Quite rightly, the human liver is considered the "laboratory" of the body. After all, complex chemical processes take place in it every minute. In addition, it acts as the main filter that protects the body from harmful substances. If its work is disturbed, then general poisoning is observed. Therefore, it is very important to recognize liver disease in time. Symptoms on the skin, suddenly occurring, signal the development of pathology.
Causes of diseases
The liver has enormous potential. It is very resistant to harmful factors. In addition, it has the ability to recover. However, as a result of some factors, liver disease can develop. Symptoms on the skin are the first signal that the body lets know about the development of pathology. Before considering them, let's analyze what can become a source of diseases:
As a rule, symptoms on the skin accompany liver disease. It is, first of all, a yellowish tint. In addition, the patient experiences heartburn, feels nausea. There is a sharp, extremely unpleasant smell of sweat. Therefore, typical cases do not cause difficulties in diagnosis.
In most cases, a doctor can already visually suspect liver disease. Symptoms on the skin, discomfort of the patient give the doctor an idea of the nature of the pathology.
The main signs of liver disease are:
- pain, discomfort in the organ area;
- liver enlargement;
- general malaise, weakness;
- headache;
- violation of mental, mental abilities;
- puffiness;
- increased sweating;
- jaundice;
- skin itching;
- rash;
- increased tendency to bleeding, fragility of blood vessels;
- symptoms of hypovitaminosis;
- changed color, character of feces, unstable stool;
- the presence of a venous pattern on the abdomen;
- weight loss;
- enlarged belly;
- bitter taste in the mouth;
- temperature reaction;
- a coating of white or brown color on it.
The nature of the pain
Most organ pathologies immediately affect the body and face of a person. This allows you to suspect liver disease in a timely manner. Symptoms on the skin are often accompanied by pain discomfort. The nature of sensations can be quite different. Therefore, you should pay attention to the following discomfort:
- The occurrence of minor pain in the right hypochondrium. It can be aching, bursting. Or give a feeling of heaviness. Such a pathology signals a sluggish process of inflammatory, toxic origin. Discomfort often occurs as a result of organ enlargement or stretching of the liver capsule. As a rule, the patient cannot clearly determine
- Intense, widespread This type of pain is rare. It signals a pronounced purulent, inflammatory or traumatic process. Sometimes it can characterize the defeat of bile duct stones.
- Local, strong point Discomfort for liver damage is not typical. It is associated with pathology in the gallbladder or extrahepatic ducts.
Sometimes the patient does not experience pain, but meanwhile he develops liver disease. Symptoms on the skin are the only signs that signal a pathology. As a rule, the absence of pain is observed in sluggish diseases that go unnoticed for a long time.
Skin manifestations
By the nature of the cover of the body, one can obtain information about the functioning of various organs. This also applies to pathologies such as liver disease. Symptoms on the skin (the photo shows these manifestations) can be quite diverse.
The patient should pay attention to the following changes in the epidermis:
- Pale or, conversely, swarthy skin. Sufficient sweating. There is swelling of the subcutaneous tissue in the extremities and face.
- Scaly, dry epidermis. There are many scratches and cracks on the surface.
- Increased tendency to allergic rash, the occurrence of psoriasis, atopic dermatitis, eczema.
- Icteric skin. This type allows you to determine the pathology. With moderate yellowness with an orange tint, liver problems are diagnosed. With mechanical damage to the organ, a brown tint is observed. Lemon yellow color indicates hemolytic pathology.
- The presence of stretch marks. Striae are localized in the abdomen. Often they are bluish stripes. Stretch marks occur as a result of a hormonal imbalance, when the liver can no longer neutralize the excess amount of steroid hormones.
characteristic rash
The development of pathology can be signaled not only by altered skin integuments. Many patients experience various rashes.
Sometimes the following symptoms occur:
- Pustular elements. There is a tendency to the formation of furunculosis, folliculitis. The source of such rashes is an immune imbalance. It occurs as a result of reduced liver function. The body is not able to synthesize immunoglobulin in sufficient quantities.
- allergic manifestations. This pathology in most cases characterizes liver disease. Symptoms on the skin: spots and papules, appear as a result of a violation of the detoxification function of the organ. That is why a person is faced with the occurrence of allergic reactions to familiar conditions.
- Small hemorrhages are observed on the surface of the skin. They are called petechial lesions. They characterize the decrease in the synthetic function of the organ. Initially, the protein contained in the blood suffers. As a result, patients have an increased tendency, even with the slightest injury, to form hematomas.
Itching with pathology
Often there are not only skin manifestations. Many patients experience severe itching. It is especially intense with jaundice. Since the non-neutralized bilirubin begins to be deposited in the skin and provokes its strongest irritation.
As a rule, traces of scratching are visible on the forearms, the sides of the abdomen.
Features of pathology in children
Unfortunately, it is not uncommon for babies to develop liver disease. Symptoms in children are quite problematic to recognize. Especially when it comes to infants. After all, even the most characteristic symptom - icteric color, can be interpreted as a natural physiological process.
You can suspect the presence of pathology in crumbs by the following signs:
- jaundice persists for more than 2 weeks;
- weakly colored stool indicates sometimes it is completely discolored;
- an enlarged tummy in an infant - such a sign may indicate the occurrence of liver failure.
Even at the slightest suspicion of a problem in a child, you should definitely contact a pediatrician.
Treatment of pathologies
It is possible to determine the necessary treatment only after the diagnosis is made. It depends on what symptoms on the skin indicate liver disease. Treatment includes many drugs that allow you to eliminate the clinical manifestations of the pathology and actively deal with its causes.
In almost any liver disease, therapy includes one of the hepatoprotectors:
- "Gepabene".
- "Bonjigar".
- "LIV-52".
- "Rezalut Pro".
- "Gepadif".
Diet food. Exclusion from the diet
However, not only drug therapy is important for patients in whom symptoms indicate liver disease. Diet is a prerequisite for effective treatment.
