Portal cirrhosis of the liver
Content:
- What is portal liver cirrhosis?
- Symptoms of portal liver cirrhosis
- Causes of portal cirrhosis of the liver
- Treatment of portal cirrhosis of the liver
What is portal liver cirrhosis?
Portal cirrhosis is the most common form of this disease, characterized by damage to liver tissue with its replacement by fibrous fibers and death of hepatocytes. These changes occur as a result of the influence of a number of morphological factors, the leading positions among which are occupied by alcohol abuse and malnutrition. Although Botkin's disease can also cause liver dysfunction, according to statistics, hepatitis A causes cirrhosis in only 20% of cases.
Most often, portal cirrhosis affects older people: from 40 to 60 years. Moreover, the male sex is twice as susceptible to this pathology as the female. In medicine, you can also find other names for the portal type of cirrhosis, for example, alcoholic, septal, fatty, Lynek cirrhosis.
Symptoms of portal liver cirrhosis
The disease is latent, the symptoms are blurred, as in the initial stages of other cirrhosis.
The clinical picture is similar to that of chronic hepatitis:
- The patient complains of digestive disorders: suffers from heaviness and bloating, does not tolerate fats and spicy food, the appetite disappears. Frequent diarrhea can be replaced by constipation, flatulence increases;
- The pains are localized in the right hypochondrium, tend to intensify after eating, as well as after physical exertion. The nature of the pain is aching, not acute;
- There is a general violation of well-being, weakness, rapid fatigue occurs;
- The liver is compacted and painful, its sharp edge is palpable, the spleen is enlarged;
- Spider veins form all over the body and on the face, erythema of the palms is characteristic. These signs appear in the early stages of the disease;
- Unexpressed yellowing of the skin is rare, no more than 12% of patients;
- As the disease progresses, the patient begins to lose body weight, signs of hypovitaminosis appear;
- The skin begins to itch, scratches appear;
- Hemorrhoids and nosebleeds may occur;
- Collaterals - dilated veins that show through from under the skin of the abdomen, are often located in the navel and diverge from it in different directions.
The final stage is characterized by the appearance of severe complications, ascites, gastric and intestinal bleeding may occur. It is at this stage that jaundice develops, the risk of death increases if an organ transplant is not performed. It should be noted that portal cirrhosis can develop over a long time and begin to bother the patient only after 20 years. In this form of the disease, it is advisable to distinguish three stages: pre-ascitic, ascetic and cachectic. As they pass, the patient's condition is increasingly aggravated.
Causes of portal cirrhosis of the liver
The reasons for the development of this form of cirrhosis can be as follows:
- The root cause of the development of portal cirrhosis is alcohol abuse. Frequent drinking of alcoholic beverages, regardless of their type, leads to the fact that liver cells gradually die, and its tissue is replaced by connective, and the organ becomes no longer able to perform its functions in the required volume;
- Portal hypertension or increased pressure in the portal vein and inability to move blood normally. It can be caused by the growth of tumors, the formation of adhesions after surgery, the development of extrahepatic blockade, thrombosis of the hepatic veins;
- Vitamin and protein deficiency due to congenital malformations, inattention to nutrition, frequent bleeding or infectious diseases;
- Toxic and allergic effects on the body;
- Hepatitis.
Treatment of portal cirrhosis of the liver
Treatment of a disease should be based on its etiology. In addition, the stage of development of pathology, the degree of necrotic activity of cirrhosis and the presence of concomitant diseases will have a significant impact on the course of the therapeutic effect.
It is necessary to control the amount of salt that the patient consumes, since sodium chloride contributes to fluid retention in the body. Periodically, the patient will need to take diuretics. In this regard, a diet with limited fluid and salt is equally important. At the same time, the diet should provide the patient with the required amount of calories and replenish the reserves of fats, proteins and carbohydrates.
Since the synthesis of vitamins in portal cirrhosis is reduced, the patient is recommended to take vitamin-mineral complexes.
With patients, it is necessary to carry out preventive measures aimed at eliminating complications of the disease, which is especially important in the early stages of cirrhosis:
- Firstly, this is psychotherapy, the purpose of which is to remove addiction and completely eliminate alcoholic beverages from the patient's life;
- Secondly, it is avoiding the possibility of poisoning with other toxic substances, for example, at work;
- Thirdly, it is adherence to a diet and a healthy lifestyle in general.
It is important that the patient is not subjected to significant physical exertion, since medical practice indicates that overstrain greatly aggravates the course of cirrhosis. In addition, it has been scientifically proven that bed rest enhances the blood supply to the liver, increases the enteroportal blood flow and triggers the regeneration processes.
Read more: List of medicines used for liver cirrhosis
Treatment of cirrhosis with drugs is divided into two large groups:
- Symptomatic therapy: taking hepatoprotective membrane stabilizing agents (Essentiale Forte, LIV-52, etc.), vitamin therapy (vitamins B12, B6, ascorbic acid, rutin, etc.), diuretics (Furosemide, Lazix, Veroshpiron), hemostatic, Vitamin K, calcium chloride), iron supplements (Sorbifer Durules). The choice of a specific drug will depend on the nature of the disease and its clinical manifestations;
- Pathogenetic and etiotropic therapy is reduced to taking antiviral agents (interferon), drugs aimed at preventing the formation of scar tissue (colchicine), immunosuppressive drugs and anti-inflammatory drugs (glucocorticosteroids and azathioprine).
The most important thing in the treatment of portal cirrhosis is avoiding a return to alcoholism and maintaining a healthy lifestyle.
The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist
Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).
