Symptoms, signs and treatment of liver disease
- Liver disease
- Signs and symptoms
- Causes of liver disease
- Diet for liver diseases
- Prevention of liver diseases
- Tips for liver disease
The human body is designed in such a way that all organs can be subdivided into vital and auxiliary ones. The liver definitely belongs to the first group. Its importance for maintaining the vitality of the organism cannot be overemphasized. After all, this is a powerful parenchymal organ that combines the functions of the digestive gland and a kind of biochemical laboratory.
This is where all the central biochemical reactions and life-sustaining processes take place. Naturally, the more complex the structure of the organ and the higher the load on it, the more vulnerable it is. And despite the excellent regenerative and restorative 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 abdominal cavity, under the diaphragm. The bulk of the organ is fixed by ligaments under its right dome, which is projected onto the anterior abdominal wall, as the area of the right costal arch and hypochondrium. From this section, the liver is directed to the left, gradually narrowing until the edges are completely joined at an acute angle in the form of a wedge closer to the left hypochondrium. Therefore, in the presence of liver problems, patients complain of pain or discomfort in the right hypochondrium with possible spread to the epigastrium.
Liver functions in the human body
No organ in the human body provides as many functions as the liver performs. 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 vital activity (protein breakdown products, phenol, ketone compounds and acetone);
- Participation in vitamin and mineral metabolism: depositing 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 the 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 immunogobullins, antibodies and other important proteins of the immune system;
- Synthesis of plasma coagulation factors and blood anticoagulation system;
- The function of hematopoiesis, especially in the prenatal and childhood period;
- Synthesis of bile and enzymes that are involved in digestion processes. Their main role is the breakdown of fats;
- Implementation of bilirubin metabolism and its neutralization by conjugation with glucuronic acid;
- Deposition of blood, which allows it to be redistributed in case of need (release of blood into the vessels with its deficiency during blood loss or concentration in case of congestive heart failure);
The liver is the largest gland in the human body and performs the most functions among all organs. Liver damage can be accompanied by a violation of one or all of its functions, which is the basis of the severity of the disease.
The group of hepatic diseases can include any types 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 separately.
The main common liver diseases are shown in the table:
Nosological units from the group
Primary inflammatory, purulent and functional lesion of the liver cells
Intrahepatic bile duct damage
Parasitic invasions and infections
Hereditary pathology and anomalies
Liver damage in pathology of other organs
Structural and functional rearrangements in the liver and their complications
Autoimmune liver disease
Pathology in which there is an unreasonable destruction of the liver by its own immune system:
Any liver disease in case of progression ends with cirrhosis and is accompanied by one or another degree of hepatobiliary insufficiency.
Signs and symptoms of liver disease
Symptoms of liver disease are frequent nausea, heartburn, a very unpleasant, pungent smell of sweat, yellowish skin color, dark yellow urine, diarrhea, fecal discoloration to dark brown or light yellow, sometimes green.
Liver disorders can also lead to acne in adulthood, frequent hunger or intense and frequent thirst, itching of some thin areas of the skin, and blurred vision. For example, a person may begin to confuse white with yellow, sharply feel cold and hot, not sleep at night, while experiencing fever, rapid heartbeat. Hair and eyebrows may begin to fall out. Convulsions occur, papillomas are formed, the development of atherosclerosis of the brain, heart, intestines, vessels of the legs begins.
Typical cases of organic and functional liver problems are easily recognized by their characteristic symptoms. But some situations make it difficult for even experienced hepatologists (specialists dealing with liver diseases) to make the correct diagnosis. It all depends on the specific type of disease, 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;
- Impaired mental and cognitive abilities;
- Increased skin sweating and swelling;
- Yellowness of the skin and sclera;
- Skin rash;
- Severe itching of the skin;
- Increased fragility of blood vessels and a tendency to bleed;
- Signs of hypovitaminosis;
- Stool instability, 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. They can be interpreted as follows:
- Slight pain in the right hypochondrium in the form of aching pain, distention 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 an overstretching of the hepatic capsule. Patients cannot clearly indicate one pain point;
- Intense widespread pain in the right hypochondrium. They are rare and speak either about a pronounced inflammatory, purulent, traumatic pathological process, or about damage to the bile ducts with stones;
- Severe local punctate pain in the projection of the liver. It is not characteristic of liver damage and in most cases is associated with pathology of the gallbladder and extrahepatic bile ducts;
- Complete absence of pain in the liver. It is very common in sluggish liver diseases, which go unnoticed for a long time and are determined only at the stage of liver failure or liver cirrhosis.
Skin for liver diseases
By the characteristics of the skin, you can determine the functioning of various organs, including the liver.