- milk, fat sour cream, kefir;
- offal;
- fat meat;
- raw garlic, onion;
- oily fish;
- radish, swede;
- mushrooms;
- tomatoes, sorrel, legumes;
- sour fruits, berries;
- alcohol, carbonated drinks, coffee, strong tea;
- chocolate.
Diet. Healthy foods
For liver disease, eat the following foods:
- slightly stale (rye, wheat) bread, biscuit cookies, biscuit;
- lean meat (rabbit, turkey, chicken, beef);
- fish - pike, pike perch, cod and other low-fat species;
- dairy products - low-fat kefir, cottage cheese, yogurt, fermented baked milk, yogurt;
- oil (sunflower, olive, butter);
- eggs (1 piece per day);
- vegetable dishes from pumpkin, potatoes, carrots, beets, zucchini, cauliflower;
- cereals - rice, buckwheat, oatmeal, barley;
- pasta - any varieties;
- fruits, berries (strawberries, strawberries, raspberries, blueberries);
- dried fruits and knots;
- fruit jam, honey (a little), marmalade.
Products must be steamed. It is allowed to eat food in stewed, baked or boiled form. Smoked, fried foods are prohibited.
With proper nutrition, many patients feel how liver disease recedes. Symptoms and treatment (diet and drug therapy) should be monitored by a doctor throughout the entire period of the fight against pathology.
Folk remedies
There are many sorcerers' recipes to defeat liver disease. Be sure to discuss symptoms and treatment with folk remedies with your doctor.
The most popular methods are:
- Oats. You will need 2 tbsp. spoons of unrefined grain. Fill the component with a liter of water. Boil the ingredients for 15-20 minutes over low heat. Then add 2 tbsp to the content. spoons of milk (preferably goat). This remedy should boil for another 5 minutes. Then strain the resulting broth and add honey to it (2 tablespoons). It should be consumed half an hour before meals three times a day for 1/3 cup. Treatment with this remedy should last two weeks.
- Decoctions of herbs. Traditional medicine advises choosing plants with yellow flowers. For liver diseases, herbal decoctions of St. John's wort, immortelle, chamomile, tansy, milk thistle are useful. It will take 1 tbsp. a spoonful of herbs for 1 cup of boiling water. The composition should be boiled for 1-2 minutes over low heat. After straining, the decoction is ready. Use it half an hour before meals three times a day for 1/3 cup. As a rule, the course of treatment lasts about 10 days.
The liver is one of the most important organs in the human body. It performs many functions - it cleanses the body of aggressive substances, takes part in the digestive processes and blood formation, as well as in the production and storage of many vitamins. Accordingly, any problems in the activity of the liver harm the work of other organs and systems, adversely affect well-being and require long-term targeted treatment under the supervision of a doctor. Let's talk about how a violation of liver function makes itself felt, symptoms, treatment of such diseases, we will consider in a little more detail.
Signs of impaired liver function
Also, for the treatment of the liver is often used - a source of phospholipids and other useful substances. Such a medicine is advised to be taken by patients with chronic and acute hepatitis, liver necrosis, cirrhosis and toxic lesions.
To achieve a detoxifying effect in liver ailments, as well as to eliminate bile stasis and restore the draining function of the biliary tract, it is usually used. And Gepabene often becomes the drug of choice for toxic damage, as well as for chronic hepatitis.
Therapy of liver diseases can be carried out using the well-known hepatoprotector Essliver Forte, which is able to restore and protect hepatocytes. This medicine is also excellent for optimizing lipid metabolism in case of damage to liver cells due to poor nutrition, extreme diets, poisoning and active weight loss. Another good hepatoprotector is. It is commonly used in chronic liver ailments.
Violations of the liver, when detected at an early stage, are quite amenable to drug correction. Preparations for the treatment of such diseases are selected exclusively by a doctor.
In the event that the pathological processes have gone too far, patients are shown to undergo surgery - a liver transplant.
Alternative treatment of liver diseases
Traditional medicine experts often advise treating liver ailments with the help of. They effectively lower the amount of bilirubin in the blood, reduce the viscosity of bile and stimulate its discharge. To prepare the medicine, you need to prepare a teaspoon of crushed corn stigmas. Brew them with one glass of boiling water and soak in a water bath for half an hour. Cool and strain the finished medicine, then take it one to three tablespoons at intervals of three to four hours immediately before the meal.
Liver diseases respond well to treatment with the help of an ordinary - popular seasoning. To prepare the medicine, you need to prepare a quarter teaspoon of turmeric and pour it with a glass of water. Dissolve a spoonful of honey in this mixture and mix well. Drink the finished medicine three to four times a day.
Oats will be a wonderful medicine for the treatment of the liver. Such a product perfectly cleanses the body of aggressive substances. To prepare the medicine, you need to boil one and a half liters of water, pour one hundred and fifty grams of pure oats into it and boil it on a fire of minimum power for twenty minutes. Remove the container from the fire and let the medicine brew for three hours in a fairly warm place. Drink the strained drink a day in several doses.
As we have already mentioned, the treatment of liver diseases can be carried out with the help of. You can prepare a medicine based on it on your own. Grind the milk thistle seeds into a powder. Brew a couple of tablespoons of such raw materials with half a liter of only boiled water. Place the medicine on a fire of minimum power and reduce by half. Ready broth should be filtered and taken in a tablespoon at intervals of an hour throughout the day.
You can also cope with diseases with the use of dry milk thistle seed powder. It should be taken in a teaspoon four to five times a day. Take this medicine with water. Follow up for a month and a half.
Many traditional medicine experts advise treating liver diseases with the help of. A couple of tablespoons of dry grass should be brewed with half a liter of boiled water only. Infuse this medicine for four hours, then strain. Take the resulting infusion in a tea cup (one hundred and fifty to two hundred milliliters) on an empty stomach - in the morning and evening.
