onions, radishes, spinach, eggplant, tomatoes and sorrel.

rosehip decoction;
dried fruit compotes;
biscuits or dried bread;
biscuit;
fish and meat with low fat content;
oil;
dairy products, the fat content of which does not exceed two percent.

Allowed vegetables (pumpkin, potatoes, carrots, beets, zucchini, bell peppers, Beijing and cauliflower) can be steamed, baked, boiled or stewed. Parsley, cinnamon, soy sauce, jam or honey can be used to add flavor to dishes.

Gallbladder disease

The most common diseases of this organ:

biliary dyskinesia;
cholecystitis (acute or chronic);
post-cholecystectomy syndrome (cholecystectomy surgery involves the removal of the gallbladder);
stones in the bile ducts and gallbladder;
various types of tumors (cancerous and polyps).

The causes of such diseases are:

infections;
violations of the composition of bile;
impaired connection of the gallbladder with nerve fibers;
disturbed metabolic processes;
genetic predisposition;
modification of the cells of its mucous membrane.

Symptoms

The main symptom is pain in the right hypochondrium, the intensity of which increases after spicy, fried or fatty foods and physical activity. Other external signs are flatulence, belching, nausea, heartburn and vomiting.

The skin and sclera turn yellow, itching on the skin is possible. The feces lighten, the urine darkens. Bile is present in the vomit.

Diagnosis - primary medical examination and history taking, after which - ultrasound or x-ray. In addition, it is possible to prescribe a blood test for biochemistry, probing to study the composition of bile and cholecystography.

As a rule, it consists in taking medications prescribed by a doctor. If the cause of the disease was an infection, antibiotics are prescribed, as well as anthelmintic, antimicrobial and antiprotozoal drugs.

To restore the outflow of bile, choleretic drugs are used. Antispasmodics and drugs are also used, whose action is directed to the autonomic nervous system. Restoration of the mucosa is helped by herbal preparations, and intoxication is treated with enterosorbents.

Physiotherapy - laser, HF, UHF, microwave, electrophoresis with mud, magnetic fields and modulated sinusoidal currents.

Stones in this organ, depending on the degree of development of the disease, are removed either by ultrasound or by chemical methods, as well as through operations. Surgery is used for tumors, cysts and large abscesses.

In severe cases, removal of the gallbladder (cholecystectomy surgery) is used. In the conditions of the removed gallbladder, diet No. 5 is also required.

Treatment of the liver and gallbladder with folk remedies

You can treat yourself with such means only with the permission of a doctor. Here are some recipes:

Herbal collection. A mixture of yarrow, mint, wormwood, immortelle flowers and fennel fruits is taken (in equal proportions). A dessert spoon of the mixture is poured with 400 milliliters of water, the container is closed with a lid and the mixture is infused for 9 hours. Then filter and drink one-third of a glass before meals three times a day.
Birch leaves. The leaves are crushed and brewed with boiling water (two teaspoons per glass). Infuse for an hour and drink a third of a glass before meals three times a day.
Dandelion. Leaves, stems and roots are used to extract juice. This juice is diluted with boiled water and drunk three times a day, one tablespoon. For all three prescriptions, the duration of the course is at least two months.

Diet

The diet for such diseases coincides with the diet for liver pathologies.

Choleretic action is possessed by: beets, zucchini, carrots, as well as low-fat sour cream and milk. Boiled vegetables, vegetable broths, bran, germinated wheat grains and kefir are recommended. You can eat pears, oranges, tangerines and prunes. Allowed seasoning is turmeric. In the process of cooking, the use of vegetable oils is recommended. The rest of the diet is the same as for diseases of the liver and bile ducts.

Sanatoriums

Treatment in a specialized sanatorium gives good results. There, the patient is provided with proper nutrition, physiotherapy, drinking mineral water and taking the necessary medicines. Such sanatoriums are located mainly in the region of the Caucasian Mineral Waters.

