How is cirrhosis of the liver and its consequences. Cirrhosis of the liver: symptoms, treatment, signs, how long they live with it, causes, stages, diagnosis, what it is, prognosis

Content

Irreversible chronic liver disease, in which cells degenerate into fibrous tissue, is called cirrhosis. The disease is not always the result of alcohol dependence and affects both men and women equally. Treatment of cirrhosis of the liver at home with folk remedies is impossible. It is impossible to do without lifestyle adjustments, drug therapy and / or surgical intervention.

What is cirrhosis of the liver

The pathological condition of the largest organ (gland) of the abdominal cavity, which is a consequence of circulatory disorders in the hepatic vessels and is characterized by a persistent lesion, is called cirrhosis. In this disease, healthy liver tissue is replaced by fibrous connective tissue. Without treatment, hepatic failure eventually develops, portal hypertension, followed by death. Death overtakes the patient, as a rule, for 2-4 years of illness. Sometimes a consequence of cirrhosis is organ cancer.

Symptoms

The main symptom of cirrhosis is pain in the right hypochondrium. However, the onset of the disease may be accompanied by other symptoms, and may be completely asymptomatic (20% of cases). Often it is possible to detect pathology only after the death of a person. For example, at the stage of compensation there are no signs of cirrhosis, except for an increase in the size of the liver. It is noticed that in men the disease at an early stage is more difficult to identify. The first signs of cirrhosis:

• dryness and bitterness in the oral cavity, especially in the morning;
• periodic disorders of the gastrointestinal tract: bloating, lack of appetite, diarrhea, vomiting, nausea;
• recurrent abdominal pain, aggravated after drinking alcohol, pickled or fatty foods;
• yellowing of the whites of the eyes, skin, mucous membranes.

How to treat cirrhosis of the liver

Treatment for cirrhosis of the liver after diagnosis is prescribed by a gastroenterologist (generalist) or a hepatologist (a narrowly specialized doctor). There is a generally accepted standard for complex therapy, which includes medication, physiotherapy, a strict diet, dosed physical activity, and, if necessary, surgical intervention. To stop the development of pathology, it is necessary to eliminate the cause, stop the degeneration of tissues, and reduce the load on the portal vein. Recently, the treatment of cirrhosis of the liver with stem cells has been used.

Drugs for cirrhosis of the liver and hepatitis

The tactics of conservative treatment of chronic hepatitis or cirrhotic degeneration of the liver in a man or woman depends on the stage and type of the disease. Inactive cirrhosis does not require any medication, except for vitamin and mineral complexes. The patient is shown following a healthy lifestyle so that the disease stops. The progression of cirrhosis is treated with hepatoprotectors based on milk thistle extract. To stop internal bleeding, intramuscular injections of Vikasol are used.

A disease of viral etiology of different activity requires the appointment of corticosteroid hormones and antiviral drugs. Decompensated cirrhosis is treated with increased doses of hepatoprotectors (injections) and lipotropic drugs. The therapy also includes taking vitamins. In biliary cirrhosis, steroid hormones, synthetic bile acids, proteolysis inhibitors are prescribed. This stage is incurable, and the above drugs only slow down the course of the disease, alleviate the symptoms. What medicines can not do without:

1. Duphalac. A mild laxative, which, in addition to the main action, has a positive effect on the growth of beneficial intestinal microflora. Available in the form of syrup or sachet. It is prescribed for cirrhosis, 15-30 ml / day. The doctor prescribes the duration of therapy individually. In case of an overdose, abdominal pain and diarrhea may develop.
2. Molsidomin. A beta-blocker, which is prescribed to lower the pressure in the portal vein. The drug reduces venous inflow to the heart, reduces the tone of peripheral vessels. Inside take 1-2 g 2-4 times / day after meals. The course of treatment is carried out from several months to several years. With prolonged use, headaches, lowering blood pressure are possible.

Hepatoprotectors

Drugs that have a protective effect on the liver are called hepatoprotectors. There are many drugs in this family. With cirrhosis, preparations of plant and animal origin, essential phospholipids, synthetic bile acids are prescribed. Among the popular:

1. Essentiale Forte. It restores the cellular structure of hepatocytes, activates the enzyme that destroys fibrosis, normalizes the carbohydrate-lipid balance in the organ. Children over 12 years old and adults are prescribed 2 capsules 3 times / day with meals. The duration of the course is at least 3 months. Contraindication: individual intolerance to the components.
2. Karsil. Herbal hepatoprotector with milk thistle fruit extract. Removes toxins, protects liver cells from destruction. Adults and children over 12 years of age take 2-4 tablets 3 times / day for 3 months. With endometriosis and pregnancy should be used with caution.

Antibiotics for cirrhosis of the liver

In uncomplicated cirrhosis, antibiotics are not required. They are prescribed for bacterial complications, suspicion of SARS. Effective antibiotics:

1. Suprax. 3rd generation antibiotic based on cefixime. The mechanism of action is due to the destruction of the integrity of the cells of the pathogen. It is prescribed 1 capsule 1 time / day for a week. Among the side effects: nausea, vomiting, dysbacteriosis, thrombocytopenia, nephritis, dizziness, itching, urticaria, skin flushing.
2. Normix. Broad spectrum antibiotic. It causes the death of bacteria that provoke intestinal infections. Take 200 mg every 6 hours for 1 to 3 days. The duration of the course should not exceed 7 days, so as not to provoke the development of side effects: increased blood pressure, lymphocytosis, Quincke's edema, anaphylactic shock.

Diuretics

Even at the stage of hepatitis, stagnation occurs in the liver, which causes increased production of lymph. The fluid constantly accumulates, causing swelling of the internal organs and limbs. To prevent ascites from developing, you need to take diuretics. Among them:

1. Veroshpiron. Potassium-sparing diuretic that prevents water and sodium retention. The daily dose is from 50 to 100 mg once. It is necessary to take tablets 1 time in 2 weeks. Among the contraindications: Addison's disease, hyponatremia, hyperkalemia, severe renal failure, anuria.
2. Diacarb. It is an inhibitor of carbonic anhydrase, which has diuretic activity. With edema, take 250 mg once in the morning. For maximum effect, take 1 tablet every other day. The duration of treatment is assigned individually. Contraindications for use are uremia, acute renal failure, diabetes mellitus.