Liver diseases are quite common pathologies among the adult population and, unfortunately, they do not always make themselves felt in the early stages of development. In order to detect such health problems in time, you need to regularly undergo preventive examinations with a doctor.
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Thus, liver dysfunction is a violation of the various processes that it normally performs.
Many diseases can be hidden under this term, so it is often used when the causes of the disease are not fully understood, and a more definite diagnosis cannot be made.
In this article, we will tell you what liver functions can be impaired, how it manifests itself, and what threatens liver dysfunction.
A normally functioning liver of a healthy person performs many vital functions:
- neutralizes poisons, toxic metabolic products, etc., converting them into harmless or quickly excreted compounds from the body;
- breaks down and ensures the excretion of spent biologically active substances (hormones, neurotransmitters, vitamins, etc.) from the body;
- during gluconeogenesis, it converts fatty acids, amino acids, glycerol and other substances into glucose as an energy source;
- accumulates glycogen (a substance that can quickly turn into glucose when it is strongly reduced in the blood);
- participates in the formation and metabolism of vitamins;
- participates in the regulation of fat metabolism;
- produces enzymes, bile acids and bilirubin necessary for the digestion of food and the neutralization of toxic substances.
- plays the role of a depot for blood volume (with large blood loss, this blood returns to the bloodstream, thereby preventing oxygen starvation of tissues).
Theoretically, any of these functions will be disturbed for one reason or another, and such a condition will be called liver dysfunction. Most often, the liver is disturbed as a result of poisoning, alcohol abuse, junk food, etc. The state of other organs and systems of the body also plays an important role. 
Possible violations
Various disorders of liver function can be combined into several groups, depending on which function of this organ undergoes pathological changes:
- Carbohydrate metabolism (metabolism of sugars). Carbohydrates play a vital role in energy production. A typical manifestation of a carbohydrate metabolism disorder is a decrease in blood glucose levels (hypoglycemia).
- Fat metabolism. Violation of the processes of digestion and absorption of fats in the intestine leads to a violation of the metabolism of fat-soluble vitamins (A, E, K, D), as well as cholesterol and fatty acids. This disrupts the functioning of blood vessels and the heart.
- Protein exchange. Impaired protein breakdown can lead to the accumulation of toxic products such as ammonia in the body. In addition, protein synthesis is disrupted, which is fraught with a wide variety of consequences, ranging from loss of muscle mass to disruption of many organs.
- Metabolism of biologically active substances and hormones. With this type of dysfunction, disturbances in the synthesis of estrogen and thyroxine are possible, as well as an increase in the patient's sensitivity to allergens.
- barrier function. Violation of the protective function of the liver is expressed in a decrease in the number or activity of enzymes that break down toxic substances into simpler, non-hazardous compounds.
- Bile formation and excretion. Most often, bile acids and bilirubin enter the bloodstream, which leads to the development of jaundice, severe skin itching and a rash on the body. In parallel, there is a decrease in appetite and disruption of the intestines (frequent constipation).
Thus, violations of the liver are diverse in their causes and manifestations. Often, a violation of one of the functions of the liver pulls another, and so on. In this case, there is a complex of symptoms characteristic of liver dysfunction of various etiologies.
Symptoms
In general, signs of liver dysfunction are quite typical. In the early stages, the general symptoms of itching of the skin, the appearance of age spots, constant fatigue, etc. are of greater importance. Often the patient does not see the connection between these manifestations and the state of the liver, attributing them to stress, allergies, poor ecology, etc. Most patients go to the doctor in the later stages of the disease, when there is pain in the right hypochondrium, jaundice and other obvious symptoms.
Early stage
The liver tissue is devoid of pain receptors, so it does not hurt in the early stages of various diseases.
Pain appears later when the pathological process affects the liver capsule, or if the disease has led to an increase in the liver (the enlarged liver stretches the capsule, which leads to pain).
How can a patient determine that the liver is not coping with its functions? In the early stages of liver dysfunction, extrahepatic symptoms occur, such as: 
- constant causeless fatigue;
- depressed mood, depression, poor sleep;
- loss of appetite;
- violation of the digestive system, the occurrence of heartburn, periodic nausea;
- causeless itching of the skin of the body (usually at night);
- the appearance of spots on the skin, sometimes a rash;
- the appearance of angiomas of "spider veins" on the skin of the face, neck, hands, feet.
People do not always go to the doctor, noticing such symptoms, and very in vain. Liver disease progresses over time. Moreover, the violation of its work affects other organs. Thus, timely seeking medical help in case of suspected liver dysfunction can protect against serious health problems.
Late stages
In the later stages of liver dysfunction, more pronounced symptoms occur that people simply cannot help but pay attention to. So, for severe violations of the work of this body, the following manifestations are characteristic:
- drawing, sharp or aching pain in the right side;
- a specific sweet smell from the mouth (the so-called "liver smell");
- yellowing of the skin is a sign of impaired bilirubin metabolism;
- pallor of the skin occurs as a result of anemia (low levels of red blood cells in the blood);
- with hemochromatosis, multiple age spots appear on the body;
- the appearance of clearly visible veins on the abdomen, resembling varicose veins (the result of portal hypertension);
- red spots on the palms (the so-called "liver palms");
- in violation of the liver in women, the development of dysmenorrhea is possible (a pathological cyclic condition in which during menstruation a woman suffers from severe pain in the lower abdomen, weakness, nausea and headache);
- in men, an increase in estrogen levels leads to an increase in the mammary glands, loss of body hair, and sexual dysfunction;
- dyspeptic syndrome (a person's appetite worsens, often nausea, vomiting, heaviness in the area above the stomach, bloating, constipation) develops with cirrhosis, hepatitis.
If you experience these symptoms, you should seek medical advice.
