The relevance of such a problem as alcoholic liver disease is very great. In terms of prevalence and social significance, this pathology ranks second after viral hepatitis.

There are no safe doses of alcohol. According to WHO recommendations regarding safe doses alcohol can be considered up to 20–40 ml of ethanol for men and up to 20 ml of ethanol for women. A dose of 10 ml of ethanol is contained in 25 ml of vodka, 100 ml of wine or 200 ml of beer.
Signs indicating bad influence alcohol on the liver, appear when drinking more than 80 ml of ethanol per day for five or more years.

For an adult man to develop alcoholic liver disease with a possible transition to cirrhosis, it is enough to drink alcohol in a dose of 50–80 ml of ethanol per day; for a woman this dose is already 30–40 ml, and for adolescents it is even lower: 15–20 ml per day. And this is only 0.5 liters of 5% beer every day!

According to WHO, more than 90% of the population drink alcohol, of which almost half do so monthly and for several days. 10% of men and 3–5% of women drink daily.

The myth about the harmlessness of “weak” alcohol

There is a common misconception that if you drink weak alcohol (beer, low-alcohol cocktails, etc.), then it will benefit the body as a whole. But is it?

The effect and harm of low-alcohol drinks is equivalent to the effects of strong ones. AND main reason of such equivalence is quantity. Few people think about how much ethanol enters the body if you drink “just” a few bottles of beer a day.

You only need to drink three bottles of beer or two cans of low-alcohol cocktail to get the same amount of ethanol as is contained in a glass of vodka.

According to statistics, beer is consumed by more than half of the population of our country. And the popularity of beer does not lose ground due to its apparent “harmlessness”. The number of beer consumers is growing every year. Experts consider beer a legalized drug, to which physical and psychological dependence quickly develops. Teenagers and women can become addicted to beer especially quickly.

Beer contains toxic compounds and heavy metals that can change the hormonal status of the body and cause poisoning.

“Beer makes you lazy, stupid and powerless,” said Bismarck, the first Reich Chancellor of Germany. And he knew a lot about beer firsthand.

Low-alcohol canned cocktails are also gaining popularity, especially among young people. Due to their sweetish taste, they are perceived as strong lemonade. But one can contains an amount of ethanol equal to 100 ml of vodka. And this is not counting various chemical additives (flavors, dyes) and sugar, which also harm the liver and cause poisoning of the body as a whole.

Therefore, we can confidently conclude that beer and other low-alcohol drinks are no less harmful than strong alcohol.

Liver and alcohol

The effect of alcohol on the liver is direct. After entering the body, part of the alcohol is eliminated through the skin, lungs and kidneys. The main “blow” and harm (and this is about 90% of consumed alcohol) is taken by the liver, where further processing of the alcohol consumed occurs.

First, under the influence of a special enzyme - alcohol dehydrogenase - ethyl alcohol is oxidized and converted into acetaldehyde. Next, acetaldehyde is oxidized through complex chemical reactions and decomposes to the final substances - carbon dioxide and water. But this only happens when the amount of alcohol is small and sufficient to completely complete the cycles of converting ethanol into breakdown products that are not harmful to the body and do not cause poisoning.

If a lot of alcohol is consumed, enzyme deficiency occurs and the process of ethanol processing at different stages is disrupted. There is an accumulation of intermediate products of its oxidation and breakdown in the liver. Acetaldehyde is tens of times more toxic than ethanol; its excess causes, in addition to its direct damaging effect, disruption of the normal outflow of bile, accumulation of fats in the liver, and general poisoning of the body. And ethyl alcohol, which does not oxidize due to excess, causes the development of connective tissue in the liver, which leads to fibrosis.

The liver has amazing regenerative functions and the ability to heal itself. But these liver abilities are not endless, and, in the end, this potential is exhausted. Liver cells begin to be replaced by fibrous tissue with a restructuring of their functions and transition to cirrhosis.

What mechanisms and risk factors cause alcoholic liver damage?

First of all, this is chronic alcohol abuse. Sometimes the quantity and quality of liver enzymes that metabolize alcohol can be genetically impaired.

It has been noted that women are more susceptible to alcohol and their addiction develops faster.

When combining alcohol intake with drugs metabolized in the liver, the harmful effect on hepatocytes increases several times.

The lifestyle that a person drinks alcohol leads also matters. It is known that the shortage nutrients(malnutrition, dieting) and alcohol are incompatible.

If there is viral hepatitis, then the negative effect of alcohol on the liver increases with its consumption. Vaccination against hepatitis helps prevent the disease. A quarter of patients diagnosed with alcoholic liver disease have antibodies to chronic hepatitis C, indicating an increased risk of infection with this type of virus.

Vaccination against hepatitis - for or against?

In recent years, distorted opinions have been formed in society related to the alleged harm of vaccinations against dangerous diseases on the body. Therefore, I would like to separately touch on the topic of vaccination against hepatitis.

Currently, there are vaccinations against two types of viral hepatitis: A and B.

Hepatitis A is considered a “disease of unwashed hands”, the main route of transmission is household.
Hepatitis B is transmitted primarily through blood. To transmit the virus, a drop of blood that remains, for example, in a syringe needle is enough. But one should not think that this is a disease only of drug addicts or socially disadvantaged elements. The spread of hepatitis B has become an epidemic in recent years.

Hepatitis B in most cases becomes chronic, which can lead to the development of cirrhosis and even liver cancer.

Vaccination against hepatitis B is included in the vaccination schedule for children. Adults are given this vaccination if they wish and consent. Typically, the vaccination schedule looks like this: 0 – 1 – 6. That is, the vaccination should be repeated after 1 and 6 months.

Many people have questions about the effect of alcohol on the effectiveness of hepatitis vaccination. Drinking alcoholic beverages in acceptable doses has no effect on vaccination. But you will still need to stop drinking alcohol for three days after vaccination due to the fact that each vaccination has its own side effects, which alcohol intake can aggravate.

This is also true for vaccination against other pathogens. The exception is the rabies vaccination, after which it is recommended not to drink alcohol for 12 months.

Alcoholic liver disease

It develops as a result of long-term poisoning of the entire human body with alcohol (ethyl alcohol).

During its course, three successive stages of development are distinguished:

  1. Liver steatosis (fatty degeneration; fatty hepatosis);
  2. Alcoholic hepatitis;
  3. Cirrhosis of the liver.

Hepatosis (steatosis)

The initial stage, or fatty hepatosis, is characterized by the deposition and accumulation of fat cells in the liver parenchyma. Occurs in people who abuse alcohol in more than 90% of cases. It is usually asymptomatic, there may be symptoms of dyspeptic disorders, a feeling of heaviness in the right hypochondrium, weakness, yellowness of the skin and mucous membranes. Liver steatosis is a reversible process, and with abstinence from alcohol and treatment, complete recovery is possible. If further exposure to ethanol occurs on hepatocytes, alcoholic liver damage progresses to the second stage - alcoholic hepatitis. In this case, deeper damage to hepatocytes occurs with disruption of their functionality.

Alcoholic hepatitis

The course of alcoholic hepatitis can be in the form of a persistent (stable course, usually without or little symptoms, relatively reversible changes in the liver) or a progressive form (transition from the previous phase in case of further alcohol abuse; an unfavorable course, as a rule, turns into cirrhosis).