The use of glucocorticoids

In liver cancer, the use of glucocorticoids is contraindicated, since they negatively affect the state of the digestive system, contribute to the development of complications, and reduce the life expectancy of the patient. Often these drugs are prescribed together with hormonal agents for autoimmune cirrhosis that has not reached the stage of decompensation. For treatment apply:

1. Metipred. Synthetic glucocorticosteroid. It has an immunosuppressive, anti-allergic, anti-inflammatory effect. The initial dose for intravenous administration is 10-500 mg / day, depending on the symptoms. The average duration of treatment is 3-5 days. Among the contraindications: systemic mycosis, the period of breastfeeding.
2. Urbazon. Glucocorticosteroid, which has antitoxic, antishock, desensitizing, antiallergic, anti-inflammatory effects. Assign intramuscularly or intravenously at 4-60 mg / day for 1-4 weeks. Do not use the drug for endocrine pathologies, severe hepatic and / or kidney diseases, ulcers, diseases of the cardiovascular system.

Prednisolone

The most popular glucocorticoid in cirrhosis. Suppresses the functions of tissue macrophages and leukocytes. Limits the migration of the latter to the area of ​​inflammation. Assign 20-30 mg / day. The duration of the course is calculated individually, but not more than 14 days. Do not prescribe the drug for bacterial, viral or fungal skin diseases, in violation of the skin and in children under 2 years of age.

Diet

With this disease, the diet dictates its own rules. Daily calorie intake should not exceed 3000. Food is consumed up to 5-6 times in small portions. In case of liver pathologies, salt intake of no more than 2 tsp is acceptable. per day. Solid foods are crushed, fried foods are not allowed. To remove toxins, it is necessary to spend fasting days once a week on dairy products or vegetable soups.

You can not eat rye and fresh bread, puff, pastry, fatty broths, meat / fish / dairy products with high fat content. Alcohol, coffee, cocoa, spices are also banned. Allowed products:

• wheat bread from premium flour;
• vegetable, cereal, milk soups;
• low-fat meat dishes;
• lean fish;
• eggs;
• vegetables fruits;
• vegetable, butter;
• herbal tea, vegetable, fruit juices, jelly, compotes, jelly.

Physiotherapy treatment

In the complex treatment of cirrhosis, physiotherapeutic procedures are prescribed. The treatment regimen is selected by the doctor, depending on the problems that need to be solved. It is impossible to carry out physiotherapy with severe complications and acute course of the disease. The arsenal of varieties of methods is wide, but more often used:

1. Diathermy. In the projection area of ​​the diseased organ, high-frequency currents are heated. The duration of the session is from 10 to 40 minutes, the course is up to 40 procedures daily or every other day.
2. Inductothermy. The treatment is carried out with a high frequency electromagnetic field. The oscillatory effect leads to positive changes in the diseased organ. The duration of the procedure is 10-20 minutes. The course is 10-15 sessions held daily.
3. Electrophoresis. The local effect of drugs is carried out by concentration through the skin by current exposure. The duration of the session is 15-20 minutes. Hen treatment is from 10 to 20 procedures carried out daily.

Dosed physical activity

If the patient does not have a history of ascites, doctors in hepatic pathology recommend dosed physical activity. Therapeutic exercise improves metabolism in liver cells, normalizes blood circulation, strengthens the immune system, and strengthens the musculoskeletal system. Exercises for therapeutic exercises are selected individually. The specialist takes into account the severity of the disease, the age of the patient, the general condition of the body. A few examples of exercise therapy:

• in the supine position, when inhaling, the stomach protrudes, while exhaling, it drops;
• the same position, arms along the body, first the left leg is bent, the heel does not come off the floor, then the right;
• standing on all fours, one leg rises while inhaling, while exhaling, the knee is pulled to the chest, then repeat the same with the other leg.

Surgery

If necessary, the patient is prescribed surgical treatment - liver transplantation. This is an expensive operation, which is complicated by the search for a donor. Transplantation is prescribed when conservative therapy does not give positive results, and the liver is constantly being destroyed. The disadvantage of surgical treatment is the subsequent lifelong use of drugs that suppress the immune system. Contraindications for surgery are inflammation of the brain, malignant tumors of the bile ducts and other oncology, obesity, infections, severe heart pathologies.

How to treat folk remedies

Treatment of alcoholic cirrhosis of the liver will be effective if at home, along with medicines, additional folk recipes are used. It should be remembered that the use of any therapeutic methods must be agreed with the doctor in order to avoid complications of the disease. Folk remedies for the treatment of liver cirrhosis, which are used at home:

1. Milk thistle. One teaspoon of crushed seeds is mixed with 1 tsp. plant leaves. The resulting mixture is poured with a glass of boiling water, infused for 20 minutes. The medicinal herb is filtered, drunk at a time. Take to cleanse the liver 3 times / day: on an empty stomach, before dinner and at bedtime for a month.
2. Elecampane. In a small container, put 1.5 tbsp. l. chopped elecampane root, pour 500 ml of water, simmer for half an hour, then insist for 20 minutes. Then the broth is filtered and taken half an hour before meals 2-3 times / day, drinking 200 ml at a time. The duration of treatment is 10 days.

Prevention

Compliance with preventive measures will not allow the development of severe liver pathology. To avoid cirrhosis, you should:

• completely abandon the intake of alcohol, smoking;
• timely treat diseases of the gastrointestinal tract;
• limit the consumption of spicy, fatty, smoked, fried foods;
• do not take medicines without consulting a doctor;
• enrich the diet with foods high in vitamins and minerals;
• follow the rules of personal hygiene.

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Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

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Treatment of cirrhosis of the liver with medication and folk remedies, diet and exercise

People who abuse alcohol are often frightened by the terrible phrase - cirrhosis of the liver. Do symptoms of cirrhosis of the liver occur only in drinkers, or can the disease develop due to other adverse factors?

How can a person and those around him recognize that the tissue of this vital organ is being destroyed in him?

Cirrhosis of the liver is the simultaneous damage of the organ in several places, which leads to the death of liver cells and their transformation.

As a result, scar tissue is formed in diseased areas, which gradually becomes larger in percentage terms.

As a result, the functionality of the organ drops significantly, which leads to the death of the internal organ and the patient himself.

The first signs of cirrhosis of the liver

At the initial stage, cirrhosis of the liver often occurs in a latent form.

At the 1st stage of the pathological process, manifestations of liver cirrhosis may be completely absent.

The disease is in a latent (hidden) form, and therefore does not have a pronounced clinical picture.

Asymptomatic course at an early stage is observed in approximately 20% of cases.

Sadly, in another 20%, the fact that a person has cirrhosis of a dangerous pathology is detected only at an autopsy of the body.

To avoid this, it is necessary to have an understanding of how cirrhosis of the liver manifests itself in men and women.

Moreover, it is important to identify the disease as early as possible, because the disease is very severe and in no case should you joke with it.

