Toxic Hepatitis Of The Liver - Causes, Symptoms And Treatment Of Acute And Chronic Toxic Hepatitis

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Causes, symptoms and treatment of toxic hepatitis

Content:

• What is toxic hepatitis?
• Causes of toxic hepatitis
• Types of toxic hepatitis
• Symptoms of toxic hepatitis
• Diagnosis of toxic hepatitis
• Treatment of toxic hepatitis
• Prevention of toxic hepatitis
• Diet for toxic hepatitis

What is toxic hepatitis?

Toxic hepatitis is a liver disease caused by the ingestion of any harmful substances, chemical and other origin. The toxic effect of these substances on liver cells leads to their inflammation and subsequent necrosis.

Acute toxic hepatitis occurs as a result of the ingestion of a single, sufficiently large dose of poison, or a small, but high concentration of a poisonous substance. Symptoms of acute hepatitis appear within 2-5 days.

Chronic toxic hepatitis develops with repeated systematic ingestion of small doses of toxic substances. Its symptoms appear gradually, over several months or even years, the disease is characterized by a slow development. If the cause is not eliminated in time, complications in the form of liver cirrhosis and liver failure are possible.

At risk for this disease are:

• Women, children and the elderly;
• Citizens who are inclined to take various medications on their own, without medical advice;
• People who work with chemicals;
• Alcohol abusers.

In Russia, there are no accurate statistics on the incidence of toxic hepatitis.

According to American doctors, in the United States, 25% of cases of acute liver failure are medication-related. In Russia, a frequent cause of acute toxic hepatitis is the combination of large doses of alcohol followed by the use of painkillers in order to relieve withdrawal symptoms.

Causes of toxic hepatitis

It is customary to distinguish between accidental, professional (work-related) and deliberate contact with hazardous substances. Substances that actively damage the liver are called hepatic poisons.

They can enter the body in different ways:

• Through the gastrointestinal tract: mouth> stomach> blood> liver;
• Through the respiratory system: nose> lungs> blood> liver;
• In a tactile way: skin> blood> liver.

Some liver poisons, the so-called hepatotropic, have a direct effect on liver cells, adversely affecting their functioning. Other types of poisons act indirectly, they disrupt blood flow in small vessels supplying the liver with oxygen, which leads to oxygen starvation of its cells and their subsequent death.

Medications

When a large dose of one of the following drugs is taken at one time, which is significantly higher than the one recommended by the doctor, toxic liver damage is observed and acute toxic hepatitis develops.

Hepatic poisons are classified as follows:

• Sulfonamides (Biseptol);
• Antiviral drugs (Interferon, etc.);
• Medicines against tuberculosis (Ftivazid);
• Antipyretics (Paracetamol, Aspirin;
• Anticonvulsants (Phenobarbital, etc.).

Industrial poisons

Usually they enter the body through the lungs or skin, when working in hazardous industries, chemical, paint and varnish, etc. Most often this happens systematically, in small doses and leads to the development of chronic toxic hepatitis.

Among industrial chemical poisons are:

• Arsenic - found in metallurgy;
• Phosphorus - used for metal processing, is a part of phosphorus fertilizers;
• Pesticides and insecticides - produced for agricultural needs;
• Carbon tetrachloride - used as a solvent for resins, fats, rubber;
• Aldehydes - used in the production of acetic acid;
• Phenols - are part of antiseptics and are used for disinfection purposes.

Alcohol

Excessive and systematic consumption of alcohol, especially of low quality, sooner or later causes toxic liver damage. When processing the alcohol that has entered the body, it interacts with liver enzymes, which leads to the formation of acetaldehyde, a toxic substance. Acetaldehyde provokes various metabolic disorders in liver cells, as a result of which they gradually die off and are replaced by adipose tissue.

Vegetable poisons

Some types of fungi and grass weeds have a hepatotropic effect, directly affecting the liver and disrupting its normal functioning.

Types of toxic hepatitis

Depending on the type of liver poison, the type of toxic hepatitis is also determined:

• Alcoholic;
• Medication;
• Professional.

Alimentary-toxic hepatitis is also possible, the infection of which occurs during oral-genital contacts (anilingus). In this case, oral contact of a healthy person with fragments of feces infected with hepatitis occurs. However, toxic hepatitis is not considered a contagious disease.

Symptoms of toxic hepatitis

In case of mild poisoning, the disease can be almost asymptomatic. In more severe situations, the following symptoms occur:

• Pain on the right under the ribs, which in acute hepatitis occurs suddenly and is a consequence of acute inflammation of the liver;
• Signs of general intoxication: fever up to 38 ⁰ С, weakness, nausea, lack of appetite, joint aches;
• Progressive jaundice, the signs of which appear simultaneously with signs of intoxication: the skin and mucous membranes acquire a yellow-orange tint, the urine is dark in color, the feces are discolored and oily. The cause of jaundice is a violation of the outflow of bile through the biliary tract;
• Hemorrhagic phenomena: small skin hemorrhages in the form of dots, nosebleeds, since toxic substances have a destructive effect on the walls of blood vessels and capillaries;
• Mental changes: increased excitability or, conversely, lethargy and sluggishness, impaired spatial orientation, etc., since poisons also have a toxic effect on nerve cells.