Diagnostics
It is possible to talk about liver dysfunction only when suspicions of possible violations are confirmed by the results of laboratory and instrumental studies. For example, if a liver dysfunction is suspected, the patient should take a biochemical blood test, including liver tests (bilirubin, transaminase, alkaline phosphatase, bile acids in the blood serum, etc.).
It is also mandatory for the patient to be assigned a general clinical blood test. It allows you to evaluate the number of platelets and red blood cells, often the proportion of these cells decreases against the background of liver dysfunction. In addition, it provides information on the number of leukocytes (with inflammation, such as hepatitis, their proportion increases significantly).
If you suspect viral hepatitis, you must take a blood test for antibodies to a specific hepatitis virus (ELISA analysis). Also, PCR analysis is often used; it allows you to detect the genetic material of hepatitis pathogens (DNA or RNA) in the patient's blood.
For a more accurate diagnosis, an ultrasound examination (ultrasound) can be performed. This diagnostic method allows you to assess the size and structure of the internal organ, detect neoplasms in tissues, tumors, stones, etc. Much less often resort to magnetic resonance imaging, if the results Ultrasound is not enough to make a diagnosis.
If the above examination options could not shed light on the cause of the violation, the question arises of conducting a biopsy. This study involves the taking of living cells of the patient's liver for subsequent cytological and histological examination. A biopsy allows you to assess the condition of liver cells, detect cancer cells, fibrotic changes, etc.
Treatment
Treatment of liver dysfunction depends on the causes and characteristics of the course of the disease. For example, detoxification dysfunction is often caused by insufficient bile production. In this case, the patient needs drugs that stimulate bile formation (holosas, ursochol, and others).
If bile is formed in sufficient quantity, but its outflow is impaired as a result of spasm of the sphincter of the bile duct, antispasmodic drugs no-shpa, papaverine are needed.
If the cause of jaundice and pain in the side is hepatitis, long-term antiviral therapy (interferon, interferon stimulants, etc.) will be required, and then a course of hepatoprotectors that help restore the functioning of the organ. Many hepatoprotectors are made on a plant basis (such as heptral, carsil, essentiale).
The patient's diet also deserves more attention. It is necessary to limit the use of salt, smoked meats, coffee, fats. Alcohol and other toxic products must be completely abandoned. At the same time, it is necessary to ensure sufficient intake of protein and polyunsaturated acids. It is worth enriching the diet with sea fish, chicken fillet, and various cereals.
Since the liver ensures the neutralization of harmful substances that enter the body with food, during treatment, you should give it a rest, make sure that the food you eat is as light and natural as possible.
The human body is arranged in such a way that all organs can be divided into vital and auxiliary. The liver clearly belongs to the first group. Its importance for maintaining the viability of the organism cannot be overestimated. After all, it is a powerful parenchymal organ that combines the functions of the digestive gland and a kind of biochemical laboratory.
It is here that all the central biochemical reactions and processes responsible for maintaining life take place. Naturally, the more complex the structure of an organ and the higher the load on it, the more vulnerable it is. And despite the excellent regenerative and regenerative abilities of the liver, the number of its diseases, turning into liver failure, continues to grow steadily.
Where is the human liver located?
Like all vital organs, the liver is located in the central regions of the body. It occupies virtually the entire upper right section of the abdominal cavity, being under the diaphragm. The main mass of the organ is fixed by ligaments under its right dome, which is projected onto the anterior abdominal wall as the region of the right costal arch and hypochondrium. From this section, the liver goes to the left, gradually narrowing until the edges are completely connected at an acute angle in the form of a wedge closer to the left hypochondrium. Therefore, if there are problems with the liver, patients complain of pain or discomfort in the right hypochondrium with a possible spread to the epigastrium.
Functions of the liver in the human body
As many functions as the liver performs, no organ in the human body provides. These include:
Detoxification of the body - neutralization of all toxic compounds that enter the bloodstream from the environment (alcohol, toxins, medicines);
Utilization and inactivation of toxic metabolic products formed in the body during life (protein breakdown products, phenol, ketone compounds and acetone);
Participation in vitamin and mineral metabolism: deposition of water-soluble vitamins of groups B, C, PP, as well as fat-soluble D, E, K, trace elements of iron, copper and cobalt;
Participation in the synthesis of steroid sex, thyroid, adrenal hormones and neutralization of their excess;
Regulation of carbohydrate metabolism;
Deposition and distribution of energy substrates in the body (glucose, glycogen) through the processes of glycogenolysis, gluconeogenesis, glycolysis;
Participation in lipid metabolism (metabolism of cholesterol, phospholipids, fatty acids, lipoproteins);
Implementation of the central processes of protein metabolism: synthesis of protein components for cell membranes and transport proteins, redistribution of amino acids;
Participation in the synthesis of immunogobulins, antibodies and other important proteins of the immune system;
Synthesis of plasma coagulation factors and anticoagulant blood system;
The function of hematopoiesis, especially in the prenatal and childhood period;
Synthesis of bile and enzymes that are involved in the processes of digestion. Their main role is the breakdown of fats;
The implementation of bilirubin metabolism and its neutralization by conjugation with glucuronic acid;
Deposition of blood, which allows redistributing it in case of need (ejection of blood into the vessels in case of its deficiency during blood loss or concentration in case of congestive heart failure);
The liver is the largest gland of the human body, which performs the most functions among all organs. Damage to the liver can be accompanied by a violation of one or all of its functions, which underlies the severity of the disease.
The group of hepatic diseases can include any type of damage to all structures that do not go beyond the anatomical limits of this organ. These can be hepatocytes and the hepatic lobules that they form, intrahepatic arterial and venous vessels, and bile ducts. Diseases of the extrahepatic bile ducts and gallbladder should be treated as a separate rubric.