Physiotherapy procedures

Any pill or herbal infusion can be taken only as directed by your doctor! Self-treatment can not only complicate subsequent therapy, but also significantly harm your health!

Many diseases have their own pronounced symptoms. Although some manifestations of different diseases are very similar, there are symptoms that appear only with a particular disease, or a disease of an organ.

If the symptoms are pronounced, then the disease is in an acute form, if the symptoms are more smoothed, then we are talking about a chronic disease.

It just so happened that a person pays attention to his health only when something starts to hurt him. Meanwhile, inattention to one's health leads to difficulties in treatment, sometimes even to disability or death.

Fatigue

This is a subjective sign that may or may not be associated with liver disease. Weakness and fatigue can also appear in the presence of other diseases of some organs, not necessarily the liver. So, maybe a good rest and taking vitamins - and you're fine. But if you feel weakness for no apparent reason, then it is better to consult a doctor for the appointment of the necessary tests.

In the presence of liver diseases, fatigue is associated with intoxication - there is a violation of its detoxification function. As a result of vital activity, toxins accumulate in the body, since they are not destroyed in the liver. In case of violation of the patency of the biliary tract, the reverse absorption of its components from the bile occurs, which also leads to intoxication. Weakness and fatigue in liver disease also occur due to violations of protein, carbohydrate, vitamin metabolism.

Indigestion

The liver plays an important role in our digestive system, so if it is not able to cope with its work, the work of the digestive system will certainly be disrupted.

In chronic hepatitis, cirrhosis, chronic cholecystitis, this will be less noticeable than in acute diseases of the liver and biliary tract. In chronic liver diseases, digestive manifestations are nonspecific. They are characteristic of chronic pancreatitis, chronic enterocolitis, etc.

Bile performs a regulatory function for the intestines, improves the absorption of fats and proteins by the cells of the intestinal walls. Therefore, in diseases of the liver and biliary tract, peristalsis, the secretory function of the intestine are disturbed, the absorption of nutrients worsens - all this leads to weight loss.

So, in diseases of the liver or biliary tract, the symptoms are varied, other organs are included in the pathological process, so it can be difficult to recognize just violations in the liver.

Pain

Pain is accompanied by many diseases, but liver disease - almost always. The pain in this case is felt in the right hypochondrium. Pain is a defensive reaction that allows us to give us signals that something is wrong with him. It is also necessary to determine the nature of the pain.

When the pathological focus is localized directly in the liver, it has a aching dull character, that is, it is not intense, it continues for a long time; a feeling of heaviness is possible. This type of pain accompanies hepatitis, the initial stages of cirrhosis, tumor diseases of the liver. If the pathological process occurs in the biliary tract, then the pain is intense, sharp, cramping. This is due to the occurrence of spasms caused by smooth muscles, or, conversely, stretching of the bile ducts and bladder. Very intense acute pain occurs with inflammatory diseases of the biliary tract, such as acute purulent cholecystitis or cholangitis. When tapping along the costal arch, the pain increases sharply. This type of pain is a sure sign to go to the doctor or call the emergency room.

Before examination by a doctor, it is undesirable to take painkillers - this will complicate the diagnosis. Especially strong or narcotic drugs. Such drugs smooth out the pain, and sometimes the presence of acute pain allows you to save the patient's life by immediately operating on him.

Temperature rise

An increase in temperature is a protective factor of the body, in which immune reactions are better aimed at destroying the infectious agent. A “normal” temperature increase for the body is considered to be up to 38 ° C, provided that it is well tolerated and lasts up to five days. In this case, taking antipyretics is not justified.

With cirrhosis, hepatitis, the body temperature usually does not rise above 38 ° C, it remains at 37-37.5 ° C. It can be at normal figures of 36.6 ° C during the day, and rise only in the evening. For acute diseases, especially purulent ones - cholecystitis and cholangitis, a rise in temperature to 39 ° C and above is characteristic. Such conditions may be accompanied by twitches of skeletal muscles, including facial ones. People say it shakes. This is another good reason to see a doctor immediately.