In the remaining 60% of episodes at the initial stage of the pathology, the following manifestations are noted:

1. Intermittent pain in right side. Pain occurs in a certain way, due to intense physical activity or due to food eaten with a high fat content, drinking alcohol.
2. In the oral cavity, the patient feels bitterness and dryness in the morning.
3. Perhaps a defecation disorder (constipation or diarrhea), increased gas formation in the intestines.
4. There are changes in a person's behavior, he gets upset over trifles, loses activity.
5. External signs of cirrhosis in the postnecrotic form appear as yellowness of the skin.

If the first signs of liver cirrhosis are absent, the manifestations of the disease develop in its next stages and are characterized by acuteness and extensiveness.

It is very important to start treating liver cirrhosis, the first signs of which have just begun to appear.

The main feature of this organ is its ability to actively regenerate cells, even if part of it is affected by the initial degree of cirrhosis.

Healthy functioning cells are able to do double work (for themselves and dead tissue).

Therefore, even if an ailment has already been diagnosed, a person has every chance to overcome it or significantly slow down development.

Symptoms of progressive cirrhosis

With the development of the disease, pains appear in the right side, deterioration of health.

As the disease progresses, it begins to manifest itself brighter, affecting other organs and systems.

The main symptoms of liver cirrhosis will be manifested in increased pain in the right hypochondrium.

This is facilitated by an increase in the hepatic capsule. Painful sensations are aching in nature with an accompanying feeling of heaviness in the side.

Therefore, when asked if the liver hurts with cirrhosis, the answer is yes. The liver hurts a lot.

With a diseased liver, a person often experiences nausea, which can result in vomiting.

Cirrhosis of the liver is characterized by the admixture of blood in the vomit, which directly indicates the weakness of the blood vessels of the esophagus and stomach.

Thinning of the vascular walls is noted not only in the digestive system.

Quite often, the patient has nosebleeds.

People with an extensive pathological process have characteristic syndromes of liver cirrhosis in the form of skin changes.

1. Firstly, the epidermis acquires an unhealthy yellow tint, while it is very flaky. Jaundice occurs in the following order: eye sclera, oral mucosa, palms and soles, then the skin of the whole body. In more rare cases, there is hyperemia of the skin of the palms (the so-called hepatic palms) and feet.
2. Secondly, the skin of a sick person is very itchy, which is explained by an excess amount of bile acid in the bloodstream.

Liver cirrhosis can also be recognized by other skin changes.

Syndromes of the last stage of liver destruction include the formation of specific spots on the skin of the upper eyelids (xanthelasma). Vessel stars often appear on the torso.

Moreover, for this disease, their localization above the navel line is characteristic.

The acute state of the disease is accompanied by an increase in the number of asterisks on the skin of the body.

With cirrhosis of the liver, strong changes in body composition occur.

Once sick, a person begins to rapidly lose muscle mass.

There is a gradual depletion of the body, characterized by thinning of the limbs and swelling of the abdomen.

The latter is explained by the onset of ascites, a neglected pathological process, which consists in the accumulation of fluid in the peritoneum.

Signs of liver cirrhosis in alcoholics can be recognized by their face.

The skin on it becomes an unhealthy shade, the cheekbones are clearly visible, the salivary glands greatly increase in size.

There may be redness of the face due to the expansion of blood vessels.

With cirrhosis of the liver, the state of the tongue also changes due to swelling and a change in color to a brighter one.

The liver is noted not only on the organs of the digestive and circulatory systems.

The disease leads to pathological growth of the spleen (splenomegaly) and psycho-emotional disorders.

Symptoms of cirrhosis of the liver in men and women

Signs of cirrhosis of the liver in men have some features.

As a result of alcohol abuse in males, the following changes occur in the body:

• the breast swells significantly and acquires the features of female mammary glands (gynecomastia);
• the hairline in the groin and armpits is reduced;
• erectile dysfunction develops with a noticeable decrease in the genitals;
• degenerative changes in the testicles.

Signs of liver cirrhosis in men occur 2 times more often than in women.

Doctors explain this by the fact that pathologies leading to the destruction of liver cells are more often diagnosed in the male half of humanity.

Signs of alcoholic cirrhosis are much more common in men, but the female body is affected many times faster.

It is the woman who in most cases develops secondary cirrhosis if she had previously suffered from gallstone disease or she has malignant tumors in the organs adjacent to the liver.

Signs of liver cirrhosis in women do not differ from those listed in the previous paragraph, however, there are some features due to a different anatomy, namely:

1. there is a decrease in libido;
2. the menstrual cycle is interrupted;
3. bleeding from the uterus that is not associated with menstruation occurs;
4. in some cases, menstruation stops altogether;
5. due to impaired sexual function, a woman cannot become pregnant and normally bear a child.

The above symptoms of liver cirrhosis in women are not specific to cirrhosis, and therefore, when they appear, you should consult a qualified doctor to find out which pathologies caused the disorders.

Signs of complete cirrhosis of the liver

With complete cirrhosis of the last stage, the organ ceases to perform its functions, severe intoxication of the body occurs, accompanied by pain.

The last stage of liver cirrhosis is characterized by severe complications that affect the circulatory, digestive, excretory, and nervous systems.

With cirrhosis of the liver, symptoms of hepatic encephalopathy develop.

This is a reversible damage to the central nervous system by toxins that are not neutralized by the structures of the liver during the period of its damage.

The patient's sleep is disturbed, memory deteriorates to a large extent, there is indifference to everything around, a clearly manifested tremor of the limbs.

Hepatic encephalopathy can occur in a latent form, then it can only be detected during a special examination.

In rare cases, for late alcoholic cirrhosis of the liver, symptoms become a change in speech in a sober state, the manner of writing changes, gait due to poor coordination of movements.

An extreme variant of hepatic encephalopathy is coma.

It overtakes the patient not suddenly, its onset can be determined by the following signs:

1. A person suddenly develops anxiety (longing, euphoria, apathy) for no apparent reason.
2. There is disorientation in space, inhibited reaction.
3. There may be clouding of the mind with further confusion of consciousness.
4. Spasms of mimic and chewing muscles.

To determine how cirrhosis of the liver and men or women manifests itself, the attending physician must conduct a number of examinations, including taking a blood test to determine the amount of total bilirubin.

At the last stage of the pathological process in the liver, it grows significantly.

Falling into a state of hepatic coma is accompanied by a cessation of motor activity, the possible appearance of convulsions in the body, there is no reaction of the pupils to light.

The last stage before hepatic coma is a change in heart rate.

Blood pressure is at an extremely low level, the pulse becomes thready, tachycardia increases.

The sphincters of the whole body are paralyzed, the symptoms of the last stage of the lesion lead to respiratory arrest.

If a person has 1 or 2 symptoms characteristic of cirrhosis of the liver, this does not yet indicate the destruction of the organ.