Hepatitis can occur with an acute onset or have a latent and then chronic course. The acute form of hepatitis is usually observed after a long, often repeated binge in an alcohol abuser, when the body is poisoned with large doses of alcohol.

There are several varieties of the course, but the most common is the icteric variant. In this case, in addition to jaundice, pain in the right hypochondrium, severe weakness, loss of appetite, nausea, vomiting, prolonged loose stools, and noticeable weight loss are observed. The liver is enlarged, has a dense structure, and is painful.
Chronic hepatitis is often relatively asymptomatic. Only laboratory and additional research methods can indicate severe damage to the organ. The liver also enlarges significantly, reaching enormous sizes.

The third stage is cirrhosis of the liver. This is a completely irreversible stage, when normal liver tissue is replaced by fibrous cords and connective tissue fibers and, as a result, a profound disruption of all its functions develops. Cirrhosis occurs, according to statistics, in 15–20% of patients with chronic alcoholism. Worsening of the symptoms and course of cirrhosis is observed when combined with chronic viral hepatitis B or C, obesity, and being female.

Symptoms of cirrhosis can be quite sparse, especially against the backdrop of a long course of the disease. The patient is concerned about fatigue, weakness, pain in the liver area, asthenia (weakness, fatigue). A characteristic “hepatic” erythema (redness) appears on the palms, and small capillaries expand over the entire surface of the body. The liver is enlarged or, conversely, reduced, may already be painless, its surface is bumpy. Signs of ascites and an enlarged spleen are revealed, as a result of which the abdomen becomes enlarged with an expanded venous network on its surface. Symptoms of portal hypertension appear. The functions of other organs and systems are disrupted as a result of poisoning by toxic products that are not neutralized by the liver.

The course of cirrhosis is unfavorable. The disease is combined with progressive liver failure, up to hepatic coma, which leads to death. There is also a high probability of malignancy - the occurrence of hepatocellular carcinoma.

The diagnosis is confirmed by laboratory, ultrasound or radioisotope studies, computed tomography. If necessary, diagnostic laparoscopy and liver biopsy are performed.

How is alcoholic liver disease treated?

The most important condition is the patient’s complete abstinence from alcohol. At some stages of alcoholic liver damage, complete regeneration of liver tissue can occur. But it should be noted that, unfortunately, no more than a third of patients follow this recommendation. Another percentage simply reduces the amount of alcohol they consume, while the rest completely ignores it and continues to lead their normal lifestyle.

The second condition is a complete energy diet with a high protein content. The calorie content of such a diet should be at least 2000–3000 kcal per day. Protein content is about 1 g per 1 kg of patient weight. It is necessary to be saturated with vitamins, especially group B. An example of such a diet would be table No. 5.

Drug treatment

Hepatoprotectors, glucocorticoids, agents that improve microcirculation and similar drugs are used. Of course, the necessary treatment in each case is prescribed by the doctor individually after a full examination and taking into account the identified disorders.

If conservative treatment is ineffective, the issue of liver transplantation is decided.

In our country, alcoholic cirrhosis of the liver is a common disease, since a large number of people abuse alcoholic beverages. It mainly affects men aged 30 to 60 years. In order for alcoholic cirrhosis of the liver to occur, you need to drink a lot for 8-10 years.

One of the most important organs of the human body is the liver, which acts as a filter that cleanses it of various poisons and toxic substances. Liver cells - hepatocytes, have a unique property of regeneration, but with prolonged and strong impact on them of harmful substances they die, and are replaced not by new formations, but by adipose connective tissue.

Effect of alcohol on the liver:

  • Alcoholic drinks, including beer, contain ethyl alcohol, which is a toxic substance. When it enters the human body, the liver breaks it down into several harmful elements and begins to neutralize them.
  • If the dose of alcohol is large, then the filter cannot cope with it, and the cells begin to die.
  • Dead cells are replaced by adipose connective tissue, which prevents the liver from performing its full functions.
  • If 50-75 percent of the hepatocytes in the liver are replaced by connective tissue, then the death of the body occurs, since this organ can no longer perform its functions.

From a medical point of view, alcoholic cirrhosis of the liver is a disease caused by harmful and long-term exposure to alcohol on the human body, which destroys hepatocytes and prevents new ones from appearing.

Special attention must be given to beer lovers. Many people believe that beer is a light drink that cannot cause any harm to the body. According to recent studies, narcologists have identified the new kind alcoholism - beer. When drinking beer in large quantities, over a long period of time, alcoholic cirrhosis of the liver also occurs.

It follows from this that all beer drinkers, regardless of gender, can develop cirrhosis. But this can happen from drinking too much beer. The daily norm for drinking beer is considered to be about 200 milliliters of this drink. Therefore, if you drink a little beer, alcoholic cirrhosis of the liver will not appear.

It is important to know that Russia occupies a leading position in diagnosing this disease. This is due not only to the high consumption of alcoholic beverages, but also to their quality, since a significant part of alcoholic products does not meet international standards.

Symptoms of alcoholic cirrhosis

Of course, cirrhosis occurs not only from alcohol abuse. It can be caused by viral hepatitis and other factors. But alcoholic cirrhosis has its own individual signs that indicate this disease.

Symptoms of alcoholic cirrhosis of the liver are as follows:

    • The first signs that will immediately indicate the presence of this disease are an increase in body temperature to 38 degrees, pain in the right hypochondrium, nausea and periodic vomiting. When you stop drinking alcohol, they go away and relief comes. This is typical for a patient with alcoholism if he drinks alcoholic beverages long time. These signs occur in the early stages of the disease.
    • Professional doctor can diagnose this disease by a superficial examination of a person. In alcoholics, the liver increases in size in the early stages of the disease, but in the later stages it shrinks and cannot be felt. Therefore, an enlarged or reduced liver indicates the presence of cirrhosis.

    • The appearance of a jaundiced coloration of the skin and sclera of the eyes. This indicates that the liver is not performing its functions well, and a lot of insoluble bilirubin appears in the body.
    • In more severe cases, when the liver is severely affected, the patient can show signs of “jellyfish” when his abdomen sharply increases in volume and venous networks begin to appear on its surface. This also indicates that the patient suffers from ascites. Ascites refers to the accumulation of fluid in the abdominal cavity.
    • With advanced cirrhosis, the venous artery, which collects blood from the abdominal organs and passes it through the liver, experiences great pressure, which is transmitted to the blood vessels of the intestines and stomach. As a result, they begin to burst and internal bleeding begins. Evidence of this is coffee-colored vomit or the presence of scarlet spots in the stool.

  • In most cases, patients experience swelling of the lower extremities, disproportionate enlargement of the abdomen, and thickening of the extreme phalanges of the fingers. In men, testicular dystrophy occurs; in women, the mammary glands may increase in volume. But these signs are typical when cirrhosis has already passed the first stage of development, and a more severe form of this disease occurs. In general, according to appearance An experienced doctor will immediately determine if a person has cirrhosis.
  • In some cases, other signs may appear. For example, the death of liver cells causes cerebral encephalopathy. Characteristic signs of this are nervous disorders in the form of sudden aggression, after which sleep suddenly sets in, loss of orientation in space, the patient generally does not pay attention to his appearance.

These signs indicate that a person has alcoholic cirrhosis, and the sooner he begins to treat it, the more he will be able to live a full life.

