Cirrhosis

Cirrhosis is an end-stage of a serious illness of a liver at which there is a regeneration of structure of a liver, substitution of normal fabric fibrous growths, death of hepatocytes therefore the liver gradually loses the functions. At the same time the most important symptoms of cirrhosis are involvement in pathological process of all tissue of liver, disturbance of its lobular structure and portal hypertensia.

People of any age can have cirrhosis, most often the disease affects aged people of 35-55 years. Men are ill more often that is connected with a big share of cirrhoses of an alcoholic origin.

Cirrhosis reasons

Cirrhosis belongs to polietiologichny diseases, it means that a set of the reasons can lead to it. The following belongs to the most common causes of cirrhosis:

• Alcoholism;
• Viral hepatitis, in particular hepatitis C;
• Diabetes mellitus;
• Thyrotoxicosis;
• Disturbance of outflow of bile from bilious channels (chronic холеостаз);
• Hepatitises of not virus origin (toksiko-allergic);
• Chronic intoxication of an organism some chemical compounds, including medicines.

Besides, some types of cardiovascular pathology, autoimmune processes, disbolism (fatty dystrophy of a liver), haemo chromatosis and some other hereditarily the caused diseases, and also a specific infection (syphilis, a brucellosis, etc.) can be the cause of cirrhosis. Besides, there are cirrhoses which reason does not manage to be found.

Types and stages of cirrhosis

Depending on the cirrhosis reason, it can be primary, developed as independent pathology, or secondary, being symptom of the general disease, as at a diabetes mellitus or syphilis.

Depending on morphological features of cirrhosis allocate:

• Portal cirrhoses;
• Biliary cirrhoses;
• Postnecrotic cirrhoses;
• Mixed.

On activity of a course of process cirrhoses happen active and inactive.

Depending on a type of nodes:

• Small nodular cirrhosis;
• Macronodular cirrhosis;
• Mixed.

In chronic process distinguish the following stages of cirrhosis:

• Initial stage of cirrhosis, or compensation stage. Destruction of vessels and a parenchyma is poorly expressed, the beginning of inflammatory and necrotic process;
• Subcompensation stage. Increase of destructive processes, gradual substitution by fibrous fabric of a parenchyma, however at this stage of cirrhosis the most part of functions of a liver is kept at the expense of the remained hepatocytes;
• Decompensation. It is a cirrhosis end-stage on which there is almost full regeneration of a liver to loss of its functions.

Cirrhosis symptoms

Cirrhosis develops is long, within months or years. Brightness of clinical manifestations depends on a cirrhosis stage, and also on a process degree of activity. At the same time early symptoms of cirrhosis, as a rule, remain unnoticed, especially against the background of already available pathology.

The asthenic syndrome belongs to precursory symptoms of cirrhosis: increased fatigue, a febricula, weakness, difficulties with concentration, a loss of appetite. The first cirrhosis symptoms attracting attention usually is the following: yellowness of integuments, a skin itch, reddening of palms, periodic fevers, nausea, feeling of weight in an upper part of a stomach, feeling of overflow of a stomach after a small amount of food, weight loss, exposure to infectious diseases. Visible and notable increase and consolidation of a liver belongs to characteristic symptoms of cirrhosis, sometimes even its dense hilly structure to the touch is defined.

One more symptom of cirrhosis is increase in a stomach due to accumulation in an abdominal cavity of free liquid (ascites). Increase in a stomach attracts attention also because there is it against the background of considerable loss of weight.

In process of process development, the cirrhosis symptoms caused by portal hypertensia join. Veins on a body appear, there are nasal bleedings, hemorrhoids can develop. There is a need to resolve an issue: how to treat hemorrhoids. A symptom of cirrhosis in the developed stage is the turbidity and darkening of urine, and kcal on the contrary, becomes lighter.

Diagnosis of cirrhosis

The diagnosis of cirrhosis is made on the basis of collecting the anamnesis, studying of a clinical picture of a disease, and also these laboratory and hardware researches. Feature of cirrhosis consists in what biochemical tests (hepatic tests) is quite long can not to show considerable aberrations.

The following hardware diagnostic methods of cirrhosis are applied:

• X-ray inspection of a liver;
• ULTRASONOGRAPHY;
• Doppler sonography of hepatic, portal and splenic veins;
• Radionuclide scanning of a liver;
• Computer or magnetic and resonant tomography of a liver;
• Transdermal biopsy of a liver.

In doubtful cases apply laparoscopic inspection.

Treatment of cirrhosis

Treatment of cirrhosis has to be active and immediate, however the cirrhotic changes which happened in a liver are irreversible. The purpose of treatment of cirrhosis is maintenance of acceptable quality of life of the patient and the termination of progressing of a disease.

Treatment of cirrhosis is begun with elimination of the main disturbing factor if that is possible (for example, complete cessation of alcohol intake). In a stage of the acute phenomena the bed rest is necessary, further exercise stresses have to be sparing. The fundamental principles of treatment of cirrhosis is the dietotherapy and normalization of a way of life.

The diet at cirrhosis consists in restriction of proteinaceous products, animal protein is replaced vegetable, one-two days a week have to be protein-free. The salt use, and also the products containing soda or baking powder, greasy food, canned food is limited. Food has to be fractional, small portions, 5-6 times a day.

Drug treatment of cirrhosis consists in use of the medicines compensating the available disturbances for removal of an aggravation and decrease of the activity of process (a symptomatic treatment of cirrhosis). At mechanical obstruction of biliary tract carry out surgical elimination of an obstacle (a removing calculus, elimination of a stenosis), at bleedings from expanded veins of a stomach and a gullet in subcompensation stage also apply an operative measure.

At inactive cirrhosis sanatorium treatment, courses of fortifying therapy one-two times a year, and also regular medical observation is recommended.

Forecast of cirrhosis

The forecast depends on a stage of cirrhosis and activity of process, and also on that, how seriously the patient will treat treatment of cirrhosis and observance of a diet. In case of discipline of the patient and inactivity of process which an udalost to find rather early, it is possible to hold cirrhosis in compensation stage for many years. At active cirrhosis in subcompensation stage, and also at dekompensirovanny cirrhosis the forecast adverse.