If there are doubts about the condition of the liver, a person needs to contact a medical institution, where he will be told how to determine liver cirrhosis, as well as everything about the symptoms of the disease.

Cirrhosis of the liver is a serious disease that cannot be cured. In just 3-5 years, it can lead to complete liver dysfunction and death. And in order to prevent the development of complications against the background of the disease and prolong life, it is necessary to diagnose the disease in a timely manner and start its treatment as early as possible. And for this you need to know all the symptoms of cirrhosis of the liver, which will be discussed now.

The first signs of the disease

Speaking about how cirrhosis of the liver manifests itself, it should immediately be noted that at the initial stage of its development, this disease does not manifest itself at all. Moreover, even a clinical and biochemical blood test does not always show malfunctions in this organ. And only when the pathological processes reach a certain phase, the first symptoms of the disease appear in a person. And it's itchy.

It occurs for no apparent reason. A person has no allergies, no dermatological diseases, nothing. But the itching is there. At the same time, every month it becomes stronger and stronger. The patient on the body appear numerous scratches, red foci. Itching may occur 4 to 6 months before other signs of illness appear. Its appearance is caused by an excess of bile acids in the blood.

In some cases, the development of cirrhosis of the liver begins with the following symptoms:

• redness of the palms and face;
• periodic pulling pains, localized exclusively in the right hypochondrium (painful sensations often increase after physical exertion or after taking heavy food or alcohol);
• bitter taste and dry mouth (especially noted in the morning after waking up);
• periodic stool disorders and flatulence;
• loss of appetite and weight loss;
• increased irritability;
• fast fatiguability.

As a rule, at the initial stages of development, these signs of liver cirrhosis are mild, so patients simply do not pay any attention to them. However, in some cases, there are no primary symptoms at all and the disease debuts with acute symptoms.

Loss of appetite and weight loss are the main signs of cirrhosis

Other signs of illness

Speaking about what symptoms are characteristic of liver cirrhosis, the following should be highlighted:

• Pain in right side. As the disease progresses, the liver capsule expands, which causes an increase in pain. It manifests itself in the form of colic. In the case of concomitant hypokinetic dyskinesia, the pain becomes even more pronounced, constant and is accompanied by a feeling of heaviness in the right side.
• Nausea and vomiting. Bouts of nausea can disturb the patient often. They become especially pronounced after eating heavy food and alcohol. Nausea is often accompanied by vomiting. In the vomit, blood impurities may be noted, which indicate ongoing bleeding from the dilated veins of the stomach and esophagus. Also, bile may be present in the vomit, which indicates destruction of the bile ducts and stagnation of bile.
• Weight loss. Initially, a person's appetite worsens. After eating even a small amount of food, he begins to feel full. The patient begins to eat less and less, the processes of digestion and assimilation of nutrients are disturbed, there is an active weight loss. As a rule, when liver cirrhosis reaches the decompensated stage, the patient has anorexia. Against the background of exhaustion of the body, other symptoms appear - weakness, drowsiness, etc.
• Muscle tone decreases, muscle atrophy occurs.
• mechanical jaundice. Occurs against the background of a decrease in the ability of hepatocytes to metabolize bilirubin. At the initial stages of the development of cirrhosis, jaundice is not very pronounced, only slight yellowing of the sclera of the eyes and mucous membranes is noted. But as the disease progresses and the destruction of the bile ducts, jaundice becomes pronounced and is characterized by yellowing of all skin integuments and strengthening of the venous network.
• Xanthelasm. This condition is characterized by the appearance of spots with a lipid component. They are localized mainly in the upper eyelids, but can also appear in other parts of the body.
• Soreness of the joints. It is accompanied by swelling, redness and other signs of joint diseases.
• Enlargement of the spleen. This phenomenon is detected by palpation.
• Nosebleeds. In the early stages of the development of the disease, they rarely occur, then they are observed almost every day.

The photo shows the external signs of xanthelasma

Nervous disorders

With the development of cirrhosis of the liver and liver failure, the patient has disorders of the nervous system. They can occur both in the early and late stages of the disease. The following disorders appear:

• sleep disturbance and insomnia (during the day a person suffers from drowsiness, cannot fall asleep at night);
• decrease in concentration;
• memory impairment;
• tremor (trembling) of the limbs;
• apathy and indifference to everything that happens.

External signs of the disease

The development of cirrhosis of the liver also affects the appearance of the patient. The first thing that catches the eye is excessive thinness. Also talking about what external signs are characteristic of this disease, the following should be highlighted:

• Fingers. They thicken and take the form of drum sticks. In addition, there is a change in the nail plates. They become reddish.
• Stomach. On the surface of the abdomen, there is an increase in the venous network.
• Telangiectasia. Characterized by the appearance of spider veins on the upper body. With an exacerbation of the disease and the appearance of complications against its background, spider veins become much larger.
• Angiomas. They are benign formations consisting of lymphatic and blood vessels. With cirrhosis of the liver, they are localized in the area of ​​\u200b\u200bthe corners of the eyes and the edge of the nose.
• Language. It acquires a bright color and increases in size (its swelling is noted).
• Face. A person with cirrhosis of the liver has an unhealthy complexion, the cheekbones become pronounced, the salivary glands increase, the capillaries expand.

Manifestations of telangiectasia

In men

In addition to the above symptoms, men may also experience the following signs of liver cirrhosis:

• breast enlargement;
• atrophy of the genital organs;
• loss of hair on the pubis and in the armpits.

Among women

In women, the above symptoms of liver cirrhosis are supplemented by:

• alopecia (hair loss is noted not only on the pubis, but also on the head);
• violation of the menstrual cycle;
• soreness of the mammary glands.

Symptoms of the disease depending on the stage of its development

The symptomatic picture in children and adults with the development of liver cirrhosis is the same. Its intensity and nature directly depend on the stage of development of the disease.

1 stage

This stage of liver cirrhosis is asymptomatic. It can only be detected by laboratory blood tests. At this stage, billiard, alcoholic and primary cirrhosis is manifested only by insufficiency of hepatocytes. This can be corrected by taking special drugs. Doctors call this stage of the development of the disease compensatory. But unfortunately, it comes to light very seldom.

2 stage

This stage of development of cirrhosis is called subcompensated and is characterized by a significant decrease in the functionality of the liver. The patient has changes in his condition. He begins to be disturbed by weakness, nausea, itching, etc. In a laboratory blood test, there is a significant decrease in albumin, the prothrombin index is at around 40.

The prothrombin index should normally be 80–90 units.