With such diseases, the skin can be:
- Pale or dark-skinned with severe sweating and swelling of the subcutaneous tissue, especially in the face and limbs;
- Dry, scaly, with multiple scratches and cracks;
- Prone to allergic rashes, the occurrence of atopic dermatitis, psoriasis, eczema;
- Jaundice. By the nature of this type of skin changes, one can determine the origin of jaundice. In case of liver problems, yellowness is of moderate intensity and is represented by an orange tint. When carrying out the differential diagnosis of jaundice, this criterion makes it possible to exclude their mechanical types (brown skin tint) 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 hormonal imbalance, both in the male and female body, when the liver is not able to neutralize excess steroid hormones.
Rash with 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 liver's ability to synthesize immunoglobulins;
- Allergic rash of the type of spots and papules. It is caused by a violation of the detoxification function of the liver, which underlies the occurrence of allergic reactions to the environmental conditions familiar to the body;
- Hemorrhagic rash. Small hemorrhages over the entire surface of the skin, which are called petechial rashes, are typical manifestations of a decrease in the synthetic function of the liver. First of all, proteins that make up the blood coagulation system suffer. Such patients have an increased tendency to hematoma formation at the slightest damage.
Itching with liver disease
It is characteristic that any type of skin rash with liver disease is accompanied by severe itching. It acquires particular stubbornness when the yellowness of the skin is combined with rashes. This symptom is explained by the fact that bilirubin, which is not rendered harmless by the liver, is deposited in the skin, causing its irritation. In addition, other toxic metabolic products are concentrated in the wide microcirculatory network of the skin, which additionally causes skin irritation and itching. In this regard, when examining patients with liver pathology, you can notice traces of scratching, especially on the lateral surfaces of the abdomen and forearms.
Causes of liver disease
Liver tissue has tremendous potential in terms of its ability to recover and resilience to harmful environmental factors.
Possible causes of liver problems include:
- Viral agents. These include hepatitis viruses of types A, B, C, D, E and other rare species. They lead to the occurrence of acute and chronic inflammatory processes in the liver tissue, which are called hepatitis, according to the name of the virus. The most favorable type of viral hepatitis is considered hepatitis A, dangerous - B, acquires a chronic course and is detected at the stage of cirrhosis - hepatitis C;
- Toxic effects. Long-term and systematic intake of toxic compounds from the environment (vapors, chemical compounds, heavy metals) or the simultaneous exposure of the liver to high doses of them leads to damage to this organ. In this case, both moderate enlargement of the liver without pronounced functional disorders, and massive necrosis of hepatocytes with a transition to progressive hepatocellular insufficiency can occur;
- Medicinal influences. Not all drugs have the same hepatotoxicity. The most aggressive of them are chemotherapeutic agents, antibiotics, hormones;
- Alcoholic drinks. Systematic abuse of ethanol-containing products causes a direct destructive effect on liver cells. Over time, this leads to liver cirrhosis. The established safe daily dose of 40% ethanol for the liver does not exceed 90-100 ml for men, and 50-70 ml for women;
- Infectious and parasitic agents. Among them, the main place is occupied by echinococcus and alveococcus, roundworms, causative agents of leptospirosis. They cause the occurrence of both acute pathological changes and cause chronic processes in the form of cystic transformation of the liver;
- Diet and nutritional errors. In this regard, the most dangerous is the systematic abuse of fatty, fried, smoked and products containing a large amount of spices. This causes a violation of the outflow of bile, which leads to its stagnation, cholangitis and the formation of stones in the duct system of the liver;
- Hereditary predisposition, genetic diseases and malformations. This kind of causes underlies various atresias of the hepatic vessels and ducts, liver hypoplasia, storage diseases and fermentopathies;
- Acute diseases of the abdominal organs, accompanied by suppurative processes. May lead to the spread of suppuration into the portal vein system, which will cause its thrombosis;
- Abdominal and liver injury. They matter not only in the near future after the occurrence. Sometimes, several years after the trauma suffered, cysts or other fluid accumulations in the liver parenchyma may be found;
- Ionizing radiation and other physical and chemical carcinogens. These causal factors can cause cancerous degeneration of certain areas of the liver tissue.
The liver has one of the highest regenerative capacities of all body tissues. The degree of realization of the detrimental effect of causal factors in the development of liver diseases largely depends on the lifestyle
On the subject: List of the best hepatoprotectors for liver restoration
Diet for liver diseases
Compliance with the dietary regimen for liver diseases is a mandatory attribute of the treatment process. Sometimes its effectiveness depends on it. Every patient with hepatic pathology should remember this. It is very important to adhere to clear lifestyle recommendations to keep the liver in a state of relative functional rest.
What should be avoided from the diet?
The following foods should be excluded from the diet:
- Alcohol is strictly prohibited, even in small quantities.
