Excessive formation of fibrous tissue disrupts the structure of the liver and ultimately leads to cirrhosis.
Fibrous tissue is formed due to inflammatory processes in the liver.
The development of cirrhosis may be asymptomatic for a long time.
The combination of glycyrrhizic acid and essential phospholipids helps to eliminate liver inflammation and reduce the degree of fibrosis.
"Phosphogliv" - an example of a modern combined drug that can help at all stages of liver damage:
The use of hepatoprotectors with a fixed affordable price is the possibility not to overpay during the treatment process.
Liver cirrhosis is a serious disease that requires severe and prolonged treatment. However, completely different factors can be the causes of this pathology, many of which are amenable, if not to treatment, then to control. In this article we will examine in detail the causes of cirrhosis and methods for its prevention.
This lesion is the final stage of various chronic liver diseases. This diagnosis is made when the pathological changes in the cells of the organ (hepatocytes) become irreversible. In cirrhosis, hepatocytes die as a result of the inflammatory process, and fibrous (connective) tissue forms in their place. In general, this process can be called immune-inflammatory. As a result, the structure of the liver is seriously impaired.
The destruction of hepatocytes is an extremely dangerous process, since these cells perform many important functions: they participate in metabolic processes and secretory activity (the secretion of bile and processed substances into the intestine), neutralize toxins and other harmful substances. As a result, the liver ceases to perform its functions fully: harmful substances enter the bloodstream, causing intoxication of the body.
Hepatocytes are cells of the liver parenchyma (liver tissue), on the basis of which liver segments are formed - structural and functional units of the liver.
In developed countries, liver cirrhosis is one of the six leading causes of death for patients between 35 and 60 years old. Worldwide, 40 million people die from it annually, in Europe - about 170 thousand. Over the past decade, the number of deaths has increased by 12%. In Russia, the incidence of cirrhosis is 20–35 cases per 100,000 population. It is said that this is primarily a male disease. The stronger sex suffers her three times more often than women. This disease usually develops after 40 years.
Cirrhosis has a staged course. Each stage is distinguished by the degree of pathological changes, symptoms and necessary treatment. To determine the stage, a Child-Pugh scale specially developed for this is used. For a correct assessment, it is required to pass some analyzes, and also to take into account the clinical manifestations of the disease at the current time.
The first degree has almost no symptoms, as the disease is compensated. Blood tests are characterized by a decrease in the level of bilirubin, as well as a decrease in the prothrombin index to 60-80 units. In this case, the inflammatory processes have already begun and the dead hepatocytes are replaced by connective tissue.
In the second stage of the disease, the first non-specific symptoms begin to appear: weakness, apathy, headaches, nausea and diarrhea, weak appetite, discomfort in the right hypochondrium, nosebleeds and bleeding gums. In men, baldness and an increase in the mammary glands is possible. Hepatic encephalopathy and ascites begin to manifest. This stage is called subcompensated cirrhosis, since the disease can still be returned to the compensation stage.
Hepatic failure - a complex of symptoms, which is characterized by a violation of one or more functions of the liver.
Ascites is one of the complications of cirrhosis, manifested by the accumulation of free fluid in the abdominal cavity.
This is followed by a terminal stage in which encephalopathy and ascites progress, the skin becomes yellowish, muscular atrophy and anemia are observed. This stage is dangerous for the development of serious complications that can be fatal. Among these complications are hepatic coma, portal vein thrombosis, liver cancer, internal bleeding, and infectious complications.
How can I find out about the state of the liver? Previously, this required a biopsy, but now the assessment is possible using a special set of calculation tests that use the results of blood tests and minimal historical data, but the biopsy remains the gold standard. Specially developed algorithms determine the stage of fibrosis (F0, F1, F2, F3, F4) and the degree of necroinflammatory process (A0, A1, A2, A3) according to the internationally accepted system METAVIR. This scale includes the analysis of 6 indicators: age, body mass index, hyperglycemia, platelet count, albumin level, the ratio of enzymes aspartate aminotransferase and alanine aminotransferase.
Depending on the degree of cirrhosis of the liver, it is possible to predict the patient's life expectancy. On average, more than 7 years live about half of all patients. In compensated cirrhosis, at least 50% of patients live 7–10 years. The subcompensated stage gives a five-year survival rate of about 40%. At the decompensation stage, 10–40% of patients live for about 3 years.
Cirrhosis can be caused by various causes, and the most common of these is hepatitis viruses. The most dangerous for the liver is hepatitis C, as it leads to the development of cirrhosis in 97% of cases. Alcoholic form develops as a result of uncontrolled consumption of alcoholic beverages. Drug type occurs due to prolonged use of hepatotoxic drugs. A congenital form of cirrhosis is the result of some genetic pathologies (hemochromatosis, tyrosinosis, galactosemia, etc.). With insufficient blood circulation and prolonged venous stasis, a stagnant form of the disease is diagnosed in the liver. Exchange-alimentary cirrhosis develops as a result of metabolic disorders. Secondary biliary cirrhosis is a consequence of a violation of the outflow of bile (the disease develops 3–18 months after a violation of the patency of the bile ducts). If the cause of the disease is not clear, this cirrhosis is called cryptogenic. Primary biliary cirrhosis also falls into the category of a disease of unknown etiology.