The main common liver diseases are shown in the table:
Group of liver diseases |
Nosological units from the group |
Primary inflammatory, purulent and functional damage to the liver cells |
Alcoholic and non-alcoholic steatohepatosis; Tuberculous and syphilitic damage to the liver; Angiosarcoma and other types of liver sarcomas; Intraductal cancer (Klatskin's tumor); Metastatic liver disease in cancer of any localization. |
|
Alveococcosis; |
|
Hereditary pathology and anomalies |
Hypoplasia and aplasia of the liver (underdevelopment or absence of the organ); Atresia of the intrahepatic ducts and vessels (narrowing or membranes that impede the flow of blood or bile); Hepatic fermentopathy with impaired bilirubin metabolism (Gilbert, Rotor, Dabin-Jones syndromes); Hepatic fermentopathy with impaired copper metabolism (Wilson-Konovalov syndrome); Hemochromatosis; Hereditary pigmentary hepatosis. |
Liver damage in pathology of other organs |
Congestive liver in heart failure; Renal and liver failure; Hepatomegaly in leukemia. |
Structural and functional rearrangements in the liver and their complications |
Liver failure; Parenchymal jaundice; Hepatic coma. |
autoimmune liver disease |
Pathology in which there is an unreasonable destruction of the liver by its own immune system: autoimmune hepatitis; Primary sclerosing cholangitis; Primary biliary cirrhosis of the liver; |
Any liver disease in case of progression ends with cirrhosis and is accompanied by some degree of hepatobiliary insufficiency.
Symptoms of liver disease are considered frequent nausea, very unpleasant, pungent odor of sweat, yellowish skin color, dark yellow urine, diarrhea, discoloration of feces to dark brown or light yellow, sometimes green.
Also, liver disorders can lead to acne in adulthood, frequent hunger or strong and frequent thirst, itching of some thin skin areas, and visual impairment. For example, a person may begin to confuse white with yellow, suddenly feel either cold or hot, not sleep at night, while experiencing fever, heart palpitations. Hair and eyebrows may begin to fall out. Convulsions occur, are formed, the development of atherosclerosis of the brain, heart, intestines, vessels of the legs begins.
Typical cases of problems with the liver of an organic and functional plan are recognized without difficulty by characteristic symptoms. But some situations make it difficult for even experienced hepatologists (specialists dealing with liver diseases) to make a correct diagnosis. It all depends on the specific type of disease, the individual characteristics of the organism, the presence or absence of concomitant pathology.
The main clinical manifestations of hepatic pathology can be:
Discomfort and pain in the projection of the liver;
Enlargement of the liver in size;
General weakness and malaise;
Violation of mental and mental abilities;
Increased skin sweating and swelling;
Yellowness of the skin and sclera;
Increased fragility of blood vessels and a tendency to bleeding;
Signs of hypovitaminosis;
Instability of the stool, change in the nature and color of feces;
An increase in the size of the abdomen;
Reinforced venous pattern on the skin of the abdomen;
Unmotivated weight loss;
Bitterness in the mouth;
Cracks on the surface of the tongue and its coating with a white or brown coating;
Temperature reaction of varying severity.
How does the liver hurt?
Pain in liver damage can be of a different nature. You can interpret them like this:
Slight pain in the right hypochondrium in the form of aching pain, bursting and heaviness. They characterize a sluggish pathological process of inflammatory toxic or other origin. This type of pain in the liver is most likely due to an increase in the size of the organ and overstretching of the liver capsule. Patients cannot clearly indicate one pain point;
Intense widespread pain in the right hypochondrium. They are rare and speak either of a pronounced inflammatory, purulent, traumatic pathological process, or of a lesion of the bile ducts with stones;
Strong local point pain in the projection of the liver. It is not typical for liver damage and in most cases is associated with the pathology of the gallbladder and extrahepatic bile ducts;
Complete absence of pain in the liver. It is very often found in sluggish liver diseases that go unnoticed for a long time and are determined only at the stage of liver failure or cirrhosis of the liver.
According to the characteristics of the skin, you can determine the functioning of various organs, including the liver.
With such diseases, the skin may be:
Pale or swarthy with severe sweating and swelling of the subcutaneous tissue, especially in the face and limbs;
Dry, flaky with multiple scratch marks and cracks;
icteric. By the nature of this type of skin changes, it is possible to determine the origin of jaundice. With problems with the liver, jaundice is of moderate intensity and is represented by an orange tint. When conducting a differential diagnosis of jaundice, this criterion makes it possible to exclude their mechanical types (brown skin tone) and hemolytic, accompanied by a lemon-yellow skin tone;
With striae. Stretch marks are stretch marks of the skin, mostly of the abdomen, in the form of cyanotic stripes of its thinning. The reason for their appearance is a hormonal imbalance, both in the male and female body, when the liver is not able to neutralize the excess of steroid hormones.
Rash in liver disease
In most patients with liver pathology, along with a change in skin color, the appearance of various rashes is noted.
The mechanisms of occurrence and types of rash can be as follows:
Pustular elements, tendency to folliculitis and furunculosis. They are based on an immune imbalance that occurs against the background of a decrease in the ability of the liver to synthesize immunoglobulins;
Mineral sparkling water, especially with dyes, or ordinary highly chilled
Fatty meats (pork, duck, goose) and offal (kidneys, liver, brains, heart);
You can not broths from rich meat, fatty, mushroom, based on legumes and sorrel
Barley, corn, barley and millet porridge
Pasta with additives, pastes and sauces with fat, strong tomato dressings and creamy sauces
All types of smoked products, sausages, canned food, confectionery fat, lamb, beef and pork are excluded
Fatty fish (salmon, salmon, sturgeon, eel, carp, stellate sturgeon, catfish), including salted and smoked fish.
Any kind of caviar and sushi
Fresh bread and pastry products (buns, pies, donuts, cookies);
Ryazhenka, full fat milk and cottage cheese, salted and seasoned cheeses
Some vegetables: kale, Brussels sprouts, sorrel, spinach, pickles, pickles, garlic, onions, eggplant, mushrooms, radishes, turnips, asparagus, and cooked bell peppers
Almost all types of fresh fruits and berries including dates, cranberries, grapes, figs and raspberries
You can not use a lot of eggs in case of liver pathology, as well as in their fried form
From snacks, sushi, smoked meats, spicy and fatty dishes are unacceptable;
From sweet, all products containing chocolate and cocoa, cream, or a lot of confectionery fat are prohibited.