3 stage

At this stage (decompensated) of the development of liver cirrhosis, a critical number of functioning hepatocytes is noted. As a result, renal failure begins to actively progress and there is an increase in symptoms, which are complemented by obstructive jaundice and pain syndrome. Most often, it is at this stage of cirrhosis that complications begin to develop. Among them is ascites. It is characterized by the accumulation of fluid in the abdominal cavity and an increase in the volume of the abdomen. It is also possible to develop hepatic coma, peritonitis and sepsis. In laboratory studies, there is a critical decrease in the level of albumin and prothrombin index.

4 stage

This stage of liver cirrhosis is called total. With its development, the functionality of the organ is completely disrupted. A person begins to suffer from constant pain, which is not completely eliminated even when taking strong painkillers. The patient's condition becomes critical and requires constant medical supervision.

It is believed that cirrhosis of the liver is a disease of alcoholics. But this is far from true. Its development can be diagnosed both in an adult and in a small child. Yes, with alcoholism, cirrhosis develops much more often, since the constant effect of ethyl alcohol on the body causes the death of liver cells. But besides alcohol, biliary, toxic, viral, portal or any other type of cirrhosis can also be provoked by:

• viral infections (hepatitis A, B, C, chickenpox, whooping cough, chickenpox, etc.);
• autoimmune diseases;
• oncology;
• chemical and drug poisoning;
• thrombophlebitis;
• heart failure;
• diabetes;
• disturbed fat metabolism, etc.

Improper nutrition can also cause the development of cirrhosis of the liver.

The causes of cirrhosis of the liver are different. And to install them, you will need to undergo a thorough diagnosis. As for the treatment of this disease, it is carried out mainly through the use of special medications and diet therapy.

It is difficult to say how long a person can live after he has cirrhosis of the liver, since everything here depends on the severity and degree of development of the disease, the presence of complications in the patient and his age. But as statistics show, the average life expectancy after diagnosis is about 5 years, but this is only subject to all the doctor's recommendations.

Cirrhosis of the liver is on the 4th place in the list of fatal diseases. To a greater extent, the strong half of humanity suffers from it, but both women and children can get sick. Consider what provokes the occurrence of pathology and whether it can be inherited or in other ways. It is also important to answer the questions why men are in a special risk group, whether the causes of cirrhosis in men and women differ, how it develops depending on the sex of the patient.

Cirrhosis of the liver is a serious disease characterized by a pathological change in the liver tissue, as a result of which it is replaced by fibrous connective tissue (stroma).

The pathogenesis of the disease largely depends on the cause of the pathology, but the general scheme of development is the same. Affecting agents or factors cause necrosis of liver cells. With the progression of necrosis, the liver parenchyma is affected, this happens under the influence of increased intrahepatic pressure. Healthy liver tissue is replaced by fibrous compounds, the structure of the organ also changes dramatically, there is a violation of blood supply and a critical failure in the distribution of bile.

During the development of pathology, the following processes occur:

1. Small blood vessels expand in the body.
2. The bile ducts are actively narrowed.
3. Gradually, there is a narrowing of blood vessels in other organs, including the kidneys.
4. Significantly reduces the flow of blood that exits the intestines to the liver. This provokes increased blood flow through the portal hepatic vein and its expansion.
5. There is a kind of varicose veins in the esophagus (lower part) and stomach. For this reason, the blood is not able to directly enter the liver.
6. With the progression of pathology in the blood, the level of bilirubin begins to rise. This blood component is an icteric-greenish pigment. The accumulated bilirubin causes jaundice. The main symptoms of the disease are an icteric shade of the skin, mucous membranes and sclera of the eyes, dark urine and colorless feces.
7. At one of the last stages, ascites occurs - the accumulation of fluid in the abdominal cavity. Also, the patient develops swelling of the legs.

Cirrhosis is a constant process of scarring of the tissue of an organ, due to which it begins to lose its functional abilities. Over time, complete destruction of the liver occurs, which has irreversible consequences.

By itself, cirrhosis is not a fatal disease and responds well to treatment. However, if treatment therapy is not started in a timely manner, the liver completely loses its viability, which can lead to the death of the patient.

Etiological factors

Preventing the development of cirrhosis, especially for people who already have impaired liver function, should become the rule of life. But in order to understand what exactly needs to be done in order to prevent complications, it is important to know the causes of the disease.

The main types of pathology

There are several forms of pathology, each of which has its own causes of development:

cardiac form. The main cause of the development of pathology is heart failure. With this pathology, stagnant processes occur, against the background of which a failure begins in the systemic circulation. This is primarily due to the long-term impaired functioning of the right ventricle of the heart muscle. Prolonged swelling eventually leads to the death of liver cells, in place of which scars form. These processes lead to:

• diabetes;
• alcohol addiction;
• hypertension;
• lung disease;
• heart disease. The danger is both congenital and acquired type of pathology.



biliary form. The main reason for the development of this form of pathology is the presence of autoimmune diseases. In the patient's body, antibodies are produced to the cells of the intrahepatic bile ducts. This provokes a violation of the secretion of bile, as a result of which it begins to accumulate in the liver. Gradually, liver cells die, and fibrous connective tissue forms in their place.

Such processes occur in the presence of infectious diseases. With the active activity of viruses and bacteria, a kind of breakdown of the immune system occurs and the production of autoimmune antibodies begins. Doctors managed to prove that the biliary form of pathology can occur due to a genetic predisposition.

Alcohol form. One of the most common forms of the disease in the Russian Federation. The main cause of the pathology is the long-term harmful effects of alcohol on liver cells. Doctors note that it is ethanol that causes the greatest toxic harm to the body. The alcoholic form of the disease occurs with regular and prolonged use of alcoholic beverages.



Many experts believe that cirrhosis can only develop if you consume strong alcohol for at least 15 years. However, this is a highly controversial opinion. The destruction of the liver under the influence of alcohol occurs much faster, and low-alcohol drinks taken regularly and in large volumes can also provoke it.

toxic form. With this form of pathology, toxins and poisons, their toxic effect on the body, are the cause of the death of liver cells. The etiology of the disease is very diverse:

• drug poisoning (special danger is represented by antipyretic, anti-tuberculosis, anti-inflammatory, anticonvulsant drugs and sulfonamides);
• poisoning with poisons of industrial production (poisonous substances include pesticides, arsenic, phosphorus, phenol, insecticides, aldehydes, oil products);
• poisoning with poisons of plant origin (the most dangerous include mushrooms, herbs and mold). Among the especially poisonous herbs are mustard and cross.



portal form. The cause is high pressure in the hepatic portal vein. Its increase leads to a slowdown in blood flow in the liver, resulting in stagnant processes. As a result, swelling and death of some liver cells. Become the cause of the portal form of cirrhosis can:

• viral hepatitis;
• alcoholism;
• poor quality food. When eating unbalanced, fatty foods, the risk of this type of cirrhosis is high.
• Viral form. The main provocateur of the occurrence is viral hepatitis of groups B and C.
  