Changes in the skin

Liver diseases, especially chronic, long-lasting cirrhosis and hepatitis, are accompanied by pallor of the skin, which is one of the components of the "unhealthy look". The reasons for this are disorders of metabolic (metabolic) processes in the body, disturbances in normal hematopoiesis, and conditions after bleeding.

Pigmentation disorders occur in liver diseases. New pigment spots appear or the skin takes on a bronze or smoky gray tint in the armpits and on the palms.

Vascular asterisks- small areas of skin with dilated capillaries - also characteristic of chronic liver diseases. They arise due to the depletion of the capillary wall against the background of metabolic disorders. More often localized on the back and cheeks.

Chronic cirrhosis is accompanied by a violation of blood coagulation, fragility of capillaries, the occurrence hemorrhagic diathesis. With gentle touches, bruises may remain.

Symmetric patchy redness of the palms and soles, called "Liver palms", especially pronounced in the area along the edges of the palms on the hills, sometimes - the palmar surfaces of the fingers. The spots become paler on pressure and quickly redden when the pressure is removed. The mechanism of their occurrence is not well understood. Characteristic for cirrhosis and chronic hepatitis.

xanthomas- yellow intradermal plaques located on the eyelids (xanthelasma), elbows, hands, feet, buttocks, knees and armpits.

They occur with violations of the outflow of bile, an increased content of fats in the blood.

Sometimes the only symptom of a violation of the outflow of bile from the liver is persistent pruritus. It can persist for years, accompanied by abrasions and scratching. It was assumed that the cause of its occurrence is in the reaction of the skin to an increase in the level of bile acids in the blood, but there are refutations of this hypothesis.

Yellowing of the skin and mucous membranes - jaundice.

This symptom is one of the specific ones that appear in diseases of the liver. The reason is the accumulation of excess bilirubin in the blood.

There are three types of jaundice depending on the origin: suprahepatic, hepatic and subhepatic.

suprahepatic jaundice is associated with increased breakdown of red blood cells and, as a result, with an increase in the level of bilirubin in the blood. Occurs in case of poisoning with hemolytic poisons, Rhesus conflicts, etc.

Hepatic Jaundice is caused by a violation of the liver to bind bilirubin and excrete it with bile. Manifested in hepatitis, cirrhosis.

Subhepatic Jaundice occurs when the bile ducts are blocked and bilirubin is released from the bile back into the blood. It occurs with cholelithiasis, tumors of the bile ducts and the head of the pancreas.

Depending on the type of jaundice, the corresponding fraction of bilirubin prevails in the body, which determines the shade of jaundice. With suprahepatic it is lemon yellow, with hepatic it is saffron yellow, with subhepatic it is green or dark olive. Jaundice is often accompanied by discoloration of feces and urine.

Enlarged veins in the abdomen

A prognostically unfavorable sign of chronic hepatitis and, as a result, cirrhosis or self-induced cirrhosis is an increase in skin veins on the abdomen. This is due to a violation of the venous outflow through the portal vein through the liver. Therefore, blood from the abdominal organs swells through the veins of the anterior abdominal wall, which increase as a result. This is often accompanied by dilatation of the veins of the esophagus, which leads to fatal bleeding. The venous network that appears on the abdomen is called the "head of a jellyfish" because of its resemblance to the original. Expansion of the veins of the abdomen is rarely seen without an increase in its volume - ascites - due to the accumulation of free fluid in the abdominal cavity.

Hair loss

Hair loss in the armpits and pubis is possible due to hormonal imbalance that accompanies chronic liver disease. In men, against this background, there may be an increase in the mammary glands - gynecomastia.

Liver odor from the mouth

This symptom does not always appear. The smell has a sweetish aroma, similar to the smell of fresh liver or overripe fruit. It is felt when the patient breathes, from his vomit and sweat. This smell is due to a violation of the metabolism of amino acids and aromatic compounds.