It is important to know that in patients with ascites, in most cases cirrhosis is detected. Only doctors will be able to determine the cause of cirrhosis: it is caused by alcohol or other diseases.

Diagnostics

Timely treatment of this disease depends on correct diagnosis. Medicine has many ways to diagnose this disease.

These methods are divided into several types:

  1. laboratory research;
  2. technical studies;
  3. superficial inspections.

In the first case, patients undergo special tests that can help identify liver damage and dysfunction.

This may include:

  1. a biopsy, in which a piece of the affected organ is taken and examined for the presence of fatty connective tissue in it, as well as the percentage of liver damage, all this happens during observation using ultrasound;
  2. a blood test from a vein, when doctors can detect the presence of various antibodies that indicate inflammatory processes and other unfavorable changes in the liver.

In the second case, attention is paid to ultrasound and computed tomography. In principle, ultrasound and tomography do not differ in their functions, but if a doctor prescribes both ultrasound and tomography, it means that he wants to earn more bonuses.

An ultrasound is prescribed in any case. Using ultrasound, you can identify the affected areas of the liver, as well as determine at what stage the disease is.

Doctors distinguish the initial stage, when nodules with a diameter not exceeding 3 millimeters form in the liver lobes, and the last stage involves the presence of larger formations. All this can be perfectly examined with the help of ultrasound and tomography, and a maintenance course of treatment can be started immediately.

Superficial inspections also play an important role.

Looking at the patient and his appearance, the doctor can immediately determine the presence of cirrhosis, and without waiting for laboratory and technical tests, prescribe initial therapy that can protect the patient from death.

It is important to know that when diagnosing cirrhosis, ultrasound plays an important role, since only with the help of it or its computer substitute - a tomograph - can one detect damage to the liver by fatty and scar tissue, as well as an increase and decrease in its volume.

How to treat this disease

Unfortunately, modern medicine does not know how to treat this disease, but it has all the means to make the patient’s life easier and prolong it for a long time.

Treatment of alcoholic cirrhosis of the liver occurs as follows:

    • First of all, this is maintenance therapy, when the patient takes various medications. This includes corticosteroids, intravenous glucose with saline, and other drugs. Gepabene and similar drugs that support the liver are taken.

  • The next way is to follow a diet, as well as walks and light exercise. Diet and exercise do not put much strain on the liver, so it does not become stressed. Physical exercise strengthen the body. When dieting, first of all, you should give up spicy, fatty, high-calorie foods. Light soups, cereals, and other foods suggested by a nutritionist are welcome.
  • Folk remedies help a lot. These include juices from cabbage, beets, and carrots. Decoctions and infusions of various herbs. The only contraindication is the use of alcohol in tinctures.
  • The last thing that is very important is to give up alcohol. It should not be taken even in the smallest quantities, including beer.

Many people are interested in the question of how long one can live with this disease. If it is diagnosed in the first stages, and the patient does not have ascites, bleeding or lesions nervous system, which means you can live 10-15 years.

If you have the above symptoms, it means that with complex treatment you can live from one to 5 years, depending on how advanced the disease is.

It's important to know that the only way The cure for cirrhosis is a liver transplant. But for those who suffer from alcoholism, it is not done.

Liver cirrhosis caused by alcohol abuse has specific symptoms. It can be detected even during an external examination of the patient. It is impossible to cure it, but maintenance therapy is necessary, as it can prolong the patient’s life by more than one year.

Alcoholic cirrhosis liver disease is the most severe form of alcoholic disease. Its essence boils down to the fact that normal functioning cells (hepatocytes) die off under the toxic effects of alcohol, and in their place inelastic fibrous tissue, similar to a scar, is formed. Toxic cirrhosis of the liver will not develop due to a one-time use of a small dose of alcohol - it is necessary to take it systematically in large quantities. The disease develops in approximately 10% of people who drink alcohol uncontrollably, but changes at the stage of cirrhosis are already irreversible.

Causes of the disease

Alcoholic cirrhosis of the liver does not develop in a day or even a year. It is diagnosed in individuals who systematically abuse alcoholic beverages for 8-12 years. This figure depends on many factors - the frequency of heavy drinking, gender, genetic characteristics, as well as the type, strength and quality of alcohol. In particularly advanced cases, cirrhosis can develop over several years.

Alcohol and heredity

Identical doses of alcohol can cause different effects, even if other conditions are the same. Doctors attribute this fact to the innate activity of enzymes that are responsible for the utilization of ethyl alcohol. There are 5 such enzymes in total, and it depends on them what proportion of alcohol consumed will be excreted from the body, and what will turn into toxic acetaldehyde, which will destroy the liver.

In addition to genetic material, the likelihood of developing alcoholic cirrhosis of the liver is influenced by the standard of living, the patient’s environment and the culture of drinking alcohol in the family. In addition, statistics indicate that most often monozygotic twins suffer from alcoholism together. This rate is lower among dizygotic twins.

The effects of alcohol on men and women

The increase in alcoholism among women is associated with the progression of their role in society. Female representatives can drink alcohol on an equal basis with men, which does not cause condemnation. However, physiologically their body is unable to absorb ethanol in full. The gastric mucosa contains an enzyme that is involved in the metabolism of ethyl alcohol, and in women it is inactive. For this reason, it is not processed and excreted from the body, but forms toxins that destroy liver cells.

Women's alcoholism often leads to more serious consequences than men's

In addition, women rarely seek medical help for alcoholism. Their loved ones and relatives also do not sound the alarm, since this disease is more often associated with men. Patients with toxic cirrhosis of the liver are admitted to the hospital in the final stages, when changes in the tissues are already irreversible. Moreover, after a course of therapy, they experience breakdowns more often than after treatment for alcoholic cirrhosis of the liver in men.

Alcoholic cirrhosis and nutrition

Toxic cirrhosis is the last stage of alcoholic liver disease. The rate of its development is influenced not only by the doses of alcohol consumed, but also by other factors. It is noted that the likelihood of this disease is highest with poor nutrition, especially with a deficiency of protein in the diet. The first signs of liver damage appear against the background of a lack of proteins and vitamins, an abundance of fatty, fried foods and fast food. Alcohol intoxication provokes further destruction of hepatocytes.

Other reasons

  • with non-alcoholic hepatitis of any origin;
  • with metabolic disorders;
  • for inflammatory and ulcerative diseases gastrointestinal tract.

When taking any medications, you also need to consider their compatibility with alcohol. In addition to a short-term deterioration in health, unacceptable combinations can provoke intoxication of the body and have a detrimental effect on the liver.

How much alcohol do you need to drink to develop cirrhosis of the liver?

The main factor that plays a role in the development of toxic cirrhosis is the duration of alcohol intake, and not its one-time use. The body is able to cope with incoming ethanol, but its processing products tend to accumulate in the liver. Therefore, alcoholic cirrhosis of the liver develops within 10-15 years with daily intake of even a small amount of alcohol.

The permissible amount of alcoholic beverages differs for representatives of different genders. The critical dose for men is 40-60 g of pure ethanol per day, for women - 20 g. If the body regularly receives alcohol in larger quantities, it is not able to cope with its processing. Fatty liver degeneration, hepatitis, and finally alcoholic cirrhosis develop.

Ethanol is present in alcoholic beverages in different concentrations. The table provides data on the permissible number of different types that will not cause signs of alcoholic cirrhosis.