Any seasonings, mustard, vinegar, pepper, adjika, ketchup, mayonnaise, and sauces, especially spicy ones;
What foods are allowed for liver diseases
The following products are allowed for liver diseases:
Beverages. A decoction of rose hips, weak black tea with lemon, milk. Instead of sugar, substitutes (xylitol) can be used. Juices from berries and fruits without sugar. Compotes are prepared from dry and fresh fruits, grinding them.
Rye or bran bread, or yesterday's wheat bread (or stale), biscuit, biscuit type cookies;
Low-fat varieties of fish. Attention is focused on pike perch, pike, cod, all low-fat varieties of river fish;
Oils. Refined vegetable oils (up to 10 g) and butter (up to 10-30 g) are allowed;
Low fat dairy products. It can be curdled milk, low-fat or low-fat cottage cheese, not spicy cheeses. Kefir and milk can only be fat-free, the maximum amount of fat should not exceed 2%. You can diversify the menu with cheesecakes, lazy dumplings, puddings.;
It is better to cook vegetable dishes from, colored, zucchini, and. Green peas and Chinese cabbage will perfectly complement the menu. Vegetables can be boiled, grated and made soup-puree, soufflé, casseroles with meat and fish. In a small amount, salads with a neutral taste (corn, iceberg, romaine) are welcome. Bulgarian pepper is useful;
You can have any varieties of vermicelli and pasta, rice, oatmeal - all boiled;
You can season ready-made dishes with bay leaves, cinnamon, parsley, dill, vanilla. Great for flavoring soy sauce.;
In people with liver pathology, confectionery and sweets should be represented by fruit jam, honey in a small amount, marmalade.
Snacks. The diet for liver disease does not limit the use of fresh vegetable and fruit salads seasoned with refined oil; after boiling, fish is made into aspic, low-fat varieties of herring are soaked, and stuffed fish is made. It is allowed in a small amount, so as not to cause flatulence, sauerkraut without vinegar. From the usual salads: vinaigrette, zucchini in the form of caviar.
How to cook and eat meals?
Any food should be steamed, stewed, baked, boiled. In no case should they be fried and smoked. It can be soup, puree soup, casserole, pudding, puree, just boiled products in their pure form. You can combine allowed foods in salads and stews. Be sure to season them properly. This will provide the body with sodium and chloride ions. Ready meals should be warm before eating. It is better to adhere to the principle of fractional dosed 6 meals a day. This approach will create the most careful attitude to the liver and provide the body with nutrients.
Unfortunately, the prevention of liver diseases depends not only on the correct behavior of one person, who, even with all his desire, will not always be able to protect himself from them. Liver pathology is to some extent a public problem. Among the reasons for its development are those that are extremely difficult to influence by the usual observance of preventive recommendations. But everyone is obliged to strive for this: state government structures, medical institutions, catering facilities and every person who monitors their health.
Prevention of liver diseases can include the following measures:
Compliance with the technology of hazardous production with the exclusion of waste disposal into wastewater or air;
Compliance by workers in hazardous production with the rules for working with toxic substances, the use of personal protective equipment;
Purchasing only fresh food from trusted suppliers. Many of them are grown and transported using chemical processing that is extremely harmful to the liver;
Exclusion of alcohol abuse;
Carry out strict control over the processing of instruments in surgical clinics and dental offices. Maximize the use of disposable devices in practice;
Strict control over the state of donor blood and its products, as well as donors. This will prevent cases of viral hepatitis;
Isolate patients with viral hepatitis A;
Exclude unprotected non-regular sexual relations;
Compliance with the principles of healthy eating;
Vaccinate against hepatitis B for persons at risk for the occurrence of this disease;
Monitor the condition of patients with chronic liver disease;
Exclude uncontrolled intake of medicines;
Use hepatoprotectors if there is a threat of liver damage;
Timely seek medical help if there is any suspicion of liver disease;
Proper treatment of any pathology that a person has that can lead to secondary liver damage.
Liver diseases are a serious threat to health and life, which in no case should be left without due attention!
Those who suffer from liver disease must give up bad habits, from the use of spicy, hot, fatty foods. Heat and sunburn should be avoided. Food should be consumed steamed or boiled, stewed. It is not recommended to eat yesterday's food. You can not eat onions and garlic, but it is better to add mustard to food; eat boiled chicken, not fried. Also, duck, goat meat, or dried meat is not allowed. Eat vegetables raw. Do not consume too many dairy products, eat often, but little by little.
You can eat sweet, sweet tea can help with pain in the liver. Eat food also besides sweet, bitter, astringent.
Which doctor should I contact?
A doctor who treats the liver - gastroenterologist (gastroenterologist), hepatologist (if you have hepatitis)
Education: Diploma in the specialty "Medicine" received at the Russian State Medical University. N. I. Pirogova (2005). Postgraduate studies in the specialty "Gastroenterology" - educational and scientific medical center.
Hepatoprotectors are a special group of drugs that have a stimulating effect on liver cells and help restore their structure, normalize the basic functions of the liver and protect hepatocytes from the pathogenic effects of such toxic substances as drugs, unhealthy and poor-quality food ...
The liver is an important human organ, which is entrusted with a rather difficult job in several directions.
- First, the liver produces bile, which is then collected in the intrahepatic ducts, the common bile duct and accumulates in the gallbladder for some time, after which it is released into the duodenum. Bile helps break down fats. In addition, bile acids have a laxative effect and stimulate intestinal motility.