Conclusion

Of course, it is impossible to make an accurate diagnosis based on signs alone, because we live with you in an age of technological progress. When making a diagnosis, it is necessary to use the full range of laboratory and instrumental examinations. And perhaps the most informative method for examining the liver is ultrasound. Therefore, if you suddenly have concerns about your illness, consult a doctor for an accurate diagnosis and treatment.

The article was prepared based on materials

Liver diseases are quite common and significantly impair the quality of life. This poses a serious problem for their owners and for public health in general. Therefore, the causes of their occurrence, course, treatment and prevention arouse the healthy interest of the inquisitive minds of scientists, ordinary fighters with this disease - doctors and, of course, people who have them.

To defeat the disease, you need to know about it as much as possible. We do not say everything, because it is almost impossible to know everything. Medicine is constantly developing, new facts are emerging, laboratory diagnostic equipment is being improved, research is being conducted, experience is being accumulated, and pharmacology is expanding.

In healthcare, there is the term "quality of life", which includes an assessment of a person's ability to work, enjoy life. Therefore, the damage caused to society and a particular person by the disease is estimated by its impact on the quality of life.

Before you begin to treat the disease, you need to study it. And the study of the disease begins with the knowledge of its cause - etiology. The causes of liver disease are varied. Sometimes a specific disease is caused by one specific cause, sometimes by a combination of them. Diseases can be caused by the imperfection of the organism itself: an abnormal development of the liver, insufficiency or complete absence of enzyme synthesis, a weak immune response to an infectious attack or, conversely, an excessively strong one, the introduction of an infection into the body from outside or a change in its own flora, etc.

Heredity

Let's start with heredity. She is the potential that a person receives from his parents and that you need to be able to use correctly. Heredity can be better or worse, but this by no means means that if we are not lucky with this, let's, as they say, fold our hands. What matters is how we manage what we have. Imagine two boys. We will give one hundred rubles to one, and ten to the other. The first will go and immediately spend everything on various boyish joys, and the other will correctly invest the funds received and receive benefit or profit from them. From the position of a sane person, it is not difficult to guess who will act more correctly. Heredity is the initial capital with which we come into this world. Hereditary causes of liver diseases can be both the imperfection of its functions and anomalies in the development of the liver itself or the biliary tract. Hereditary dysfunction of the liver is manifested by insufficiency or lack of ability to synthesize and utilize any substances. This, as a rule, causes a disease not of the liver itself, but of the body as a whole. For example, Gilbert's syndrome, in which it is not able to bind bilirubin, which is manifested by jaundice, general intoxication. Liver diseases directly cause anomalies in the structure of it and the biliary tract. Anomalies in the structure of the latter are more common in the form of narrowing, bending of the bile ducts, distortion of the shape of the gallbladder. This leads to a violation of the outflow of bile, its thickening, which is characterized by an increase in the intrahepatic pressure of bile and, in turn, leads to the destruction of hepatocytes and a violation of the process of bile formation. Both the liver itself and the digestive process, in which bile plays an important role, suffer from this. Thickening of bile creates fertile ground for the occurrence of gallstone disease. Bile becomes more concentrated, which leads to sedimentation, which turns into stones. Heredity also determines the regulation of bile excretion by the ducts, the imperfection of which causes dyskinesia of the biliary tract. The above are the main reasons for the influence of heredity on the occurrence of liver diseases. Hereditary diseases associated with an abnormality of the red blood cell membrane also deal a blow to the liver. Sickle cell anemia, thalassemia, spherocytosis and other hereditary diseases are characterized by a shortened lifespan and fragility of red blood cells. This leads to their increased breakdown and an increase in the level of bilirubin in the blood, which increases the load on the liver.

infections

An infectious factor is one of the most common causes of liver diseases. Viruses mainly infect the liver. They are a unique form of life. Viruses are negligible, but, according to scientists, they can destroy the whole world. They freely enter cells, disrupting their normal metabolism, and they begin to create new viruses. Then, destroying the cell, the viruses leave it to infect other cells.