Ethanol in small quantities does not harm the liver if consumed 1 or 2 times a week. However, the problem with most alcoholics is that they cannot control their dosage. Alcoholism is a disease that requires significant self-control. It is best to avoid any amount of alcohol and prefer other drinks. Non-alcoholic beer contains a minimal percentage of alcohol and can serve as an alternative to the classic recipe.

Pathogenesis - how does alcohol affect the body?

Alcoholic cirrhosis is the last stage of liver damage caused by ethanol. First, the liver cells manage to produce specific enzymes in sufficient quantities, and it is completely eliminated from the body. If you take it regularly in abnormal amounts, the enzymes cannot cope with this task, and toxic acetaldehyde is formed during the processing of alcohol. It determines the negative effects of alcohol on the human body.


Cirrhosis is the final stage of alcoholic liver disease

At the cellular level, acetaldehyde produces a number of negative effects:

  • interferes with the normal course of redox reactions in liver cells;
  • increases the susceptibility of hepatocytes to the harmful effects of free radicals;
  • provokes lipid peroxidation reactions, which occur with the destruction of functional cells;
  • disrupts the structure of important cellular elements: microtubules, mitochondria and nuclei.

First, fatty liver degeneration develops from alcohol. This is a syndrome associated with lipid metabolism disorders in which fat accumulates in normal cells. Then inflammatory reactions are involved in the process, and alcoholic hepatitis develops. If you continue to drink alcohol, the first manifestations of cirrhosis occur: tissues die and are replaced by dense connective tissue.

There is an alternative option for the development of cirrhosis - fibrosis. In this case, it appears bypassing the first stages of fatty degeneration and cirrhosis. Doctors believe that lactic acid plays a leading role in this mechanism, which affects specific fat-storing Ito cells. They turn into fibroblasts, which resemble a scar in structure. In addition, increased collagen synthesis is observed in liver tissue instead of normal hepatocytes.

If the disease is detected at the first stage, it can be completely eliminated with medications and diet. An alcoholic is rarely able to recognize his problem on his own, so providing him with medical care and monitoring the treatment process is the task of his loved ones and relatives. Over time, the task only becomes more complicated, and rarely do any patients manage to live with liver cirrhosis for more than 5 years.

Forms of alcoholic cirrhosis

There is a Child-Pugh classification of toxic cirrhosis, which determines the severity of the disease. Based on the results of ultrasound and blood tests, as well as clinical manifestations, you can select from 1 to 3 points on a special scale. Next, the points are summed up, and based on the resulting value, the class of the disease can be determined. These data make it possible to predict how long different patients with liver cirrhosis will live.

Options Points
1 2 3
Ascites (presence of fluid in the abdominal cavity) No Slightly A large number of
Brain damage No Easy stage Severe stage
Bilirubin in blood, µmol/l Less than 34 (2.0) 34-51 (2,0-3,0) More than 51 (3.0)
Albumin, g More than 35 28-35 Less than 28
PTI (prothrombin index) More than 60 40-60 Less than 40

Interpretation of results:

  • 5-6 points - class A, or compensation stage. This is the first stage, in which life expectancy can be up to 15-20 years.
  • 7-9 points - class B, or subcompensation stage. In this case, the clinical manifestations of cirrhosis are pronounced, frequent exacerbations and severe pain are observed. The patient's life expectancy is 5-7 years. Liver transplantation has a mortality rate of up to 30%.
  • 10-15 points - class C, or stage of decompensation. Symptoms of alcoholic cirrhosis of the liver are pronounced, complications develop. With this diagnosis, a patient can live from 1 to 3 years, the probability of death after a liver transplant is up to 82%.

The disease is also usually classified according to the extent of damage to liver tissue. He can be:

  • small nodular - small areas of cirrhosis are formed in the parenchyma;
  • large nodular - large cirrhotic lesions;
  • mixed, if scar lesions of different sizes are formed.

Cirrhosis is distinguished from fibrosis by the severity of liver damage. If during fibrosis its structure is preserved, then cirrhosis destroys the normal structure in the form of lobes and lobules.

Symptoms of the disease

Signs of liver cirrhosis in alcoholics do not appear immediately. Over the course of several years, the replacement of normal tissue with scar tissue can occur unnoticed. Then the organ cannot cope with the toxins that enter the body, and the first symptoms appear.


Jaundice is a symptom that occurs when the flow of bile is impaired

General symptoms

Intoxication affects all organ systems and causes a general deterioration in the patient’s well-being. The first signs will not be specific, but will only indicate the presence of a pathological process in the body:

  • permanent increase in body temperature by 0.5-1 ᴼС;
  • insomnia and other sleep disorders;
  • fatigue, decreased performance;
  • weight loss;
  • frequent mood changes.

The patient may experience pain in the right hypochondrium, but the liver is not visually enlarged in size. An accurate diagnosis at this stage can only be made based on the results of an ultrasound and blood test.

Liver failure syndrome

Over time, symptoms appear that indicate liver cirrhosis:

  • pain in the right hypochondrium;
  • an increase, and over time, a decrease in the volume of the organ;
  • nausea, flatulence, vomiting of intestinal contents;
  • jaundice - yellowing of the skin and mucous membranes;
  • the appearance of spider veins on the skin;
  • “drumsticks” - thickening of the joints of the terminal phalanges of the fingers;
  • Dupuytren's contracture is an anomaly of the tendons of the hands, which leads to impaired mobility;
  • enlargement of salivary glands.

Some patients develop encephalopathy associated with the entry of toxins into the brain. It manifests itself as loss of orientation in space and time, and changes in mood. If the disease progresses, there is a possibility of hepatic coma.

Portal hypertension

This term means high blood pressure in the portal vein system. The walls of the blood vessels weaken, and internal bleeding may occur. Clinically, this phenomenon is manifested by characteristic symptoms:

  • vomiting with blood from gastric and intestinal bleeding;
  • black stool with bleeding from the intestinal veins;
  • stool mixed with bright blood (bleeding from hemorrhoidal veins);
  • ascites - dropsy of the abdominal cavity;
  • "jellyfish head" syndrome - the abdomen is swollen due to the presence of fluid, veins are clearly visible on it;
  • enlarged spleen.

Treatment at this stage will no longer be effective. The disease is accompanied by constant pain in the liver and interferes with the patient’s normal life.


A characteristic symptom of liver cirrhosis is the accumulation of free fluid in the abdominal cavity

Cardiovascular failure

Liver cirrhosis affects all organ systems, including the cardiovascular system. The walls of blood vessels become brittle and the heart cannot cope with the stress. The patient is diagnosed with:

  • decreased blood pressure;
  • tachycardia;
  • shortness of breath when moving;
  • heart rhythm abnormalities;
  • pain in the heart area.

Increased vascular permeability is manifested by swelling. The symptom intensifies when it is impossible to carry out normal physical activity.

Diagnostics

In many cases, the diagnosis can be made by characteristic clinical signs, as well as by interviewing the patient. First of all, you need to determine whether you have been drinking alcohol for a long time. The doctor also studies the medical history to identify possible concomitant pathologies. Past liver diseases of various origins are important.

The diagnosis can be confirmed by ultrasound and blood tests. These diagnostic methods will reveal;

  • enlargement of the liver, changes in its structure;
  • enlarged spleen;
  • in the blood - increased activity of liver enzymes (ALT, ALT), bilirubin levels, erythrocyte sedimentation rate; decrease in the number of red blood cells.