- Coffee and strong tea;
- Grape juice, tomatoes and tomato juice
- Mineral sparkling water, especially with dyes, or regular very chilled
- Fatty meats (pork, duck, goose) and offal (kidneys, liver, brains, heart);
- You can not broths from rich meat, fatty, mushroom, legumes and sorrel
- Pearl barley, corn, barley and millet porridge
- Flavored pasta, pasta and sauces with fat, strong tomato dressings and creamy gravies
- 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 (rolls, pies, donuts, cookies);
- Fermented baked milk, full-fat milk and cottage cheese, salted and seasoned cheeses
- Some vegetables: cabbage, Brussels sprouts, sorrel, spinach, pickles, pickles, garlic, onions, eggplant, mushrooms, radishes, turnips, asparagus and bell peppers after cooking
- Nearly all types of fresh fruits and berries including dates, cranberries, grapes, figs and raspberries
- You can not use a lot of eggs for liver pathology, as well as in their fried form
- Sushi, smoked meats, spicy and fatty dishes are unacceptable from snacks;
- From sweets, 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 hot ones;
What foods are allowed for liver diseases
The following products are allowed for liver diseases:
- Beverages. Rosehip decoction, weak black tea with lemon, milk. Substitutes (xylitol) can be used instead of sugar. Fruit and berry juices without sugar. Compotes are prepared from dry and fresh fruits by grinding them.
- Rye or bran bread, or wheat of yesterday's baking (or stale), biscuit, biscuit-type biscuits;
- Low-fat meat products. We recommend turkey meat, beef, rabbit, chicken. It is better to remove the peel from poultry meat;
- Low-fat varieties of fish. Attention is focused on pike perch, pike, cod, all low-fat varieties of river fish;
- Oils. Vegetable refined 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 varieties of cheese. Kefir and milk can only be skimmed, the maximum amount of fat should not exceed 2%. You can diversify the menu with cheesecakes, lazy dumplings, puddings.;
- Eggs. The recommended number of eggs per day is only one. These can be eggs of any type of bird;
- Vegetable dishes are best prepared from potatoes, pumpkin, cauliflower, zucchini, carrots and beets. Green peas and Chinese cabbage will perfectly complement the menu. Vegetables can be boiled, grated and made into puree soup, soufflé, casseroles with meat and fish. In small quantities, salads with a neutral taste (corn, iceberg, romaine) are welcome. Bulgarian pepper is useful;
- You can use any varieties of noodles and pasta, buckwheat, 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, small amounts of honey, and marmalade.
- Snacks. The diet for liver disease does not limit the use of fresh vegetable and fruit salads seasoned with refined oil; after boiling, they make aspic from the fish, soak low-fat varieties of herring, make stuffed fish. Allowed in small quantities, so as not to cause flatulence, sauerkraut without vinegar. From the usual salads: vinaigrette, zucchini in the form of caviar.
How should you cook and eat your 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, mashed potatoes, just boiled foods in their pure form. You can combine permitted foods in salads and stews. Be sure to salt them normally. This will provide the body with sodium and chlorine ions. Ready meals should be warm before use. 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.
On the subject: A complete list of permitted and prohibited foods for the liver
Prevention of liver diseases
Unfortunately, the prevention of liver diseases depends not only on the correct behavior of one person, who, even with all his wishes, will not always be able to protect himself from them. Liver pathology is to some extent a social problem. Among the reasons for its development there are those that are extremely difficult to influence by the usual adherence to preventive recommendations. But everyone is obliged to strive for this: state government agencies, medical institutions, public catering facilities and everyone who looks after their health.
The prevention of liver diseases include the following activities:
- Compliance with the technology of hazardous production with the exclusion of waste disposal in 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 their chemical processing, which is extremely harmful to the liver;
- Elimination of alcohol abuse;
- Carry out strict control over the processing of instruments in surgical clinics and dental offices. Make the most of disposable devices in practice;
- Strict control over the state of donated blood and its preparations, as well as donors. This will prevent cases of viral hepatitis;
- Isolate patients with viral hepatitis A;
- Eliminate unprotected frenetic intercourse;
- Compliance with the principles of healthy eating;
- Vaccine against hepatitis B to persons at risk of developing this disease;
- Monitor the condition of patients with chronic liver disease;
- Eliminate uncontrolled intake of medicines;
- Use hepatoprotectors if there is a threat of liver damage;
- Seek medical attention in a timely manner if there is any suspicion of liver disease;
- Correct 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 proper attention!
Tips for liver disease
Those who suffer from liver disease need to give up bad habits, from the use of spicy, hot, fatty. Heat and sunburn should be avoided. Food should be eaten steamed or boiled, stewed. It is not recommended to eat yesterday's food. You cannot eat onions and garlic, but it is better to add horseradish and mustard to food; eat boiled chicken, not fried chicken. Also, you can't duck, goat meat, or it's dried meat. Eat vegetables raw. Do not eat too much fermented milk products, eat often, but little by little.
You can eat sweet, sweet tea can help with pain in the liver. Eat foods that are also sweet, bitter, astringent.
Which doctor should I go to?
The doctor who treats the liver - gastroenterologist (therapist-gastroenterologist), hepatologist (if you have hepatitis)
The author of the article: Gorshenina Elena Ivanovna | Gastroenterologist
Education: Diploma in the specialty "General Medicine" received at the Russian State Medical University named after N. I. Pirogova (2005). Postgraduate studies in the specialty "Gastroenterology" - educational and scientific medical center.