Hepatitis viruses are specific to the liver. There are several of them: hepatitis viruses A, B, C, D, E, F, G. Accordingly, the diseases caused by them are called hepatitis A, C, C, D, E, F, G. Hepatitis A, B and C can provoke acute diseases, the rest flow sluggishly and are associated with the first, making their course heavier. Hepatitis A is also called alimentary because it is transmitted through food, water and enters the environment with the feces of a sick person; and the famous Russian infectious disease specialist S.P. Botkin is the author who first described it. Due to the easy transmission of hepatitis A, outbreaks of hepatitis A often occur in children's institutions and military units. Hepatitis B and C are called serum hepatitis because they are transmitted with blood and physiological fluids - saliva, tears, semen, secretions of the glands of the skin and mucous membranes. But their most threatening concentration is in the blood, less dangerous is in the semen. Viruses B and C penetrate well through damaged skin. These hepatitis have recently been very common and represent a serious social problem.

The hepatitis B virus is transmitted through sexual contact one hundred times more easily than the human immunodeficiency virus (HIV). This is due to a higher concentration of the hepatitis virus in the secretions of the gonads compared to HIV. The presence of superficial lesions of the skin and mucous membranes increases the likelihood of infection tenfold.

Hepatitis viruses destroy hepatocytes, cause inflammation of the liver tissue; dead cells impede the movement of bile through the bile ducts. As a result, many liver functions are impaired. And damage to the liver by the hepatitis C virus can lead to hepatobiliary cancer, in which liver cells and bile-forming structures are destroyed. The insidiousness of this virus is in its quiet course without pronounced symptoms, for which it received the characteristic name “gentle killer”.

Toxic effect

Toxic effects on the liver is a sore subject of modern mankind. All the toxins absorbed in the intestines, which enter the bloodstream through the skin, mucous membranes, and lungs, enter the liver. And only in it they can become less toxic or vice versa. The evolution of mankind does not keep pace with the inevitable and necessary progress of industry, the change of social priorities. This leads to a delay in the adaptation of the organism to the rapidly changing conditions of the social environment. When environmental factors affecting a living organism evolve slowly, then the organism has time to adequately respond to them with various internal restructurings. For a person, such adaptation is most difficult, since there are no main drivers of adaptation - natural selection and a rapid change of generations. Thanks to the latter, by the way, many insects are so successful and adapt to household poisons, with which we very unsuccessfully try to fight them. But do not be discouraged - we still have chances! Man is given something that other living organisms do not have, and what helps him to be the most numerous and powerful individual is intelligence. We created medicine, we know what is the cause of most of our ailments, and we can overcome them, and finally we can avoid and predict dangers. But the perversion of the intellect can lead people to drug addiction, substance abuse and alcoholism - independent and directed self-destruction.

We all know what kind of role alcohol plays in a person's life. How many people have ruined their health, how many fatal acts committed while intoxicated, how many victims of those who were under the influence of alcohol. But along with such sad facts, alcohol is a product that has firmly entered our everyday life. In moderation and with a low frequency of use, it is not harmful to a healthy person, and in some ways even useful, as it relieves mental stress, improves appetite, and stimulates digestion.

75-98% of alcohol is broken down in liver cells by the enzyme alcohol dehydrogenase. As a result of this process, carbon dioxide and water are formed, which, as we know very well, are completely harmless substances. It is a completely different matter when there is a huge amount of alcohol in the blood. The liver, as the most devoted friend, fights with any of its volume, as a result of which the consumption of oxygen and enzymes increases, but their number in the body is limited and it will not work to “run away” for another portion of these important components “to the store”. This leads to a perversion of the process of alcohol utilization in the liver and the release of a poisonous product of acetaldehyde, which primarily affects the organ that produced it, i.e. the liver. Which, in turn, leads to the destruction of hepatocytes, their replacement by non-functional connective tissue. Hepatocytes that survived undergo fatty degeneration. At the same time, throwing all its strength into the fight against alcohol, the liver ceases to fully perform other important functions. Therefore, excessive alcohol consumption puts an unbearable burden on the liver, exhausting it, and has a toxic effect, destroying its structures. Drinking alcohol leads to steatosis (fatty degeneration), cirrhosis of the liver, hepatitis. Changes in the liver under the influence of alcohol have a common name - alcoholic liver disease.