As already mentioned, the symptoms of liver cirrhosis depend on the stage of the disease. The main ones, regardless of etiology, are: decreased working capacity, unpleasant sensations in the abdomen, increased body temperature, pain in the joints. On examination, a moderate enlargement of the spleen, enlargement and hardening of the liver, and deformation of its surface are detected. In more serious stages, abdominal distention, nausea and vomiting are observed, diarrhea is possible when eating fatty foods, heaviness and pain in the right hypochondrium. At the terminal stage, jaundice, ascites, leg edema, esophageal varicose veins may occur. In some cases hemorrhoids develop. If any liver disease is found, it is necessary to consult a gastroenterologist-hepatologist.
Treatment of cirrhosis is a long process, and it is not so much a treatment as a secondary prevention. At the same time, a special diet, hepatoprotective drugs, and a vitamin complex are prescribed, and hepatotoxic medications and alcohol are excluded. In general, a cirrhosis of the liver is an irreversible condition and is considered incurable. Etiotropic therapy for most forms of cirrhosis is currently absent, with the exception of viral hepatitis, in which antiviral drugs can be prescribed.
In patients with liver diseases, as a rule, patients are prescribed the so-called diet No. 5, aimed at normalizing the functions of the organ and improving bile secretion. Food should be taken in small portions 5-6 times a day, and you should completely eliminate fried and fatty foods. Preference should be given to boiled and steamed food. Be sure to use enough water - at least 1.5 liters per day. It should completely abandon alcohol. The amount of proteins is limited to one hundred grams per day, salt — 10 grams per day. When ascites prescribed salt-free diet.
The most popular in the treatment of liver diseases are homeopathic remedies such as:
In addition, homeopathic preparations can be found extracts from the May celandine Chelidonium majus. Indeed, the plants taken as a basis are known as folk remedies for liver regeneration. However, we should not forget that homeopathy as such is not recognized by official evidence-based medicine, and its methods do not pass serious clinical trials. So far, there is no compelling evidence that it acts due to the declared beneficial components, and not due to the placebo effect. Not all homeopathic patients note an improvement in their state of health. In any case, homeopathic treatment of the liver is a long process that takes more than one month. The breakdown of hepatocytes and the growth of fibrous tissue can develop faster. If we talk about cirrhosis of the liver, then the patient simply does not have time for risky treatment.
With compensated and subcompensated cirrhosis, maintenance therapy is prescribed - a strict diet and hepatoprotectors (drugs based on glycyrrhizic acid, phospholipids, amino acids, milk thistle (Silybum marianum Carduus marianus) and other components that contribute to the restoration of the functions of the liver). Antiviral therapy (PVT) is used for viral cirrhosis. However, it is fair to note that there is no specific treatment for cirrhosis.
Glycyrrhizinic acid is a biologically active substance that is naturally found in licorice root (Glycyrrhiza glabra), after the name of this plant it got its name. However, the hepatoprotective functions of glycyrrhizic acid were studied not so long ago; therefore, it is still far from being found in every drug against liver diseases. The complex of glycyrrhizic acid and phosphatidylcholine is especially effective - numerous clinical studies have shown its anti-inflammatory, hepatoprotective and antifibrotic effects.
At the decompensated stage of cirrhosis, drug therapy is not very effective and it is necessary to raise the question of liver transplantation. Thus, the treatment of cirrhosis is an extremely difficult task, so it is better to prevent it. To this end, in case of liver disease of non-viral nature or viral hepatitis and inaccessible HTP, doctors may prescribe a Russian drug based on glycyrrhizic acid, which is affordable and has almost no contraindications (except for standard: allergic reactions to the component, pregnancy and lactation). The components of the drug protect liver cells from damage, reduce inflammation, the growth of connective tissue and contribute to the recovery of the organ.
If the above methods of treatment do not help, carry out a liver transplant (transplant). Surgical intervention is necessary at the last, decompensated stage of the disease, when the liver no longer performs its functions. In addition, part of the liver can be taken from a relative of the patient or another person who has expressed his consent to this operation.
Preventive measures include any procedure to prevent hepatitis infection, which is a common cause of cirrhosis of the liver. It is recommended to lead a healthy lifestyle, give up alcohol and follow a balanced diet, not to get involved in fried and fatty foods. Care should be taken to take excessive amounts of drugs, many of which are toxic to the liver. It is also worth taking care of leveling the adverse environmental conditions of the environment, which can have a negative impact on liver cells - more rest in the fresh air.
One of the effective methods of preventing cirrhosis is the use of hepatoprotective drugs for liver diseases. They protect liver cells, restore their structure, reduce the degree of inflammation, normalize protein and lipid exchanges, and stop the development of fibrosis. So, glycyrrhizic acid has antioxidant and membrane stabilizing activity, potentiates the action of endogenous glucocorticosteroids, providing anti-inflammatory effect in non-infectious lesions of the liver. The positive effect of this compound was proven in 54 clinical trials, 31 of which are randomized. Tests were conducted on different categories of patients, including patients with hepatitis and alcoholic liver disease. In all of these studies, the glycyrrhizic acid safety profile was assessed as favorable, which made it possible to include it in the recommendations of the Asia-Pacific Association for the Study of the Liver (APASL) and to permit the European Medical Agency (EMA) for human medical use.
So, taking modern hepatoprotectors is a reliable and safe way to improve the clinical picture of liver disease, but any self-medication is unacceptable, and, despite the fact that many drugs are available for sale without a prescription, you should consult with your doctor.
Liver cirrhosis is a serious disease that adversely affects the work of the whole body, requiring long and complex treatment. Therefore, if you have a liver disease, it is necessary to do everything possible to slow down the pathological processes and restore the liver function as much as possible. Much depends on you. Start with self-discipline, taking total control of your diet, daily routine and taking medications prescribed by a doctor - this alone can significantly improve the prognosis.