The main thing is to find out the etiology of toxic cirrhosis. The fact of alcohol intake may be kept silent by patients, but it is especially important in diagnosis. The patient's accompanying person can provide this information to the doctor.

Treatment methods

At the stage of cirrhosis, there are few ways to cure the disease. In some cases, transplantation is performed from a healthy donor, but this method also has contraindications. During surgery, mortality can reach 80%. Before surgery, you must completely avoid alcohol for a period of 6 months or more.


The only method of preventing disease is healthy image life and compliance with alcohol consumption standards

In other cases, it makes no sense to treat the disease. All manipulations are aimed at prolonging life and relieving symptoms, but not at complete recovery. The patient is prescribed:

  • detoxification infusions;
  • hormonal anti-inflammatory drugs;
  • hepatoprotectors;
  • diuretics to relieve swelling.

Diet is important. Alcohol in any doses is contraindicated for the patient throughout his life. You should also exclude fatty and fried foods, salty and smoked foods, carbonated water and drinks. The diet should contain large quantities of protein, vitamins and minerals.

Prevention and prognosis

The only measure to prevent the disease is proper consumption of alcohol. In this case, it is worth paying attention not only to the amount of alcohol, but also to the quality of the drinks. Liver disease can also be prevented if you watch your diet. The diet should contain a sufficient amount of protein, vitamins and microelements. You should reduce your consumption of fatty, fried foods, and carbonated non-alcoholic drinks. If cirrhosis develops, treatment will not imply complete recovery. Therapy is aimed at maintaining the patient's life and delaying death. In different cases, the patient can live from 1 to 15 years with this diagnosis.

Toxic cirrhosis of the liver develops at the last stage of alcoholic disease. This dangerous pathology, which is characterized by complete destruction of the organ, intoxication of the body, and disruption of the functioning of all systems. It is completely impossible to cure, but some patients undergo a liver transplant. This operation allows him to prolong his life and get rid of the symptoms of cirrhosis, but it is not available to all patients. Treatment of alcoholic cirrhosis of the liver in any case implies a complete abstinence from alcoholic beverages, otherwise the prognosis will be disappointing.

(NAFLD). In addition, cirrhosis is caused by hereditary diseases: hemochromatosis, Wilson-Konovalov disease, alpha-1-antitrypsin deficiency and etc., as well as autoimmune liver diseases, including primary biliary cirrhosis and toxic liver damage from industrial poisons and drugs.

Diagnosis of liver cirrhosis

1. Assessment of liver condition

The diagnosis in the early stages of liver cirrhosis is difficult to establish, since there are often no pronounced changes in the liver. First of all, an ultrasound examination of the liver (ultrasound diagnostics) is performed, which makes it possible to identify diffuse changes in the liver tissue and an increase in its size (although this does not always happen). It is advisable to carry out Dopplerography of the vessels of the abdominal cavity to determine the width of the lumen of the vessels and the speed of blood flow. This allows us to determine the presence of signs of portal hypertension.

Important for characterizing the structural and functional state of liver cells is a biochemical blood test ( ALT, AST, GGT, bilirubin, alkaline phosphatase, protein fractions), and clinical analysis blood and coagulogram - blood clotting.

To accurately diagnose the degree of fibrosis, modern non-invasive (replacing biopsy) examination methods are used: elastometry (elastography) of the liver on the Fibroscan device, Fibrotes, FibroMax. Liver damage is characterized by degrees from 0 to 4; 0 – healthy liver, 4 – cirrhosis.

2. Determining the cause of liver cirrhosis

First of all, you need to do tests for hepatitis B and C viruses, since viruses are the most common cause of cirrhosis, especially in combination with alcohol. If viruses are not identified, then the search for the cause consists of excluding hereditary liver diseases, autoimmune indicators, as well as alcoholic liver disease, NAFLD and toxic liver damage.

Severity of cirrhosis determined by the Child-Pugh scale, taking into account the severity of clinical and laboratory data, the main of which are the content of bilirubin, albumin, prothrombin in the blood, as well as the severity of encephalopathy and ascites. There are active and inactive cirrhosis, compensated and decompensated. Decompensated cirrhosis is characterized by the development of portal hypertension, the appearance of ascites, and the occurrence of gastrointestinal bleeding.

Cost of diagnosing liver cirrhosis

The total cost of the examination in our center is about 30,000 rubles. However, the cost of the examination can be significantly reduced if the patient has the results of tests and examinations already done from another specialized medical institution.

Treatment of liver cirrhosis

Treatment of liver cirrhosis carried out with the aim of stopping or slowing down the progression of the disease and improving the quality of life.

The treatment program includes: therapeutic regimen and nutrition, drug treatment, prevention and treatment of complications.

Treatment results and prognosis depend on the severity of the disease.

With compensated cirrhosis the functional state of hepatocytes is preserved, there are no signs of portal hypertension and disturbances in the protein-synthetic function of the liver. Treatment of cirrhosis at this stage of the disease is determined by the cause of the disease, depending on which specific therapy is prescribed. In addition, it is necessary to limit mental and physical stress.

If the cause of cirrhosis is viral hepatitis B or hepatitis C, then antiviral therapy is prescribed, which, as studies have shown recent years, not only suppresses the activity of the virus, but also has antifibrosis and anticirrhosis effects.

With alcoholic cirrhosis ( alcoholic liver disease) hepatoprotectors are prescribed, which, subject to complete abstinence from alcohol, make it possible not only to stop the progression of cirrhosis, but also help reduce the degree of fibrosis.

Good day, dear readers!

In today's article we will look at such a disease as liver cirrhosis, as well as its signs, causes, types, degrees, diagnosis, treatment, folk remedies and prevention. So…

What is cirrhosis of the liver?

Cirrhosis of the liver– a chronic liver disease characterized by persistent liver damage, in which normal liver tissue is replaced by fibrous connective tissue. The end result of the lesion, if no action is taken, is the development of liver failure and portal hypertension, after which the patient's death usually occurs. Death usually occurs between 2 and 4 years of illness. Sometimes a consequence of cirrhosis becomes.

The liver plays one of the main roles in cleansing the body of toxic substances; it also promotes the synthesis of fats, proteins and carbohydrates, participates in the digestion processes and the production of substances necessary for the normal functioning of the body. With cirrhosis, the liver becomes scarred, grows and increases or decreases in size, becomes dense, rough and lumpy. Its cells (hepatocytes) degenerate and cease to perform their functions, which is why the destruction of this organ poses a threat to the life of a living organism, be it a person or an animal.

The main signs of liver cirrhosis are gradually increasing pain in the abdomen (mainly in the right hypochondrium), which at the last stage of the patient’s development becomes so strong that patients are even prescribed narcotic drugs as an anesthetic, as well as indigestion (heaviness in the abdomen, nausea and vomiting).

The main causes of the development of liver cirrhosis in most cases are -, as well as frequent and, which actually poison not only the liver, but the entire body.

How long do people live with cirrhosis of the liver?

The number of years of life with cirrhosis largely depends on the degree (stage) of the pathological process in the liver, treatment methods and strict adherence to the therapeutic and preventive instructions of the attending physician, as well as the patient’s lifestyle.

The compensated form of liver cirrhosis is usually characterized by a survival rate of 50% of cases. With a subcompensated form, doctors predict the patient’s life expectancy to be on average 5 years, with a decompensated form – up to 3 years.