  The viral form of cirrhosis is recognized as the most severe and most difficult to treat.

• postnecrotic form. Pathological changes occur in the liver - nodes of connective tissues form in the place of damaged, dead liver tissues. Cirrhosis can be provoked by:

  • hepatitis of any form;
  • alcoholism;
  • complications against the background of biliary and toxic cirrhosis. Postnecrotic cirrhosis has a second name - large-nodular form of the disease.

Heredity and infection

Having thoroughly familiarized yourself with all types of cirrhosis, you can understand that their etiology is more than diverse, and not all of them are acquired: the biliary form of pathology can be inherited. Doctors note that it is not uncommon for newborns to have a congenital pathology - an anomaly of the biliary system.

It is characterized by underdevelopment of the bile ducts. Cirrhosis can also be a consequence of a genetic pathology, consisting in an altered composition of bile. In the presence of such a violation, thickening and blockage of small intrahepatic ducts occurs.

Cirrhosis is a non-infectious disease, so it cannot be infected in the full sense of the word, but it is quite possible to become infected with one of the hepatitis viruses, which will subsequently lead to the development of pathology. Infection can occur at home, through blood, from mother to child during childbirth. Sometimes it is possible to infect the fetus transplacentally. In this case, cirrhosis can develop in a child in utero.

Psychosomatics

There is another interesting interpretation of the etiology of cirrhosis. We are talking about psychosomatic reasons. Psychologists say that many diseases in the human body are directly or indirectly related to the emotional state of a person. Stress and anger, in particular, can provoke cirrhosis.

So, with a nervous shock, a person begins to seize or drink problems. The tastier and fatter the food, the supposedly faster stress passes. For many, the best antidepressant is alcohol and drugs. That is, running away from failures in his own life, a person exposes his liver to serious danger. From such methods of relieving stress, the liver primarily suffers.

Another possible cause of cirrhosis is a feeling of anger. Many people are dissatisfied with their lives, work, personal relationships, from this they begin to experience negative emotions. The brain, finding no way out for emotions, directs a destructive effect on the internal organs, in particular the liver, since it is directly responsible for cleansing the body.

Features of development in men and women

Doctors say that the factors for the development of cirrhosis may differ slightly depending on the gender of the patient. Consider these features:

You can prevent the development of cirrhosis in the following ways:

1. Exclude alcohol. The most common factor in the development of cirrhosis in both men and women is alcohol.

   The most elementary way to prevent a dangerous disease is to eliminate or minimize the consumption of alcoholic beverages!

2. Eat right, consume plenty of fruits and vegetables, limit the intake of fatty and fried foods. You also need to reduce your salt intake.
3. Be attentive to your health, in the presence of any ailments and diseases, treat them immediately.
4. When planning a pregnancy, a woman needs to undergo a thorough examination, in case of detection of pathologies, undergo therapy. This minimizes the risk of hereditary transmission of the disease.

Preventive measures should also be aimed at maintaining the most healthy lifestyle, moderate exercise, and the correct daily routine.

Cirrhosis of the liver is caused by a variety of diseases that damage healthy liver cells over time. Ultimately, the lesion leads to a violation of the normal structure and all functions of the liver. Cirrhosis of the liver is a chronic disease caused by damage to healthy liver tissue.

Cirrhosis is much more common in men than in women, with an average ratio of 1:3. The most susceptible to the disease are people over 40 years of age. According to statistics, more than 350 thousand people die from cirrhosis every year in the world, and every year these numbers are growing.

The disease leads to disappointing consequences:

• Progressive decline in liver function
• Excessive accumulation of fluid in the abdomen (ascites)
• Blood clotting disorder (coagulopathy)
• Increase in blood pressure
• Disorders of the functions of the brain (hepatic encephalopathy) and blood vessels (portal hypertension).

Excessive alcohol consumption is the main cause of cirrhosis of the liver. In addition to alcohol, increasing fibrosis is caused by viruses and many other diseases. There is a replacement of healthy tissue with scar tissue, however, cirrhosis of the liver leads to significant changes in the flow of blood and bile from the liver.

Such changes in blood and bile, in turn, lead to serious consequences:

• Small blood vessels appear in the liver, and the bile ducts narrow
• Gradually, blood vessels constrict in other organs, including the kidneys.
• The flow of blood leaving the intestines to the liver also decreases and seeks other routes through the portal vein system.
• In the stomach and lower part of the esophagus, the so-called varicose veins form, due to which the blood flow does not reach the liver
• Bilirubin (yellow-green pigment) begins to accumulate in the blood, leading to jaundice, the main signs of which are a yellowish tint of the skin and eyeballs, as well as dark urine.
• Fluid (ascites) begins to accumulate in the abdominal cavity, and swelling appears on the legs

Causes of cirrhosis of the liver

Cirrhosis of the liver is a disease that is characterized by permanent scarring of the liver, which directly affects its normal functionality. Processes that can lead to cirrhosis of the liver:

- Alcoholism. Chronic alcoholism compromises the healthy functioning of the liver by causing alcoholic liver disease. Such a disease contributes to the development of fatty liver disease, alcoholic hepatitis (inflammation of the liver caused by drinking), and alcoholic cirrhosis of the liver.
It is known that in the USA alcoholic cirrhosis of the liver is the main type of liver cirrhosis and occurs in 10-20% among heavy drinkers after 10-15 years of excessive alcohol consumption (70 grams of pure alcohol per day for men and 30 grams per day for women ) People who not only drink a lot, but also suffer from hepatitis C are at particular risk. Alcohol itself leads to cirrhosis of the liver, which turns into a chemical that damages healthy tissues.

- Chronic hepatitis B and C. Chronic viral hepatitis, such as hepatitis B and hepatitis C, is the second leading cause of cirrhosis of the liver. For example, chronic hepatitis C is most prevalent in developed countries, while hepatitis B is prevalent worldwide, especially in sub-Saharan Africa and parts of Asia.
The main risk group is people with chronic hepatitis C, since this disease, if not properly treated, almost always ends in cirrhosis.

Viral hepatitis leads to inflammation of the liver cells, which contributes to its destruction. Gradually, cell destruction progresses and leads to the appearance of scar tissue. In the later stages, the liver even shrinks in size, a condition called post-necrotic or behind-hepatic cirrhosis of the liver.

The main risk group includes people who inject drugs through needles, including healthcare workers and emergency workers.

