Biliary cirrhosis of the liver
Content:
- What is biliary cirrhosis?
- Symptoms of biliary cirrhosis
- Causes of biliary cirrhosis
- Treatment of biliary cirrhosis
What is biliary cirrhosis?
Biliary cirrhosis of the liver is a chronic disease of an organ that forms against the background of damage to the biliary tract. Doctors distinguish between primary and secondary forms of the disease. Biliary cirrhosis is considered primary, which is the result of autoimmune processes, first leading to cholestasis and only after a long time to cirrhosis. The secondary form of the disease develops as a result of a violation of the outflow of bile in the large bile ducts.
The disease affects most often people of working age (25 to 55 years), this type of cirrhosis accounts for one case in 10. Women are dominated by the primary form of the disease, and in men, the secondary. The disease is rare among children.
Life expectancy with biliary cirrhosis
The life expectancy of a patient with biliary cirrhosis depends on the stage at which the disease was diagnosed. Often people live with this disease for 20 or more years, and not even suspecting that they have biliary cirrhosis. After the first clinical symptoms appear, life expectancy is about 8 years. On average, 50% of patients die 8 years after the onset of the disease, although much depends on the level of hyperbilirubinemia.
However, it is impossible to predict the life span of a particular patient in absentia, since a number of factors that are individual for each patient have an influence on the course of the disease.
Symptoms of biliary cirrhosis
It is advisable to group the symptoms according to the primary and secondary forms of the disease.
So, primary biliary cirrhosis is characterized by:
- Intermittent itching of the skin, which often appears during a night's rest, with additional irritating factors (for example, after contact with wool or after taking a bath). Itching can last for many years;
- Coloring the skin dark brown, primarily in the area of the shoulder blades, large joints, and later on the whole body;
- The appearance of a flat formation on the eyelids, which looks like a plaque. Most often there are several of them, xanthelasmas can appear on the chest, palms, buttocks, elbows;
- An enlarged spleen is a common symptom of the disease;
- A person may begin to be bothered by pain in the right hypochondrium, in the muscles, in the mouth, a bitter taste often appears, and the body temperature rises slightly.
With the progression of the disease, all the symptoms intensify, there is a loss of appetite, and the itching becomes unbearable. Areas of pigmentation coarse, the skin swells, the terminal phalanges of the fingers thicken. The pain intensifies, varicose veins of the esophagus and stomach are observed, internal bleeding may develop. The absorption of vitamins and nutrients is difficult, symptoms of hypovitaminosis join. Lymph nodes enlarge, disorders in the digestive system occur.
The secondary form of the disease is characterized by the following symptoms:
- Intense itching of the skin, which, even at the initial stages of the development of the disease, causes serious discomfort;
- Pain in the right hypochondrium, while the liver is indurated and painful on palpation and without;
- The skin and mucous membranes of the mouth and eyes turn yellow, urine darkens, and feces become discolored;
- Body temperature exceeds 38 ° C;
- Complications of liver cirrhosis occur much earlier, in particular, we are talking about portal hypertension and liver failure.
Causes of biliary cirrhosis
Doctors have established the fact that the primary form of the disease is not infectious in nature. Therefore, the main reason is considered to be a malfunction of the immune system and the production of specific antibodies that are aggressive towards the intrahepatic biliary tract. Also, the role of a genetic predisposition to the onset of primary biliary cirrhosis is not denied. It is possible that diseases such as autoimmune thyroiditis, scleroderma, rheumatoid arthritis are also affected.
The development of a secondary form of the disease leads to:
- Cholelithiasis;
- Bile duct cyst;
- Chronic pancreatitis and the narrowing of the bile duct caused by it;
- Sclerosing or purulent cholangitis;
- Congenital anomalies of the biliary tract;
- Enlargement of lymph nodes and clamping of the biliary tract.
Treatment of biliary cirrhosis
The treatment regimen will depend on what form of the disease is diagnosed in the patient. If he suffers from primary biliary cirrhosis, then therapy should be aimed at lowering the concentration of bilirubin in the blood, at lowering cholesterol and alkaline phosphatase levels. This is facilitated by the intake of ursodeoxycholic acid. In addition, the patient is prescribed colchicine (to prevent the development of complications of the disease) and methotrexate (to provide an immunomodulatory effect). If the disease has already led to the development of connective tissue in the liver, then anti-fibrotic drugs are prescribed.
In addition, the patient needs to improve the quality of life and get rid of the accompanying symptoms of the disease. To relieve itching, it is recommended to take Colestipol, Naloxin, antihistamines. It is advisable to take statins to lower cholesterol levels. If the patient develops ascites, then the use of diuretics is necessary. When serious complications develop, a donor organ transplant is necessary.
If a patient is diagnosed with a secondary form of the disease, then first of all he needs to normalize the outflow of bile. This is done either using endoscopy or by surgery. When it is not possible to implement such manipulations, the patient is prescribed antibiotic therapy to stop the progression of the disease.
In addition, patients need to follow a special diet. Doctors recommend adopting a dietary table number 5. It involves limiting the consumption of fats, salt and proteins. The basic principle of nutrition is fractional, food is taken in small portions.
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.
