Diffuse changes in the liver parenchyma
The liver is the organ that does not show itself for a long time in case of illness. Most often they are found during ultrasound diagnostics. And quite often in the discharge you can find a small, but frightening record - diffuse changes in the liver parenchyma. Do not panic, first you should try to figure out what this phrase means. As such, the diagnosis of "diffuse changes in the liver parenchyma" does not exist. The record can only mean that certain processes occur in the organ that have caused a similar state. But because of what it happened, it is necessary to determine with the help of studies of a different nature.
Diffuse changes can be a symptom of such diseases:
- any hepatitis
- sclerosing cholangitis
- autoimmune hepatitis
To understand what is at stake, you should know that the parenchyma is not a shell, but a set of the most important elements responsible for the functioning of the organ. The liver consists entirely of parenchymal tissue, which, in turn, is formed from certain cells - hepatocytes.
Therefore, speaking about the fact that the parenchyma has diffuse changes, the doctor means the transformation of the liver tissue. So, minor deviations may be the result of a past viral disease. But there are also severe lesions, so it is imperative to conduct additional studies that will reveal the full depth of liver damage. But in any case, diffuse changes in the liver parenchyma cannot be ignored, and identifying the reasons that led to such a condition is the key to successful treatment.
- Signs of diffuse liver changes
- Diagnostic methods
- The nature of diffuse changes in the parenchyma of the organ and the reasons that caused this condition
- Treatment of diffuse changes in the liver parenchyma
- Prognosis for diffuse changes in the liver parenchyma
Signs of diffuse liver changes
As for the pronounced signs with damage to the liver tissue, they appear rather rarely.
But sometimes the compaction can be accompanied by a number of symptoms that a person feels:
- After eating, in particular fried or spicy, a feeling of heaviness.
- Bitter taste in the mouth, it is most pronounced in the morning after sleep or after eating.
- Feeling of weakness and increased fatigue, even after light exertion.
- Nausea not justified by poisoning.
- Irritability and frequent headaches, mood swings.
The most pronounced signs, especially with the progression of certain diseases leading to serious changes in the liver parenchyma, are: pain in the right hypochondrium, yellowing of the sclera and even the tongue are alarming symptoms. These are the signs that a person can notice and feel, and seek medical help.
The main method for assessing the nature of diffuse changes in the liver parenchyma was and remains an ultrasound study. The signs by which the doctor determines them can be both pronounced and moderate.
To some extent, the diagnosis allows you to identify:
- All serious diseases, previously suffered or occurring at a given time. They leave noticeable marks on the organ, so the doctor will definitely see these pronounced signs of decomposition of certain parts of the liver.
- Moderate signs, as a rule, do not cause such serious damage, but are noticeable on ultrasound, and can be caused by viruses, unhealthy diet, etc.
On ultrasound, the doctor determines the size of each organ lobe, its echogenicity, as well as the clarity of the contours and the uniformity of the structure.
A competent specialist will immediately see by the echo - signs of diffuse changes in the organ, these include:
- Non-uniform fabric.
- Parenchyma with increased echo density.
- The size of the organ is increased.
- The drawing of the blood vessels is disturbed.
- Decreased and increased echogenicity is noted in different hepatic lobes.
- Consolidation of the periportal tracts.
- Rapid decay of ultrasound.
Only a competent specialist with knowledge in the field of physiology and anatomy can diagnose diffuse changes in the structure of the organ parenchyma, since this is a complex and time-consuming process. Thanks to modern advances in the field of ultrasound, the possibilities of differential studies have been significantly expanded. But sometimes such a diagnosis alone is not enough, since pathological conditions can be quite serious, and morphological changes are not very pronounced.
The nature of diffuse changes in the parenchyma of the organ and the reasons that caused this condition
Depending on the reasons that caused the diffuse change in the liver, it can be of the following nature:
- Fibrous changes in the parenchyma. This happens when, as a result of certain pathological processes in the organ, cicatricial or, so-called, fibrous tissue begins to grow. Its appearance can be triggered by a number of diseases, for example: alcoholic, toxic, or viral hepatitis, due to congenital pathology, due to parasitic infection. Fibrous changes can also be the result of any disease of another organ that has a direct effect on the liver.
- Hypertrophic nature of changes in the parenchyma.
- Sclerotic changes in the parenchyma.
That is, due to a number of reasons, changes in the parenchyma of the organ have occurred, and to clarify them, it is necessary to conduct additional analyzes. The stronger the inflammation, the more noticeable the parenchymal edema will be.
Quite often, a similar verdict can be heard with diseases of the following nature:
- Diabetes mellitus, alcoholism and obesity. The liver in such situations begins to degenerate, to increase in size, during the study, the echogenicity of its structure is several times higher than it should be normal.
- In chronic hepatitis, the liver can be significantly increased in size, but diffuse changes are not very pronounced.
