Steatosis

Steatosis, or fatty dystrophy of a liver – morbid condition at which in hepatocytes fat in the form of drops collects. Fat it can be formed very much that the hepatocyte is broken off, and fat accumulates in intercellular space in the form of the fatty cysts breaking structure of a liver.

This widespread disease which can meet even at children's age, but people after 45 years, women more often than men suffer from not alcoholic steatosis, men – the steatosis which developed owing to alcoholism are most subject to it. The steatosis of a liver can be independent pathology, or a symptom of some other primary diseases (for example, a diabetes mellitus of the second type).

Steatosis reasons

There are two main reasons for a steatosis of a liver. This excessive alcohol intake, and disturbance of a giro carbohydrate metabolism. Now not alcoholic steatoses of a liver are prevailing. Development of not alcoholic steatosis is connected with excess intake of fat in an organism, very often from it people with obesity suffer.

There are data on influence of genetic factors on development of a steatosis of a liver – its risk increases if in a family there are cases of a steatosis, diabetes mellitus, obesity substantially.

The steatosis can develop under the influence of some is long the accepted medicines (a medicinal steatosis of a liver), such for example as antibiotics of a tetracycline row, corticosteroid and cytostatic drugs.

Steatosis symptoms

Steatosis – the disease which develops is long, the slow, chronic form of a current is characteristic of it. Symptoms of a steatosis can be absent at all, in this case it is found accidentally, when performing medical examination in other occasion. Emergence of weakness, nausea, increase in a liver, emergence of feeling of weight and a prelum in the field of the right hypochondrium belong to the most common symptoms of a steatosis. There can be spontaneous pains in right hypochondrium. One more symptom of a steatosis is exposure to catarrhal and other infections, owing to decrease in immunity. The steatosis can lead to bile outflow disturbances, in this case cholestasia symptoms (stagnation of bile) join symptoms of a steatosis: yellowness of integuments, a skin itch, a megalgia in right hypochondrium, nausea and vomiting with bile impurity.

Development, stages and complications of a steatosis

The steatosis of a liver develops at excess intake of fats in liver cells. In the beginning single hepatocytes (the disseminated fatty hepatosis), then groups of hepatic cells (zone obesity) are involved in process, then the steatosis covers all tissue of a liver (diffusion obesity). Fat collects in a hepatocyte, then the fatty drop increases so that breaks off a hepatocyte therefore the fatty cyst is formed. The fatty cyst influences surrounding tissue of a liver, causing mesenchymal and cellular reaction which leads to consolidation of fabric around a cyst and to its regeneration in fibrous fabric. It is the beginning of cirrhosis, a state which can end with a lethal outcome.

Allocate the following stages of a steatosis:

• Simple obesity. Fat collects in a hepatocyte, hepatocytes whole;
• The obesity which is combined with a necrobiosis of hepatocytes. In tissue of a liver fatty cysts are formed, there is a mesenchymal and cellular reaction;
• Precirrhotic stage. Around fatty cysts sites of growth of connecting fabric are formed, breaking structure of a liver.

Diagnosis of a steatosis

Diagnosis of a steatosis can be a complex challenge as laboratory analyses often do not show the changes characteristic of inflammatory processes in a liver. The preliminary diagnosis can be made on the basis of steatosis symptoms taking into account data of the anamnesis (obesity, a diabetes mellitus, alcoholism).

For confirmation of the diagnosis carry out a computer tomography or a magnetic and resonant tomography, finally the diagnosis can be confirmed only after capture of an aim biopsy under control of a computer tomography. Detection of drops of fat, and also sites of fibrous fabric is a diagnostic character of a steatosis of a liver.

Treatment of a steatosis

Treatment of a steatosis consists in elimination of the reason which caused fatty dystrophy of a liver, and normalization of a metabolism.

At a steatosis aggravation treatment is carried out in a hospital. The bed rest, medicamentous therapy and a dietotherapy are appointed. After subsiding of the acute phenomena of the patient write out home, and treatment of a steatosis is carried out on an outpatient basis.

As the disease is connected with excess intake of fat, the diet in treatment of a steatosis plays an important role. Content of fat is sharply limited, preference is given to milk and vegetable food, special attention is paid to enough the easily acquired protein. Recommend to eat food fractionally, small portions. The patient has to observe the sparing mode, with limited exercise and emotional and mental stress. Out of a phase of an aggravation the easy exercises contributing to normalization of a metabolism are recommended.

Drug treatment of a steatosis consists in purpose of a long course lipotropic (promoting a lipolysis) drugs: _{B12 vitamin}, lipoic acid, methionine, Essentiale, anabolic steroid drugs, etc.

Also physiotherapeutic influence is applied: ozonotherapy, stay in a pressure chamber, ultrasound.

In general, treatment of a steatosis is usually successful, and involution of process is observed quickly enough after the beginning of effective therapy. The exception makes a liver steatosis 3 stages at which in a parenchyma of a liver connecting fabric was formed. This stage of a steatosis is irreversible, however vigorous medical measures and elimination of a disturbing factor, and also further regeneration of a liver and development of cirrhosis are capable to stop strict observance of medical instructions.