Eastern peoples are very sensitive to the effects of alcohol - this is due to the predominance of altered alcohol dehydrogenase in their liver. They are inferior to them in this only northern peoples, who lack the synthesis of the named enzyme. Perhaps this is due to their relatively recent acquaintance with alcohol, since in the harsh conditions of the North there is no excess of fruits, berries and fermentation processes with the formation of alcohol are difficult, and, as you know, it began to be imported to them not so long ago.

Various drugs have a toxic effect on the liver. As Hippocrates said: "Any medicine is essentially a poison, it's all about the dose." The saying, uttered a thousand years ago, has not lost its meaning to this day, if not to say that it has become even more relevant. This is due to the development of pharmaceutical science and chemistry. Medicines have become more complex and active. However, they cannot be abandoned. But even saving one and ruining the other, it is necessary to seek a compromise.

Some drugs can directly affect the processes occurring in the liver, changing its metabolism, or have a direct toxic effect. Others are inactivated in the liver, overloading it, and their waste products can also have a toxic effect. All this naturally leads to liver disease. Therefore, before you start taking any medication, you should consult a doctor who can prescribe laboratory tests that characterize the condition of the liver. And for people with chronic liver and kidney disease, this is vital.

Poisons are substances that disrupt the life of the body. Biological and technological poisons can be distinguished. Biological - these are poisons of animal and vegetable origin. Technological poisons are produced by man on purpose or are a by-product of the technologies used. Poisons are able to block any biochemical reactions or destroy the cell wall. The venom of some snakes causes massive destruction of red blood cells. This leads to the release of a huge amount of bilirubin, which is neutralized by the liver, which puts a significant load on it. The poison of green fly agarics strikes directly at the functional activity of the liver. More dangerous and insidious technological poisons. These are various solvents, phenols, phosphorus, arsenic, aniline, etc. In everyday life, these poisons surround us everywhere. There are few people who have never encountered paints, gasoline, and they contain toxins for the liver. Particularly affected are people involved in the production of toxic products. For them, toxic liver disease is considered an occupational disease. Its unpleasant ending is cirrhosis of the liver, which is very difficult to treat.

We must not forget about the environment. The twentieth century gave rise to the unrestrained development of industry and motorization. The twenty-first century "worthily" took this baton. All this leads to the accumulation of various toxins and heavy metal salts in the atmosphere, land, and water. It would not be a big discovery to say that such a negative effect on people's health. And the liver, as our most important defender in the fight against toxins, suffers a lot. But, alas, this is our payment for the benefits of industrial progress.

Tumors

Like any other organ, the liver has not escaped acquaintance with tumors. In addition to tumors arising from the tissue of the liver itself, metastases of tumors from other organs very often get into it - especially from the stomach and intestines. Tumors of the liver itself and metastases, growing, destroy its structures, disrupt functions, grow into the vessels, causing serious bleeding.

There are tumors of the bile ducts: the gallbladder, common bile duct, Vater's papilla - the place where the common bile duct flows into the duodenum. Such tumors appear quickly enough and are rarely malignant. They block the outflow of bile, causing the consequences described above for the liver and digestion. The same effect is exerted by tumors of nearby organs: the head of the pancreas, intestines, which cause pressure on the bile ducts from the outside.

Fat Metabolism Disorders

Violations of fat metabolism in the body lead to a disorder of the liver. It plays an important role in the utilization of fats. Fats that enter the body are broken down in the liver into triglycerides and fatty acids. The latter are used to build cell membranes, and triglycerides are utilized with the release of energy. Therefore, in violation of fat metabolism and excessive intake of fats with food, pathological changes occur in the liver. She does not cope with the arriving amount of fats or their exchange in her is perverted; fats begin to accumulate, causing its fatty degeneration. Fat is collected in hepatocytes in the form of large or small droplets. Naturally, this does not allow the liver to fully fulfill its role in the body.