- If a person has cirrhosis of the liver, then the structure of the organ is completely exposed to diffuse changes, it becomes heterogeneous, there are many damaged areas, echogenicity is significantly increased.
- If a cyst or tumor has grown in the organ, then significant changes will be visible in a certain lobe of the liver.
- With a viral infection, the liver parenchyma changes, but these processes are not global in nature and the organ after a certain time is restored on its own.
- Parasites can also cause the liver parenchyma to undergo diffuse changes.
- An irrational approach to nutrition, the use of fatty foods rich in calories, as well as the abuse of alcoholic beverages negatively affects the structure of the organ and causes significant changes in its parenchyma.
As it becomes clear, there can be many reasons for the radical changes in the structure of the organ. In order to clarify the diagnosis, additional examinations should be carried out. They include taking blood for analysis: general, biochemical and clinical, serological studies, and it is also possible to take a liver puncture, MRI, angiography, radioisotope scanning.
Treatment of diffuse changes in the liver parenchyma
If we take into account that, as such a diagnosis, changes in the liver parenchyma do not exist, then the methods of treatment will be aimed at eliminating the disease that caused such a transformation. After the cause is identified, the hepatologist will determine the therapeutic regimen and prescribe the appropriate drugs.
As a rule, standard treatment methods include taking medications according to a certain scheme:
- If the changes were caused by viruses, then antiviral agents will be prescribed to reduce their toxic effect on the organ. Etitotropic treatment for hepatitis is reduced to the appointment of certain drugs, depending on its type. And it is also necessary to eliminate additional damaging factors, such as alcohol and other toxins. Often prescribed hepatoprotectors capable of "protecting" hepatocytes. These can be drugs, both natural and synthetic, this also includes amino acids, vitamins and phospholipids.
- Phospholipids are able to normalize the structure of the membrane of liver cells, reduce hepatocyte necrosis, as a result of which biochemical parameters are significantly improved.
Means of natural origin have a stimulating effect on liver cells, due to which hepatocytes are restored, this effect is also achieved due to the choleretic effect of drugs. The digestion process improves, the effect of harmful substances entering the body with alcohol, drugs and food is largely minimized.
- The action of synthetic drugs is varied and extremely difficult, as a rule, they are prescribed for cancer.
- Amino acids help to normalize the liver and make up for the deficiency of the compounds it needs.
- Vitamins of group B and E are hepaprotectors and are often prescribed in the general scheme of liver treatment.
In addition to adherence to the treatment regimen, almost any liver disease that caused its diffuse changes requires following a specific diet. Nutrition will need to be adjusted in a special way, the doctor will promptly tell you how to do this, but the main recommendations are as follows: the exclusion of salt, seasonings, spicy, fatty, fried foods. The introduction of fiber and potassium-rich foods into the diet. Naturally, depending on the nature of the disease, recommendations will vary in favor of certain products. But alcohol is strictly contraindicated in the treatment of the liver, since in some cases it can not only reduce the effectiveness of the prescribed regimen, but also, in combination with certain drugs, lead to death.
If the changes in the parenchyma of the organ are caused only by improper diet and alcohol consumption, then doctors recommend dietary table No. 5 according to Pevzner's classification, where fortified and protein foods prevail, as well as fermented milk products. Depending on the state of the body, with diffuse changes in the liver parenchyma, immunomodulators and some hepatic charges are also prescribed.
On the subject: List of the best hepatoprotectors for liver restoration
Prognosis for diffuse changes in the liver parenchyma
Naturally, the prognosis of the success of a particular treatment regimen directly depends on the disease that led to diffuse violations of the liver parenchyma.
If we consider the uncomplicated form of lipomatosis, most chronic hepatitis, as well as changes in the parenchyma due to improper diet and lifestyle, then competent treatment in most cases leads to the fact that the organ begins to function in the same volume, and its damaged structure is restored. It should be borne in mind that with lipomatosis, a favorable outcome of treatment will directly depend on what area of the liver was subject to fatty degeneration. Since in this case, the restoration of the affected areas is impossible. It will only be possible to normalize the functioning of the unaffected lobes of the organ.
Diseases such as cirrhosis, fulminant forms of hepatitis, and uncontrolled fatty hepatosis are distinguished by an unfavorable prognosis. In these cases, the liver parenchyma changes dramatically, and the organ itself becomes unable to perform its functions. Death most often occurs due to intra-abdominal bleeding or the development of severe infectious diseases.
It should be understood that changes in the liver parenchyma of a diffuse nature cannot be unfounded. Such a violation of the structure of an organ is necessarily preceded by a number of reasons. Depending on those factors or diseases that provoked diffuse transformations in the liver parenchyma, hepatologists prescribe appropriate treatment. But in order not to miss the moment, it is necessary to undergo an ultrasound scan at least once a year by qualified specialists. The sooner diffuse changes in the liver parenchyma are detected, the more favorable the prognosis for complete recovery.
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.