- Autoimmune hepatitis. Autoimmune hepatitis, like other autoimmune diseases, develops when the immune system is impaired, that is, when the system attacks the body's own cells and organs. For people who suffer from autoimmune hepatitis, a specific condition is characteristic: lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome, scleroderma, inflammatory bowel disease, glomerulonephritis and hemolytic anemia.
Autoimmune hepatitis usually occurs in women between the ages of 15 and 40.

- Diseases of the bile ducts. Especially disorders that block or damage the bile ducts. Stagnation of bile in the ducts contributes to inflammation of the ducts and all this leads to cirrhosis of the liver. Enough 6-18 months of hornic blockage of the ducts and cirrhosis may occur.

- Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. Non-alcoholic fatty liver disease (NAFLD) resembles alcoholic liver disease but is more common in people who do not drink alcohol heavily. This disease is especially prevalent in the United States.

In addition, NAFLD includes a progressive spectrum of liver disease. Moreover, non-alcoholic fatty liver disease is the earliest stage of NAFLD. The disease is characterized by the presence of fat in the liver (steatosis), the destruction of which has not yet occurred. Fatty liver disease is not yet considered a serious disease.

Non-alcoholic steatohepatitis (NASH) is the next stage of liver cirrhosis. This disease is characterized by inflammation of the liver and signs of fatty liver. NASH is dangerous because it can lead to scarring of the liver. In addition, it is NASH that is one of the main causes of liver cirrhosis. In other words, cirrhosis of the liver is the final irreversible stage of non-alcoholic fatty liver disease.

Obesity and diabetes are the two main causes of NAFLD. Another important factor is considered to be metabolic syndrome, which includes a combination of risk factors: abdominal obesity, unhealthy blood lipid levels, high blood pressure and insulin resistance.

Non-alcoholic fatty liver disease refers to benign tumors that progress very slowly. In some patients, this condition can lead to cirrhosis of the liver and eventually liver failure. NAFLD also increases the risk of cardiovascular disease, which is the leading cause of death.

- Metabolic disorders. These diseases, first of all, include hemochromatosis or a disorder of iron metabolism in the body. This disease leads to the fact that iron is absorbed from food and accumulates excessively in organs and tissues. An excess amount of iron in the liver just causes cirrhosis.

- Heredity. Hereditary diseases that can cause cirrhosis of the liver include:

• Wilson (causes accumulation of copper in the body)
• Alpha-1 antitrypsin deficiency (a genetic disorder caused by a defect in a specific enzyme)
• Glycogen diseases (groups of diseases that lead to an abnormal accumulation of glycogen in the liver)

- Chemicals and drugs. Long-term exposure to drugs or harsh chemicals, including arsenic, the drug methotrexate, toxic doses of vitamin A, and certain prescription drugs.

- Venous congestion in the liver - most often caused by constrictive pericarditis, veno-occlusive disease, and can also be caused by heart failure.

Unfortunately, it is often impossible to identify the cause that caused cirrhosis, in which case it is called cryptogenic cirrhosis. These cirrhosis include primary biliary cirrhosis of the liver (PJLC). Primary biliary cirrhosis of the liver up to 95% of cases occurs in women under the age of 50 years. In people with PAC, the immune system weakens and destroys cells in the bile ducts of the liver. As with many other autoimmune diseases, the cause of PCOS is unknown.

Symptoms of cirrhosis of the liver

In the clinic for the development of cirrhosis of the liver, two stages of the course of the disease are distinguished: compensated and decompensated.

1. Compensated cirrhosis of the liver(according to the international classification, this is class A). This is the initial stage of cirrhosis and the body is still functioning quite well, there are no pronounced symptoms of the disease, despite the damage and scarring of the liver tissue.

At this stage, it is important to find out the cause of the disease, which will save the rest of the liver from destruction.

2. Decompensated cirrhosis liver (classes B and C). The appearance of scars is observed, and the most important functions of the body are violated. Patients develop many serious and life-threatening symptoms and complications.

Symptoms of compensated cirrhosis of the liver include:

• Fatigue and loss of energy
• Changes in consciousness and behavior
• Loss of appetite and weight loss
• Nausea and abdominal pain
• Bleeding gums
• Darkening of the urine
• Discoloration of feces
• Yellowness of the skin and eyes
• Swelling of the legs
• Skin itching
• Ascites is the accumulation of fluid in the legs (edema) and in the abdomen.
• Dull or aching pain in the liver
• Foci of angiomas on the skin (red spots the size of a pinhead, "spider veins")
• Palmar erythema - reddish and patchy palms.
• Frequent bacterial infections (respiratory tract, etc.)
• Decreased sexual activity
• Male breast enlargement and/or testicular shrinkage
• Enlargement of the spleen

Diagnostics liver cirrhosis

- Physical examination. At this stage, the following abnormalities are detected in patients with cirrhosis of the liver:
The liver is hardened and often enlarged in the early stages of the disease. (In the later stages of cirrhosis, the liver may shrink and shrivel.)
A swollen abdomen is checked for ascites by palpation and listening to the wave movements of the fluid.
The doctor will also check for signs of jaundice, muscle atrophy; in men - an increase in the mammary glands.
The patient's medical history is another indicator of the risk of liver cirrhosis. Basically, these are patients affected by alcoholism, hepatitis B or C and some other diseases.

- Blood tests. Blood tests are also done to measure the activity of liver enzymes related to liver function. Enzymes known as aminotransferases, including aspartate (AST) and alanine (ALT), are released when the liver is damaged. Blood tests can also reveal:

• Serum albumin concentration. Serum albumin levels in the blood (low levels indicate poor liver function).
• prothrombin time. This is the time required for the patient's blood plasma to clot (the longer, the greater the risk of bleeding).
• Alkaline phosphatase. High levels of ALP may indicate blockage of the bile ducts.
• Bilirubin. One of the clearest indications of liver damage is bilirubin, a red-yellow pigment that is normally metabolized in the liver and then excreted in the bile. In patients with hepatitis, the liver cannot process bilirubin and the substance builds up in the blood, sometimes causing jaundice.

- visualization methods. Magnetic resonance imaging (MRI), computed tomography (CT), ultrasound can be useful in identifying and identifying complications in the course of diseases such as ascites and hepatocellular carcinoma. These examination methods can also provide information about the extent of liver damage.

- Biopsy. Liver biopsy is the only productive method to confirm the diagnosis of liver cirrhosis. It also helps to determine its causes, treatments, extent of damage and make predictions. For example, biopsy results in patients with chronic hepatitis C who have mild liver scarring have shown a low risk of cirrhosis.
The biopsy procedure takes about 20 minutes. It is performed under local anesthesia and patients may feel pressure and some dull pain. Guided by ultrasound data, the doctor uses a thin needle to take a small sample of liver tissue for examination. A biopsy may be performed using a variety of approaches, including:

1. Percutaneous liver biopsy. In this method, a needle is inserted through the skin in the region of the liver to obtain a sample of liver tissue. Various needle shapes are used that allow suction or cutting of the tissue to be examined. This method is contraindicated in bleeding patients and should be used with caution in patients with ascites or obesity.