Many experts determine the stage of the disease using the prognostic system of Child-Pugh, Cox and others.

However, I hasten to note that on the Internet there are testimonies of people who believed in Jesus Christ who recovered after conversion, even in the most advanced stages of cirrhosis, when doctors did not give a chance for recovery, therefore, there is always hope!

Disease statistics

Doctors note that cirrhosis is observed predominantly in the male half of the population, approximately 3 to 1. This is due, first of all, to the fact that men like to drink strong alcoholic drinks more often than women, and this, as we have already said, in most cases is the main cause of liver cirrhosis.

If we talk about the overall picture, pathological changes in the liver (cirrhosis, hepatitis, etc.) lead to the death of about 300 thousand people every year. What does it have to do with developed countries, liver cirrhosis occurs on average in 20 people per 100,000 population, while in the territory former USSR, this figure is 1% of the population. Below is a map of the prevalence of cirrhosis around the world (as of 2004). The lighter the color (closer to yellow), the fewer cases of the disease; the darker, the more:

Over the past 10 years, the incidence of this disease has increased by 12%!

The age of patients in most cases ranges from 40 to 60 years.

Liver cirrhosis - ICD

ICD-10: K74.3 - K74.6;
ICD-9: 571.

The main sign of cirrhosis of the liver is, mainly in the right hypochondrium, however, the onset of the disease may be accompanied by other symptoms. In addition, there are cases (approximately 20%) when liver damage is asymptomatic, and pathology can be detected only after the person’s death. However, let us consider how the disease manifests itself in the initial stages, in the middle and at the end of its development.

The first signs of liver cirrhosis

  • Periodic pain in the abdomen, mainly in the right hypochondrium, intensifying after eating fatty, fried and pickled foods, alcoholic beverages, as well as with excessive physical exertion;
  • Feeling of bitterness and dryness in the mouth, especially in the morning;
  • Increased fatigue, irritability;
  • Periodic disorders of the gastrointestinal tract - lack of appetite;
  • Yellowing of the skin, mucous membranes and whites of the eyes is possible.

Main symptoms of liver cirrhosis

In addition to the initial symptoms, the patient also exhibits the following signs of liver cirrhosis:

  • Abdominal pain intensifies over time, in the final stages to the point of unbearability; it is aching or stabbing in nature, with a feeling of heaviness;
  • Rapid weight loss, exhaustion of the body, the legs especially lose weight, while the stomach can bulge forward, as with;
  • Nausea accompanies the patient more and more often, as do attacks of vomiting, and the vomit may contain blood, which usually indicates bleeding of the veins of the digestive organs;
  • Muscles weaken, atrophy, a person is often in an exhausted state;
  • There is also swelling in the joints, the tips of the fingers thicken, and the skin around the nails acquires a reddish tint;
  • The palms, feet, and capillaries on the face are also painted in red tones;
  • The upper part of the patient's torso is covered with spider veins, the number and visibility of which increase as liver decomposition progresses;
  • The mammary glands in men enlarge, hair in the armpits and pubic area falls out, the genitals atrophy;
  • The skin, mucous membranes and whites of the eyes (sclera) acquire a yellowish tint, which indicates that the liver can no longer process bilirubin;
  • Swelling of the legs and tongue appears, itching of the skin, bleeding from the nose, which, together with the eyelids, is also covered with tumors (angiomas), and xanthelasm begins to appear in the eyelid area;
  • The patient is plagued by apathy towards everything, confusion and disturbances of consciousness, memory deteriorates;
  • Body temperature is usually normalized only when the condition of the liver improves and normalization;
  • An increase in the size of the spleen, the amount of fluid in the abdominal cavity, and portal hypertension are also observed.

Complications of liver cirrhosis

Among the complications of liver cirrhosis are the following signs and consequences of the disease:

  • Ascites (excess fluid in the abdominal cavity);
  • Hepatic encephalopathy;
  • Varicose veins throughout the body, thrombosis, as well as internal bleeding;
  • , followed by development ;
  • Kidney failure;
  • Hepatic gastropathy, colopathy or coma;
  • Accession of secondary –, and others;
  • Death.

The main causes of liver cirrhosis are:

  • viral, mainly type , and G, the end result of which is pathological degeneration of the liver;
  • regular consumption of alcoholic beverages, especially excessive;
  • metabolic disorder, which is accompanied by fatty hepatosis;
  • liver poisoning with certain medications (androgens, anabolic steroids, Iprazide, Inderal, Methyldopa, Methotrexate, etc.), salts of heavy metals, industrial poisons, () and other substances;
  • systematic malnutrition, as well as nutrition predominantly;
  • the presence of chronic hereditary and pathological conditions - hemochromatosis, deficiency of alpha-1-antitrypsin and galactose-1-phosphate-uridyltransferase, Wilson-Konovalov disease, Randu-Osler disease, autoimmune liver diseases, extrahepatic obstruction, cholangitis, portal hypertension, congestive heart failure, Budd-Chiari syndrome, the presence of infections (aspergillosis, candidiasis, opisthorchiasis, schistosomiasis) and others.

The simultaneous impact on the body of several of the above factors, for example hepatitis with alcohol consumption, accelerates the pathological degeneration of the liver, sometimes tens of times!

Classification of liver cirrhosis

Liver cirrhosis, according to the classification, is divided into the following types:

According to morphology:

  • Small nodular (small nodular) cirrhosis - the diameter of the nodes is 1-3 mm;
  • Large nodular (macronodular) cirrhosis - the diameter of the nodes is 3 mm or more;
  • Incomplete septal form;
  • Mixed form.

By etiology:

  • Alcoholic;
  • Viral;
  • Drug;
  • Secondary biliary;
  • Congenital, caused by the following diseases:

- hemochromatosis;
- tyrosinosis;
- hepatolenticular degeneration;
- deficiency of α1-antitrypsin;
- glycogenosis;
- galactosemia.

  • Budd-Chiari disease and syndrome;
  • Stagnant (with insufficient blood circulation);
  • Metabolic and nutritional, occurring when:

— Cryptogenic;
— Primary biliary;
- Indian children's.

Stages of liver cirrhosis

The development of liver cirrhosis occurs over several stages, each of which is characterized by its own clinical manifestations, as well as treatment methods. Let's take a closer look at them.

Stage 1 of liver cirrhosis (compensatory stage). Liver cirrhosis of the 1st degree is characterized by the absence of almost any signs - the patient may rarely be bothered by short-term pain in the right hypochondrium, and mainly only in cases where the person drank an alcoholic drink or ate something fatty or fried. Tests usually show a decrease in bilirubin and prothrombic index (up to 60). The positive prognosis for treatment is very favorable, and therapy mainly includes the use of drugs aimed at restoring hepatocytes (liver cells).

Stage 2 of liver cirrhosis (subcompensated). Stage 2 liver cirrhosis is characterized by frequent abdominal pain with right side, constant feeling of fatigue and periodic attacks of nausea, weight loss, short-term ascites. Men show signs of gynecomastia, in which the mammary glands increase in size, in addition, hairline the armpits are starting to thin out. Laboratory studies show a decrease not only in bilirubin, as in the first degree of the disease, but also in albumin, in addition, the prothrombic index decreases to 40. It is very important to choose the right treatment and transfer the disease from subcompensated to compensated form.