Signs of chronic toxic hepatitis include:

• Recurrent pains in the right hypochondrium, which are of moderate intensity and intensify after eating;
• Severity on the right under the ribs, which is caused by an enlargement of the liver and stretching of its capsule;
• Prolonged increase in body temperature within 37-37.5 ⁰ С;
• Increased fatigue, decreased performance;
• Decreased appetite, bitterness in the mouth, bouts of nausea, bloating, diarrhea;
• Itchy skin;
• Enlargement of the spleen.

These symptoms may subside periodically and then worsen again. If untreated, severe toxic hepatitis can lead to the following complications:

• Liver failure, which develops as a result of the death of liver cells and their replacement with fat cells;
• Hepatic coma, which leads to progressive liver dysfunctions; the consequence may be a violation of the central nervous system (convulsions, fainting, reflex disorder) and even death;
• Liver cirrhosis - in the course of this disease, liver cells die off and are replaced by connective tissue.

Diagnosis of toxic hepatitis

When diagnosing this disease, laboratory and instrumental methods are used. A biochemical blood test is performed, which determines the level of bilirubin and enzymes such as AST and ALT, alkaline phosphatase, gamma-glutamyl transpeptidase.

Read more: The norm of bilirubin in the blood

Treatment of toxic hepatitis

First of all, it is necessary to completely stop any contact with liver poisons.

Treatment regimen:

• Bed rest;
• Gastric lavage; with a single ingestion of a large dose of a toxic substance, you can first artificially induce vomiting;
• Removal of toxins from the body by taking drugs of activated carbon, droppers with electrolyte solutions, plasmapheresis; to reduce the effect of poison on the stomach walls, you can drink milk or a decoction of flax seeds;
• Taking vitamins C and group B;
• Reception of hepatoprotectors;
• Taking choleretic drugs;
• Compliance with a special protein-free diet.

With signs of acute toxic hepatitis, urgent hospitalization is required.

Hepatoprotectors

These are drugs that restore damaged liver cells, its functions and resistance to harmful effects.

5 and below 2 Preparation Liv.52

A herbal remedy that includes chicory, yarrow, nightshade, tamarix, etc.

Pros:

• Neutralizes toxic substances by increasing the activity of the corresponding enzymes;
• Reduces the negative effects of alcohol on the liver and promotes its excretion from the body;
• Stimulates the production of substances that block the action of free radicals that damage healthy cells;
• It has a choleretic and anti-inflammatory effect. Together with the flow of bile, toxins, cholesterol and excess fats are actively removed from the body.

Essentiale forte

This preparation contains special fats (essential phospholipids), which are obtained from soybeans. Essentiale forte normalizes metabolic processes in the liver, promotes the restoration of its cells and prevents tissue scarring.

Pros:

• Strengthens and heals the liver by integrating essential phospholipids into its damaged cells;
• Reduces the level of cholesterol and fats in the blood by reducing its production by the liver and increased separation with bile;
• Suppresses the process of scarring of liver tissue;
• Slows down the onset of cirrhosis;
• It is highly effective in the treatment of alcoholic hepatitis, as well as in case of poisoning with pesticides, mushrooms and antiepileptic drugs.

The drug is available with and without vitamin supplements. The variant with the content of vitamins has a number of restrictions in use: the daily dose and duration of administration are reduced in order to avoid hypervitaminosis, patients with individual intolerance to certain vitamins should not take the drug.

Heptral

The main active ingredient is ademetionine, which stimulates the growth of liver cells, participates in the synthesis of serotonin and neutralizes toxins. Ademetionine is produced by the liver, but with its diseases, the concentration of this substance in the body decreases. Heptral replenishes ademetionine deficiency and stimulates its natural synthesis.

Pros:

• Promotes the formation of phospholipids;
• Has a choleretic effect;
• Strengthens the detoxifying ability of the liver, activating the synthesis of specific amino acids;
• It has antidepressant properties, as it actively participates in the production of serotonin and dopamine (mood-enhancing substances) and increases the sensitivity of certain brain structures to these substances.

In the course of clinical studies, the effectiveness of this drug has been proven in the treatment of alcoholic and drug-induced hepatitis.

On the subject: List of the best hepatoprotectors for liver restoration

Prevention of toxic hepatitis

Prevention of the disease consists in the complete elimination of contact with toxic hepatotropic substances. It is recommended to systematically undergo treatment in specialized sanatoriums, as well as attend annual preventive examinations. When working in hazardous work, try, if possible, to retire as early as possible.

Diet for toxic hepatitis

It is necessary to adhere to fractional meals, eat in small portions and often, as this improves the outflow of bile. Fatty and fried foods, spicy and salty food, smoked meats and canned foods should be excluded from the menu.

The bulk of the diet should be foods rich in fiber and pectin: fresh vegetables and fruits, legumes. Meat can be lean, easily digestible (chicken, rabbit).

On the subject: What can and cannot be eaten with liver disease?

Persons working in hazardous industries must consume dairy products every day. The daily diet should include approximately 80 grams. vegetable fats and butter. Drinking alcohol and smoking is strictly prohibited.

Author of the article: Kletkin Maxim Evgenievich | Hepatologist

Education: Diploma in the specialty "General Medicine" received at the Military Medical Academy. S. M. Kirov (2007). At the Voronezh Medical Academy. NN Burdenko graduated from residency in the specialty "Hepatologist" (2012).