Cirrhosis of the liver is a common disease with a chronic course, caused by progressive damage to the liver with a complete restructuring of its tissue, which leads to a violation of all its functions and the development of chronic liver failure. It develops as a result of viral hepatitis, against the background of chronic alcoholism, sometimes it is not possible to establish the cause of liver cirrhosis. Men are more often affected, mostly at about the advanced age. There are micronodular (small-nodular), macronodular (large-nodular), mixed micromacronodular, biliary cirrhosis of the liver.
Symptoms and course of liver cirrhosis. The main complaints are general weakness, weight loss, a feeling of heaviness or pain in the pit of the stomach and in the right hypochondrium, nausea, bitterness in the mouth, belching, and bloating. Jaundice of varying intensity, erythema (redness) of the palms, spider veins on the chest, back, shoulders, vascular network on the face. The liver is enlarged, dense, with a sharp edge, moderately painful or painless. A decrease in the size of an enlarged liver is an unfavorable sign. The spleen can reach a considerable size. With biliary cirrhosis, persistent pruritus of the skin, xytomas (subcutaneous deposits of cholesterol in the form of yellow seals), changes in the bones (decrease in bone density – osteoporosis) are also noted against the background of severe jaundice. As cirrhosis progresses, signs of portal hypertension are found: an increase in the size of the abdomen due to the accumulation of fluid in the abdominal cavity (ascites), varicose veins of the esophagus and stomach, anterior abdominal wall, rectum (hemorrhoidal veins). In connection with the violation of protein metabolism, edema of the lower extremities, lumbar region, and anterior wall of the abdomen are detected. Cirrhosis of the liver may accompany bleeding from the nose, gums, hemorrhoids.
Recognition of cirrhosis of the liver . Changes in the biochemical blood test are similar to those in chronic hepatitis and depend on the activity of the process. Ultrasound examination of the abdominal cavity, scintigraphy (radioisotope examination) reveals changes in the liver and spleen, characteristic of cirrhosis. When roentgenoscopy of the stomach and gastroscopy – varicose veins of the esophagus. The most accurate diagnosis is by laparoscopy with targeted liver biopsy. Often anemia (decreased hemoglobin in a blood test). In the primary diagnosis of biliary cirrhosis of the liver, it will be necessary to exclude obstructive jaundice caused by cholelithiasis, cancer of the pancreatic head and Vater’s nipple.
Treatment of cirrhosis of the liver . Meals 4 or 5 meals a day, diet No. 5. Completely eliminate the use of alcohol, taking medications that affect the liver. With inactive cirrhosis of the liver, drug treatment is not carried out. With an active process in the liver, courses of B vitamins, cocarboxylase, ascorbic acid, folic acid, vitamins A, D are shown. If signs of liver failure appear, a solution of 5% glucose, gemodez 1-2 times a week, salt solutions are administered. In violation of protein metabolism, solutions of albumin and blood plasma are administered. With severe inflammation, corticosteroid hormones, levamisole (Decaris) are prescribed in doses as in chronic active hepatitis. Treatment is carried out under the supervision of a physician with regular biochemical blood tests for liver tests.