Stage 3 of liver cirrhosis (terminal). Stage 3 liver cirrhosis is characterized by sharp pains, rapid weight loss, attacks of nausea and vomiting, yellowing of the skin and mucous membranes, nosebleeds, spider veins, constant weakness, apathy, insomnia. The patient experiences a metabolic failure. Laboratory studies show a decrease in bilirubin, albumin and prothrombic index to critical levels. At this stage, the patient sometimes develops internal bleeding, liver cancer, hepatic coma, peritonitis and other diseases and conditions in which a person can quickly die.

Stage 4 of liver cirrhosis. Liver cirrhosis of the 4th degree is characterized by an exacerbation of all kinds of signs and symptoms of the disease, severe pain, which can only be relieved by strong drugs, sometimes of a narcotic nature. Doctors today cannot stop the further development of the disease and the person dies.

The severity of liver cirrhosis, as well as the percentage of deaths, are also determined using the Child-Pugh system. However, you need to remember that this “test” does not take into account many additional factors of the disease, therefore it is only indicative, and therefore, whatever it shows, do not give up!

The peculiarity of this classification is a small test. For each answer, there are from 1 to 3 points, after which a count is made, and based on the number of points, the patient’s condition and the further prognosis for his recovery are determined.

So, in the following table there are 4 columns - 1 of them is the test questions, the next three (A, B and C) are the answers and the number of points for each of them.

Scoring

  • The total score is 5-6 (the patient belongs to class A): the patient’s survival rate in the first year from the moment of testing is 100%, in the second year it is about 85%;
  • The total score is 7-9 (the patient belongs to class B): survival rate in the first year from the moment of testing is 81%, in the second year it is about 57%;
  • The total score is 10-15 (the patient belongs to class C): survival rate in the first year from the moment of testing is 45%, in the second year about 35%;

Diagnosis of liver cirrhosis

Diagnosis of liver cirrhosis usually includes the following examination methods:

  • Anamnesis;
  • Angiography;
  • Esophagogastroduodenoscopy;
  • Test for the presence of hepatitis viruses;
  • Stool analysis;
  • Scintigraphy;
  • Liver biopsy.

How to treat liver cirrhosis? Treatment of liver cirrhosis usually begins with eliminating the cause of the disease and includes the following points:

1. Drug treatment;
2. Strict diet;
3. Physiotherapeutic treatment;
4. Dosed physical activity;
5. Surgical treatment (liver transplant, if necessary).

1. Drug treatment of liver cirrhosis (medicines for cirrhosis)

1.1. Liver cell protection

As we have already said, the main mechanism for the development of liver cirrhosis is the degeneration of its cells (hepatocytes). Therefore, one of the most important points in the treatment of cirrhosis is the use of drugs that protect hepatocytes from pathological degeneration and replacement. In addition, these drugs usually support the liver itself and its functioning.

To protect liver cells, hepatoprotectors are used - a conditional group of drugs that indirectly in certain situations have a beneficial effect on the performance of the liver.

The following groups of drugs can be classified as hepatoprotectors:

  • Herbal preparations for the treatment of liver cirrhosis;
  • Essential phospholipids;
  • Lipotropic substances;
  • Vitamins for the liver.

Herbal preparations for the treatment of liver cirrhosis. All hepatoprotectors plant origin based primarily on the plant – milk thistle. This is due to the fact that milk thistle contains silymarin, which performs the protective function of liver cells from pathological influence and destruction on them.

Another wonderful medicinal plant that is the basis of some hepatoprotectors is the artichoke, the seeds of which are rich in cynarine. Cynarin is similar in its protective function to silymarin.

Among other plants that perform the protective function of liver cells, as well as helping to normalize the functioning of the liver, extracts of birch, tansy, cassia, and others can be distinguished.

Among the drugs against liver cirrhosis of plant origin, one can note: “”, “Legalon”, “Silymarin”, “Gepabene”, “Galstena”, “Tsinariks”, “Allohol”, “Sibektan”, “Bonjigar”, “Dipana”,

Essential phospholipids. This group of drugs are essential complex fats that are part of the membranes of all cells of the body, playing an important role in normal metabolism, for example, between blood plasma and red blood cells (erythrocytes). Maintains a normal balance of fats, carbohydrates and cholesterol.

Essential phospholipids contribute to the destruction of collagen, which actually causes the replacement of liver cells with fibrous tissue.

Among modern essential phospholipids we can highlight - “Phosphogliv”, “Phosphonziale”, “”, “Essentiale Forte N”, “Eslidin”, “Essliver Forte”.

Lipotropic substances. It is a group of drugs consisting mainly of amino acids that lower the level of “bad cholesterol” (low-density lipoproteins - LDL) in the blood, enhance the effect of lipase, which promotes the breakdown of fats, and also protect the liver from fatty infiltration. Many lipotropic substances are vitamin-like substances.

Lipotropic drugs are usually based on the following substances - ademetionine, arginine, betaine, ornithine, cysteine ​​and others.

Among the drugs with lipotropic action we can highlight: “Betargin”, “Hepa-merz”, “Heptral”, “Glutargin-alcoline”, “Ornilatex”.

Specific vitamins and their dosages are prescribed only by a doctor, and only on the basis of tests, because Some of the vitamins, if overdosed, can cause allergic reactions and other adverse effects.

1.2. Restoring bile acid deficiency

With biliary insufficiency, the body decreases the production of bile acid, which plays a direct role in the digestion of food. In addition, in this condition, the conversion of enzymes is disrupted, which subsequently also participate in the maintenance and normal functioning of the gastrointestinal tract (GIT).

In order to restore the flow of bile and pancreatic juice into the intestine, ursodeoxycholic acid (UDCA), which is a synthetic analogue of bile acid, is prescribed. The dosage is usually 10-15 mg per 1 kg of weight/1 time per day, preferably at night.

In addition, UDCA helps normalize the body’s immune response to infectious agents in the liver, prevents the liver from absorbing so-called “bad” cholesterol, enhances the action of the lipase enzyme, which promotes the breakdown of fats, and UDCA also helps lower blood sugar levels. In fact, ursodeoxycholic acid can be classified as a hepatoprotector.

Among the preparations of ursodeoxycholic acid we can highlight: Ursonan, Ursodex, Ursorom, Exhol.

1.3. Strengthening and stimulating the immune system

To strengthen and stimulate work immune system, as well as to further strengthen the liver and maintain normal functioning of the whole body, immunostimulating drugs are prescribed.

Among the drugs intended to stimulate the immune system are: Vilozen, Zadaxin, Thymogen.

1.4. Removing excess fluid from the body

Liver cirrhosis is often accompanied by the accumulation of extremely large amounts of fluid in the abdominal cavity. This process is called ascites. With ascites, patients also experience swelling of the arms, legs, and internal organs. To prevent this from happening, the patient is additionally prescribed diuretics. However, some doctors, for preventive purposes, prescribe diuretics even before visible signs of ascites appear.

Among the diuretics for liver cirrhosis, the following groups of drugs can be distinguished: aldosterone antagonists, potassium-sparing agents, thiazides, carbonic anhydrase inhibitors and loop diuretics.

Each group is very different in its principle of action, so their independent use is strictly contraindicated. The doctor prescribes a specific group of diuretic drugs only on the basis of tests.