- Secondly, the liver is a laboratory in which many poisons and toxic substances are neutralized. Blood, passing through the liver, is cleared of ammonia, phenols, acetone, ethanol, ketone bodies. Some of the vitamins and hormones are also destroyed here.
- Thirdly, the liver plays the role of a warehouse for vitamin B12, A and D, glycogen, iron, copper and cobalt.
Even in the liver, cholesterol and fatty acids are synthesized (see). A certain volume of blood can be deposited in this organ, which, if necessary, is additionally thrown into the vascular bed.
The smallest structural unit of the liver is the hepatic lobule, which has the shape of a prism and is about 2 mm in size. It consists of hepatic beams (a number of double liver cells), between which the intralobular bile ducts pass. In the center of the lobule is a vein and a capillary. Interlobular vessels and bile ducts pass between the lobules.
Today, approximately 200 million people in the world suffer from liver diseases, which are among the ten most common causes of death. Most often, the liver is affected by viruses and toxic substances. The most popular outcome of chronic liver pathologies is. But liver cancer is relatively rare, while oncology metastases of other organs affect the liver 30 times more often than liver cancer itself.
Which symptoms of liver disease require the most attention, only a doctor can decide. Therefore, at the first suspicion of hepatic disorders, it is worth contacting a specialist.
List of liver diseases
- Hepatitis: acute or chronic inflammation of the liver - viral, drug, toxic, against the background of a lack of blood supply (ischemic).
- Cirrhosis: alcoholic, biliary, postnecrotic, with hemochromatosis, rare species (against the background of Wilson-Konovalov disease, cystic fibrosis, galactosemia).
- Neoplasms of the liver: hepatocellular carcinoma, liver metastases, cysts (echinococcosis, polycystosis), abscess.
- Infiltrative lesions of the liver: amyloidosis, glycogenosis, fatty liver, lymphomas, granulomatosis (sarcoidosis, tuberculosis).
- Functional disorders with jaundice: , cholestasis of pregnancy, Crigler-Najjar syndrome, Dubin-Johnson syndrome.
- Intrahepatic bile duct lesions: blockage of the bile duct (stone, scar), inflammation of the bile duct (cholangitis).
- Vascular pathologies: congestive liver in heart failure and cardiac cirrhosis, hepatic vein thrombosis, arteriovenous fistulas.
General signs of liver pathologies
Asthenic manifestations
These are the first symptoms of liver disease. Weakness, lethargy, fatigue, decreased performance, drowsiness - a consequence of a violation of the neutralization of nitrogen metabolism products in the liver.
Pain in the liver
Jaundice
This is the coloring of the skin, the white of the eyes and mucous membranes (the frenulum of the tongue) in different shades of yellow. This manifestation is directly related to impaired bile transport or bilirubin metabolism. The norm of the level of bilirubin in blood biochemistry: total from 8.5 to 20.5 μmol per liter, indirect (bound) up to 15.4 μmol per liter, direct (not bound) - 2-5.1 μmol / l.
- Jaundice with damage to the liver cells is called parenchymatous and is characteristic of hepatitis, Dubin-Johnson syndrome and other functional disorders. The cause of this type of jaundice is a violation of the transformation of direct (toxic) bilirubin into indirect. Jaundice has a lemon hue. In parallel with this, due to a violation of the metabolism of bile pigments, urine acquires the color of beer, and feces - light clay. In a biochemical blood test, total and direct bilirubin will increase.
- Cholestatic jaundice is characteristic of a violation of the patency of the bile ducts both inside the liver and outside it. At the same time, stagnation of bile provokes a yellow coloration of the skin with a greenish tint. mucous membranes and sclera. In biochemistry, there will be high total bilirubin and increased indirect (bound) bilirubin.
- Hemolytic is called jaundice, in which the level of direct bilirubin in the blood increases. With Krieger-Najjar syndrome.
Other symptoms
Other manifestations of liver diseases are associated with the toxic effect of products that are not completely neutralized by the diseased organ.
- Against this background, insomnia, memory impairment may occur.
- Other symptoms on the skin: spider veins, small hemorrhages in the skin - the result of a clotting disorder.
- Also for a number of liver diseases are characteristic:
- red palms (plantar erythema)
- fatty plaques on the eyelids
- raspberry varnished tongue against the background of vitamin B12 deficiency.
Liver syndromes
When describing liver diseases, it is customary to combine many of their manifestations into groups (syndromes). From them, as from a designer, you can add up a picture of certain hepatic ailments.
cytolytic syndrome
It develops as a result of damage to liver cells (hepatocytes), primarily their walls and membranes of cell structures. This leads to an increase in the penetration of various substances into hepatocytes, which can be replaced by cell death. Viral, drug, toxic damage, starvation can lead to cytolysis. Hepatitis, cirrhosis, liver tumors are accompanied by cytolytic syndrome.
Laboratory criteria for this syndrome is an increase in blood transaminases:
- ALT, AST (more than 31 g/l for women and 41 g/l for men) (LDH (more than 250 U/l)
- bilirubin (due to direct)
- an increase in iron in the blood serum (26 µmol/l in women and 28.3 µmol/l in men).
The activity of cytolysis is described by the De Ritis coefficient (ratio of ALT to AST). Its norm is 1.2-1.4. With a coefficient of more than 1.4, there are severe lesions of the liver cells (chronic hepatitis with high activity, tumor or cirrhosis).
mesenchymal inflammatory syndrome
Mesenchymal inflammatory syndrome provides insight into the activity of hepatic immune inflammation. The clinical manifestations of the syndrome are fever, joint pain, swollen lymph nodes and their soreness, enlarged spleen, vascular lesions of the skin and lungs.
Laboratory indicators change as follows:
- total blood protein decreases (below 65 g/l)
- increased serum gamma globulins (>20%)
- thymol test exceeds 4 units
- non-specific markers of inflammation (seromucoid >0.24 U, C-reactive protein >6 mg/l)
- specific antibodies to DNA, as well as immunoglobulin fractions, increase in the blood.