Sometimes there are situations when a person goes to celebrations, during which, for some reason, he will certainly have to drink alcohol. In this case, medical scientists recommend taking 50 ml of a strong alcoholic drink about eight hours before the celebration. This will put the liver in a certain readiness to produce a preliminary portion of alcohol dehydrogenase. Also, the intake of protein foods and liquids simultaneously with alcohol significantly reduces its toxic properties.

Diseases of the digestive system

A living organism is a single entity. Therefore, it is impossible to speak separately about any particular organ. All organs directly or indirectly interact with each other, especially the organs of any one interconnected system. The liver belongs to the digestive system, which means that the pathology of some organ of this system will necessarily affect it - and not in the most positive way. The first part of the digestive tract is the mouth, followed by the esophagus, stomach, duodenum, small and large intestines. The digestive tract is a sequential pipeline of processing food into absorbable forms of nutrients. It is difficult to imagine all the subtleties of this difficult process. And if one link falls out, then the whole chain will fall apart. If the initial stage of digestion is disturbed, say, in the oral cavity, then all the underlying sections will inevitably suffer. Poorly prepared food at the level of the stomach, entering the duodenum, must first meet bile and pancreatic secretions in it. Naturally, this will require more bile and thus put an additional burden on the liver. The work of the biliary tract is regulated by substances secreted by the wall of the duodenum, which means that the pathological process in it will also affect the function of the liver. The relationship between the pancreas and the biliary tract is interesting. The common bile duct in most cases combines with the pancreatic duct, after which they jointly flow into the duodenum. This is fertile ground for influencing each other in the development of a disease of one of these organs. For this reason, in medicine there is the term "cholecystopancreatitis", which characterizes the joint inflammation of the pancreas and gallbladder, since they often get sick together. The role of tumor diseases of the digestive system was discussed above.

The quality of nutrition is one of the most important factors influencing the occurrence of diseases of the digestive system. Food contacts the entire digestive tract, moving from section to section, being exposed to digestive juices. Food is different, and therefore the digestive organs must respond adequately to it. Fatty, salty, boiled, fried, spicy stimulates the release of bile into the duodenum in different ways. In small amounts and with moderate frequency, it does not play a significant role in the digestive tract and may even provide pleasure and benefit. Another thing is when a person abuses fatty, spicy, fried foods. In this case, the liver and bile ducts begin to work for wear and tear, and no one knows how long they will last without the onset of a disease. Such abuses are even more destructive for people with an already diseased liver.

From the foregoing, it follows that there are many factors that have a negative impact on both the liver and the body as a whole. But a person can save himself from most of them, and at the same time, he does not need excessive expenses. The elimination of even one or two negative influences can significantly improve the health and, consequently, the well-being of a person.

Symptoms allow you to recognize the disease in its diagnosis. They can be bright, permanent. This is characteristic of acute diseases. A more smoothed symptomatology is a sign of a chronic disease. The ability to distinguish, notice the manifestations of the disease is very important for the doctor and the patient himself. A person may not pay attention to any symptoms and not suspect that he is developing an ailment until he sees a doctor, perhaps for a completely different reason. Therefore, knowledge of the elementary manifestations of diseases is the necessary basic basics for people who care about their health. However, having discovered a symptom of a particular disease, you should not immediately diagnose yourself, lose heart, and even more so start self-treatment. You need to clearly understand that, having suspected a violation of the function of some organ, you must immediately go to the doctor. Only he can objectively identify the symptoms, analyze them and proceed to adequate treatment or prescribe additional studies.

Symptoms are divided into objective and subjective. Subjective ones are connected with the sensations of a person and do not have manifestations that others can see. For example, complaints of pain. Objective symptoms have real manifestations that another person can see. For example, yellowing of the skin or enlargement of the liver, felt on palpation. Objective signs of diseases are more reliable, and therefore more informative.