1.5. Symptomatic therapy

To alleviate the course of liver cirrhosis, symptomatic medications may be additionally prescribed.

For severe itching - antihistamines: “Diazolin”, “”, “”, “Diphenhydramine”.

Against insomnia and anxiety - sedatives: Valerian, Tenoten.

Diet for liver cirrhosis is one of the fundamental points, without which the favorable outcome of the disease is reduced to a minimum. From a medical point of view, a diet for cirrhosis is aimed at relieving the liver from processing “heavy” foods, normalizing metabolism, restoring liver cells and preventing complications of the disease, for example, ascites.

In medical practice, M.I. Pevzner developed a dietary supplement for liver cirrhosis, which is called -.

In short, diet No. 5 is based on avoiding foods that irritate the digestive tract and the liver itself, as well as increasing the intake of proteins and carbohydrates, while the amount of fat in food should be reduced by 30%. You also need to reduce it to 1-2 teaspoons/day, no more! The calorie content of foods should not exceed 2500-3000 kcal/day, the amount of liquid should not exceed 1.5 liters. Meals are fractional. All roughage food should be ground and consumed only warm.

What can you eat if you have liver cirrhosis?

  • Soups: vegetable, with various cereals, fruit, dairy, but without frying.
  • Meat: no fatty varieties meat and fish - chicken, beef, low-fat meat, turkey, hake, pollock.
  • Eggs: Can be eaten as steamed omelettes;
  • Salads – from fresh vegetables and vegetable oil
  • Bakery products: wheat bread made from flour premium(not fresh), not baked goods, not butter cookies;
  • Dairy products: low-fat milk, fermented milk drinks, cottage cheese, mild cheese;
  • Sauces: dairy and vegetable sauces are allowed, preferably homemade, as well as sweet fruit sauces;
  • Sweets: fresh and dried fruits and berries, but in soft (ground) form, jelly, honey, jam, marshmallows, sugar.
  • Drinks: compotes, freshly squeezed juices, rosehip decoction, jelly, weak tea.
  • Allowed to use butter, but from natural ingredients.

What should you not eat if you have liver cirrhosis?

  • Fresh baked goods, fried pies;
  • Fatty soups, borscht and other first courses with fatty meat, mushrooms, cabbage;
  • Fatty meat - pork, duck, goose, smoked meats, sausages, lard, liver, kidneys, brains, fatty fish;
  • Vegetables and fruits: legumes, cabbage, turnips, spinach, sorrel, radishes, radishes, green onions, mushrooms, pickled vegetables, sour fruits and berries;
  • Fatty dairy products - cream, sour cream, cottage cheese, hot cheese;
  • Eggs – fried or hard-boiled;
  • Spicy snacks, sauces, ketchups, mustard, pepper, horseradish, marinades, canned food;
  • Sweets: chocolate, ice cream, products with cream;
  • Drinks: alcohol (any), strong tea, coffee, cocoa, lemonade.

3. Physiotherapeutic treatment

Physiotherapeutic procedures for liver cirrhosis help improve metabolism and maintain liver health. Physiotherapeutic procedures include:

  • Plasmapheresis;
  • Ultrasound on the liver area;
  • Inductothermy;
  • Diathermy;
  • Iontophoresis with solutions of iodine, novocaine or magnesium sulfate.

4. Dosed physical activity

Therapeutic exercises improve metabolism, blood circulation, help strengthen the immune system, and also strengthen the musculoskeletal corset.

5. Surgical treatment (liver transplant, if necessary)

Surgical treatment for liver cirrhosis includes liver transplantation (transplantation). This is a rather expensive procedure, which, in addition to finances, is also complicated by finding a donor.

Typically, transplantation is prescribed in cases where conservative treatment of liver cirrhosis has not brought the necessary results, and the pathological process of destruction of this organ continues to develop mercilessly.

In addition to the price, the disadvantage of a liver transplant is the continued use of immune-suppressing drugs throughout life.

Contraindications for liver transplantation include those with metastases, some severe pathologies of the heart and lungs, infectious diseases, inflammatory processes in the brain and others.

However, I want to remind you once again that even if doctors refuse to help and write off a person, there is a way out in God!

Important! Before use folk remedies against liver cirrhosis, be sure to consult your doctor!

Milk thistle. Mix 1 teaspoon of crushed milk thistle seeds with 1 teaspoon of leaves of this plant, then pour a glass of boiling water over the resulting mixture, set aside for 20 minutes to infuse and cool. Next, you need to strain the product and drink it completely at once. Every day, this infusion should be taken 3 times, in the morning (on an empty stomach), before lunch and before bed. Additionally, you can drink tea from, which, in addition to the calming effect, will also enhance the effect of milk thistle infusion.

Elecampane. Add one and a half tablespoons of crushed powder to a small saucepan and fill it with 500 ml of water, put the product on low heat for 30 minutes, then leave the product to infuse for 20 minutes, strain it and take 2-3 times a day, 30 minutes before meals, drinking 200 ml at a time. The course of treatment is 10 days.

Turmeric. Pour 1 teaspoon of turmeric powder into a glass of warm boiled water, add here to improve taste qualities, mix thoroughly and drink 100 ml 2 times a day, 30 minutes before meals.

Vegetable juices from Norman Walker. The essence of the treatment is the daily consumption of freshly squeezed vegetable juices. The optimal amount of juices drunk is 1 l/day. Below are 3 recipes that you can drink like this, 1 large glass (250 ml) 3 times a day, alternating:

  • Recipe 1. Combination of vegetables in the following proportion (10:3:3) - carrots, cucumber and beets.
  • Recipe 2. Combination of vegetables in the following proportion (10:6) - carrots and spinach.
  • Recipe 3. Combination of vegetables in the following proportion (5:1) - carrots and black radish.

Herbal collection 1. Make a collection of the following ingredients - fruits (20 g), wheatgrass rhizome (20 g) and foliage (10 g). Grind everything thoroughly, mix and 1 tbsp. Pour a glass of boiling water over a spoonful of the mixture, then put the product on the fire for 15 minutes, remove, set aside for 15 minutes to cool and infuse, strain. You need to take the decoction 2 times a day, morning and evening.

Herbal tea 2. Make a collection of the following ingredients (all in equal proportions) - fruits (rose hips), roots (elecampane, sage, yarrow and burdock), flowers (, tansy) and herbs (, and knotweed). Mix everything thoroughly and 1 tbsp. Pour a glass of boiling water over a spoonful of the mixture, then put the product on low heat for 15 minutes, boil, remove, and set the product aside for 15 minutes to infuse and cool. Afterwards, strain the broth and take half a glass 3 times a day, 30 minutes before meals.

Herbal tea 3. Make a collection of the following ingredients (all in equal proportions) - St. John's wort herb, yarrow herb, and chicory bark. Grind everything thoroughly, mix and 1 tbsp. Pour a glass of boiling water over a spoonful of the mixture, leave it for 20 minutes, strain and take this portion during the day, in 3 doses.

Prevention of liver cirrhosis

Prevention of liver cirrhosis includes compliance with the following preventive measures:

  • Completely stop drinking alcoholic beverages and smoking;
  • Do not leave to chance, especially of an infectious nature (hepatitis, etc.);
  • Try to limit yourself in eating fatty, spicy, fried and smoked foods, processed foods and other unhealthy and unhealthy foods.

    Video about liver cirrhosis