- At the same time, an increase in Ig A is characteristic of alcoholic liver damage.
- Ig M - for primary biliary cirrhosis
- Ig G - for active chronic hepatitis
- in a blood test from a finger, ESR is accelerated (above 20 mm / h in women and above 10 mm / h in men).
cholestasis syndrome
It indicates the stagnation of bile in the intrahepatic (primary) or extrahepatic (secondary) bile ducts. The syndrome is manifested by jaundice with a greenish tint, skin itching, the formation of flat yellow plaques on the eyelids (xanthelasm), darkening of urine, lightening of feces, skin pigmentation. In blood biochemistry, alkaline phosphatase (> 830 nmol / l), gamma-glutamine transpeptidase (GGTP), cholesterol (above 5.8 mmol / l), bilirubin (due to indirect) increases. The amount of bile pigments (urobilinogen) increases in the urine, stercobilin decreases or disappears in the feces.
portal hypertension syndrome
- The initial one is manifested by appetite disorders, bloating, pain in the epigastrium and right hypochondrium, unstable stool.
- Moderate hypertension gives an increase in the spleen, the initial manifestations of varicose veins of the esophagus.
- Expressed attaches to the accumulation of fluid in the abdominal cavity (ascites), swelling, bruising on the skin.
- Complicated is aggravated by bleeding from the esophagus and stomach, disorders in the work of the stomach, intestines, kidneys.
Syndrome of hepatocellular insufficiency
It is characterized by dystrophy or replacement of hepatic cells with connective tissue, a drop in all hepatic functions. In the clinic of this syndrome appear:
- temperature rise
- weight loss
- jaundice
- bruising on the skin
- red palms
- lacquered crimson tongue
- spider veins on the chest and abdomen.
- due to changes in the exchange of sex hormones in women, excessive hair growth, menstrual irregularities, atrophy of the mammary glands, uterine involution appear
- men suffer from gynecomastia, testicular atrophy, libido disorders
In the blood, the protein decreases due to the fall of albumin, prothrombin (PTI<90%), падают факторы свертываемости, холестерин, растут билирубин (за счет прямого), АлАТ, АсАТ, печеночные ферменты.
Acute and chronic liver failure
As a rule, this term means a large liver failure, in which, in addition to the insufficiency of liver cells (hepatic cell failure syndrome), there is also damage to the central nervous system by ammonia, phenols, which is called hepatic encephalopathy. At the same time, sleep disorders (insomnia at night and drowsiness during the day), memory, hand trembling, inaccuracy of movements are noted.
The causes of acute liver failure are liver damage in case of poisoning (, toxin pale toadstool), viral and autoimmune hepatitis, Wilson-Konovalov's disease, acute fatty liver disease in pregnant women. Chronic liver failure - the outcome of cirrhosis or tumors, as well as vascular pathologies of the liver. It is divided into four stages.
- Compensated insufficiency- manifested by sleep rhythm disturbances, unstable mood, decreased motor activity. There is fever, jaundice, spontaneous hemorrhages in the skin.
- Severe or decompensated insufficiency manifested by an increase in all manifestations of the first stage. Inadequacy is noted, sometimes aggression, alternating with drowsiness and disorientation, slow speech, pronounced. There is a liver smell from the mouth.
- Terminal or dystrophic phase- this is drowsiness, depression of consciousness, difficulty in awakening, which is accompanied by anxiety or confusion. The contact of the patient with others is disturbed, but pain sensitivity is preserved.
- Hepatic coma - loss of consciousness, separate movements and reaction to pain, which disappear as the coma develops. Divergent strabismus, lack of pupillary response to light, convulsions. Probable death.
On the activity of some enzymes
Enzymes determined in a biochemical blood test can suggest in which direction to look for liver diseases. Thus, gamma-glutamine transpeptidase (GGTP) is very characteristically increased in steatohepatitis. ALT - in chronic viral hepatitis, and AST - in alcoholic lesions.
Alkaline phosphatase is characterized by the following changes.
Manifestations of liver disease
| Disease | Manifestations | Laboratory tests |
| Acute drug-induced hepatitis | Beginning 2-8 days after taking the drug (isoniazid, paracetamol, methyldopa, atenolol, rifampicin, niacin, ketoconazole). The clinic is similar to acute viral hepatitis | Similar to acute viral hepatitis |
| Chronic drug-induced hepatitis | More often in the elderly with long-term use of clofibrate, isoniazid, sulfonamides, chlorpromazine, paracetamol. Scanty symptoms: dull pain in the right hypochondrium, decreased motor activity, enlarged liver, moderate jaundice. |
|
| Acute viral hepatitis A | From the moment of infection to the clinic 14-45 days:
|
The increase in ALT is greater than the AST, the increase in total and direct bilirubin, alkaline phosphatase. |
| Viral hepatitis E | The incubation period is from 40 to 60 days. The clinic is similar to hepatitis A. | Similar to hepatitis A |
| Chronic viral hepatitis B | The incubation period is 1-6 months.
|
|
| Chronic viral hepatitis C | A long latent low-symptomatic course followed by a rapid increase in symptoms and outcome in cirrhosis or carcinoma. | Similar to hepatitis B |
| Acute alcoholic hepatitis |
|
Increase in AsAT>AlAT, increase in GGTP |
| Chronic alcoholic hepatitis | Weakness, lack of appetite. Enlargement of the liver. 30% of patients have cholestasis syndrome | ASAT>ALAT |
| Steatosis of the liver | Nausea, vomiting, dyspepsia, pain in the right hypochondrium, liver enlargement | An increase in AsAT prevails over ALT, an increase in GGTP |
| cirrhosis | Hepatic cell failure syndrome, encephalopathy, portal hypertension syndrome | An increase in bilirubin, GGTP, AsAT>AlAT, a drop in platelets, a decrease in PTI, an increase in gamma globulins. |