Naturally, liver diseases, like diseases of many other organs, have their specific and non-specific, objective and non-objective manifestations.

In liver diseases, weakness and fatigue are associated with intoxication. However, if in infectious diseases intoxication is caused by the pathogen itself or its toxins, then in liver pathology this occurs due to a violation of its detoxification function. The body accumulates toxins formed as a result of its vital activity, since they are not destroyed in the liver. In case of violation of the patency of the biliary tract, the reverse absorption of its components from the bile occurs, which also leads to intoxication. Weakness and fatigue in liver disease also occur due to violations of protein, carbohydrate, vitamin metabolism.

Digestive disorders

Pain

Most diseases of the liver and biliary tract are accompanied by pain. The pain in this case is felt in the right hypochondrium. There are no pain receptors in the liver tissue, so pain in liver diseases occurs due to stretching of the fibrous capsule that covers the liver. With the inflammatory process in it, stagnation of blood, tumor growth, the volume of the liver increases accordingly. This leads to slow expansion of the capsule.

Pain is a special reaction of the body. to an irritant that threatens the normal functioning of the body. The sensation of pain is a signal to eliminate the stimulus that causes it. Pain is a necessary component that allows a living organism to adapt to nature. She, or rather, her character and localization help the doctor to make the correct diagnosis.

Temperature rise

Often, liver disease is accompanied by a rise in body temperature - fever. It is a protective reaction of the body to a pathogenic factor. At elevated temperatures, immune reactions are better aimed at exterminating the infectious agent. When a disease occurs, a fever of up to 38 ° C is considered normal for the body, provided that it is well tolerated and lasts up to five days. In this case, the use of antipyretics is not justified.

Skin and integument changes

Pigmentation disorders occur in liver diseases. New pigment spots appear or the skin takes on a bronze or smoky gray tint in the armpits and on the palms.

Chronic cirrhosis is accompanied by a violation of blood clotting, fragility of capillaries, the occurrence of hemorrhagic diathesis. With gentle touches, bruises may remain.

« liver palms"- symmetrical spotty reddening of the palms and soles, especially pronounced in the area along the edges of the palms on the hills, sometimes on the palmar surfaces of the fingers. The spots become paler on pressure and quickly redden when the pressure is removed. The mechanism of their occurrence is not well understood. Characteristic for cirrhosis and chronic hepatitis.

xanthomas- yellow intradermal plaques located on the eyelids (xanthelasma), elbows, hands, feet, buttocks, knees and armpits.

They occur with violations of the outflow of bile, an increased content of fats in the blood.

Jaundice

Jaundice (icterus)- one of the specific signs of suffering from the liver. Jaundice - yellowing of the skin, sclera, mucous membranes due to the accumulation of excess bilirubin in the blood. There are three types of jaundice depending on the origin: suprahepatic, hepatic and subhepatic. The suprahepatic is associated with increased breakdown of red blood cells and, as a result, with an increase in the level of bilirubin in the blood. Occurs in case of poisoning with hemolytic poisons, Rhesus conflicts, etc. Hepatic jaundice is caused by impaired liver function to bind bilirubin and excrete it with bile. It is characteristic of hepatitis, cirrhosis. Subhepatic jaundice occurs when the bile ducts are blocked and bilirubin from the bile back into the blood. It occurs in cholelithiasis, tumors of the bile ducts and the head of the pancreas. Depending on the type of jaundice, the corresponding fraction of bilirubin prevails in the body, which determines the shade of jaundice. With suprahepatic it is lemon yellow, with hepatic it is saffron yellow, with subhepatic it is green or dark olive. Jaundice is often accompanied by discoloration of feces and urine.

Hair loss

Expansion of the veins in the abdomen

Liver odor from the mouth

Sometimes you can hear the expression "liver smell". It has a sweetish aroma, similar to the smell of fresh liver or overripe fruit. It is felt when the patient breathes, from his vomit and sweat. This smell is due to a violation of the metabolism of amino acids and aromatic compounds.