Cirrhosis of the liver – symptoms, diagnostics, treatment – Cirrhosis first signs

A chronic progressive disease with severe symptoms in varying degrees of functional failure of the liver and portal hypertension. In the development of liver cirrhosis leading role belongs to the alcoholic effects, Hepatitis B virus, C, D effects and certain toxic medication.

Clinical signs of cirrhosis

Frequent nosebleeds, weakness, fatigue, reduction of disability, decreased appetite, unstable chair, abdominal distention, aching pain in the right abdomen, itching, fever, fever.

On examination, patients pay attention to themselves visible yellowness of the skin and mucous, veins of the anterior abdominal wall ("Head of Medusa"), redness (hyperemia) Leather palms, enlarged liver when viewed from the abdomen, change in its texture and shape.

In a laboratory study noted increased rates of liver function tests (TOOLS, AsAT, GGT, alkaline phosphatase). However, with compensated cirrhosis liver enzyme levels may be normal. A significant increase can be observed in alcoholic hepatitis with cirrhosis in the outcome; a sharp decline - with end-stage cirrhosis, when there are almost no functioning hepatocytes.

The clinical diagnosis of liver cirrhosis

Clinical diagnosis of cirrhosis should be confirmed by liver biopsy.

Contraindications to liver biopsy are: and bleeding disorders, associated with blood loss; changes in laboratory parameters (decrease in the rate of blood clotting, decreased platelet, prothrombin); symptomatic ascites (the presence of free fluid in the peritoneal cavity).

The most important microscopic criteria include cirrhosis: the nodes of regeneration of liver parenchyma, irregular architectonic (the hepatocytes of different sizes, thickening of hepatic plates, uneven ! changes in vascular lumen, and others.). There are active and inactive stages of cirrhosis. With the active cirrhosis expressed microscopic signs of mesenchymal cell infiltration, liver parenchyma and connective tissue, hepatocyte necrosis phenomena expressed. When inactive cirrhosis mesenchymal cell infiltration missing, hepatocyte necrosis phenomena have.

Clinical evaluation of the stage and severity of cirrhosis based on the criteria of severity of portal hypertension, presence of liver failure, histological examination of biopsy samples, clinical signs.

Treatment of liver cirrhosis

Under the influence of adequate therapy cirrhosis should not progress, even if it is irreversible. In the treatment of patients with cirrhosis of the big role of basic therapy, relief of symptoms, Prevention of complications.

In compensated cirrhosis specific dietary recommendations are not required! Patients can do light physical work, not related to forced posture, prolonged walking or standing, Exposure to high or low temperatures.

When portal hypertension, patients should avoid strenuous exercise, causing increasing intraperitoneal pressure.

In decompensated process, in end-stage cirrhosis patients showing bed rest and treatment in a hospital.

When compensated viral cirrhosis therapeutic effect of interferon is reduced to the appointment on the testimony (patients with active cirrhosis on the background of hepatitis C virus). In the active phase of autoimmune cirrhosis appointed hormones (prednisolone). In end-stage cirrhosis, their use is not shown, since they promote adherence infection and sepsis, renal and hepatic encephalopathy, that shortens the life of the patients.

Surgical treatment of liver cirrhosis demonstrated in patients with portal hypertension. Contraindications to surgical treatment of patients with liver cirrhosis are progressive jaundice and older age 55 years.

Symptomatic treatment is the appointment of enzyme preparations, not contain bile acids (eyebrow pencil, Fort mezim), on the testimony appoint eubiotics (ʙifikol, baktisubtil et al.).

Forecast cirrhosis

The prognosis of liver cirrhosis depends on many factors and trudnopredskazuem. The clinical course of cirrhosis complicated by a number of serious conditions, such as esophageal varices, splenomegaly, ascites, hepatic encephalopathy, gepatocellûlârnaâ cancer.