2. Transvenous liver biopsy. This method uses a catheter (thin tube) that is inserted into the jugular vein in the neck and passed through the hepatic vein to the liver. The catheter along with the needle, having a suction device, collects liver samples. This procedure is quite risky, but it can be used for patients with severe ascites.

- Laparoscopy. The procedure is quite effective for detecting liver cancer, ascites and some other pathologies. During laparoscopy, a small incision is made in the abdominal wall, through which the doctor inserts a thin tube containing small surgical instruments and tiny cameras to view the surface of the liver.

- Endoscopy. Some doctors recommend endoscopy in patients with early symptoms of liver cirrhosis to detect esophageal varices and prevent the risk of bleeding. In this procedure, a fiber optic tube is inserted into the larynx. The tube contains tiny cameras that allow you to examine the esophagus to identify areas where varicose veins may develop.

- Paracentesis. This procedure is performed to determine the causes of existing ascites. To carry it out, a thin needle is used, with which fluid is taken from the abdominal cavity and checked for various factors to identify the cause of ascites:

Culture of bacteria and white blood cells. (They are used to diagnose an infection.)
- Protein level. The low level of protein in the fluid, as well as the low content of white blood cells, suggests that it was cirrhosis that caused the ascites.

- Tests for liver cancer. Some doctors recommend that patients with cirrhosis be re-examined every 6 months to detect the development of hepatocellular carcinoma cancer. This is done using both blood tests to check AFP levels and imaging techniques (ultrasound, MRI, or CT).

Treatment of cirrhosis of the liver

Cirrhosis of the liver is an incurable disease. Treatment is done to slow the progression of liver damage and reduce the risk of further complications. Currently, there are no drugs to treat liver scarring, but at the same time, scientists are studying various types of anti-fibrotic drugs.

Treatment of liver cirrhosis also depends on the cause of the disease.

- Chronic hepatitis. Many types of antiviral drugs are used to treat chronic hepatitis B, such as PEG interferon, nucleoside analogs, and nucleotide analogs. Patients with chronic hepatitis C received PEG-interferon and ribavirin in combination therapy. In 2011, two new combination therapy drugs, Telaprevir (Incivek) and Boceprevir (Victrelis), were approved for hepatitis C.

- autoimmune hepatitis. Autoimmune hepatitis is treated with the corticosteroid prednisolone and sometimes immunosuppressants such as azathioprine (Imuran).

- Bile duct disorders. Ursodeoxycholic acid, which is a natural component of human bile, also known as ursodiol or UDCA, is used to treat primary biliary cirrhosis but does not slow its progression. Modern preparations containing UDCA include: Ursosan, Ursofalk, Ursodez, Ursohol, Ursoliv.
Itching is usually relieved by cholesterol medications such as cholestyramine (Questran) and colestipol (Colestide).
Antibiotics and drugs that have an immunosuppressive effect (Prednisolone, Azathioprine, Cyclosporine, Methotrexate) can also be used to treat infection in the bile ducts. Sometimes, in order to open the bile ducts, they resort to surgical intervention.

- Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (BASH)). The main approaches to the treatment of these diseases (including diabetes and high cholesterol) are weight loss through diet and exercise.

- Hemochromatosis. Hemochromatosis is treated with bloodletting, a procedure that involves removing some blood once or twice a week while maintaining normal iron levels.

- Treatment of ascites. The first step in the treatment of patients with ascites (fluid accumulation in the abdominal cavity) includes the following:

• Limiting salt intake (usually less than 15 mg per day)
• Drug treatment with diuretics such as Spironolactone (Aldactone) and Furosemide.
• Complete abstinence from alcohol
• Fluid restriction is usually not required if blood sodium levels are low.
• Patients with ascites who are not helped by conventional diuretics may need procedures to reduce fluid in the abdomen after a month of illness (refractory ascites). For the treatment of ascites or for complications, paracentesis (removal of fluid from the abdominal cavity using a thin needle) can be used.

All patients with cirrhosis of the liver can improve their condition through lifestyle changes. This includes:

- Refusal to drink alcohol. It is very important for people with cirrhosis to completely abstain from alcohol.

- Limit your salt intake. Sodium (salt) increases the amount of fluid in the body. Eating a variety of foods every day will help you limit the intake of salt in your body. It is best to have fresh vegetables and fruits on the menu and avoid processed foods whenever possible.

- Eating healthy food. People with cirrhosis of the liver tend to eat poorly and require more calories and nutrients (on the other hand, excess protein can lead to hepatic encephalopathy). You should also avoid raw seafood, shellfish, which carry the risk of blood poisoning (sepsis). For more detailed recommendations, you can contact a nutritionist.

- Get vaccinated. Patients with cirrhosis should ask their healthcare provider which vaccinations (eg, hepatitis A, hepatitis B, influenza, pneumococcal pneumonia) they need.

- Discuss medication with your doctor. Before taking any medications (including over-the-counter pain relievers such as acetaminophen), ask your doctor if they are safe for you. Liver damage affects drug metabolism. Patients with cirrhosis of the liver should not take non-steroidal anti-inflammatory drugs (NSAIDs) such as Aspirin, Ibuprofen and Naproxen as they can cause bleeding, worsen the condition, and possibly lead to kidney failure.

Let your doctor know what herbs or supplements you are considering taking.

Herbal treatment.Certain types of herbs (kava, chaparral, kombucha, mistletoe, pennyroyal, and some traditional Chinese herbs) may increase the risk of liver damage. While individual herbs such as milk thistle have been studied for possible beneficial effects on liver disease, there is no scientific evidence that they can help.

Liver transplant

A liver transplant, or liver transplant, is an operation to remove a diseased or damaged liver and replace it with a healthy one.

• Liver damage due to alcoholic cirrhosis of the liver;
• Primary biliary cirrhosis;
• Chronic active infections such as hepatitis
• Thrombosis of the hepatic vein;
• Congenital defects of the liver or bile ducts (biliary atresia);
• Metabolic disorders associated with liver failure (for example, Wilson's disease).

Complications liver cirrhosis

Liver damage affects almost every system in the body. The functions of the digestive, hormonal and circulatory systems are disturbed. With decompensated cirrhosis of the liver, the risk of serious and very life-threatening complications increases. (Without decompensated liver transplantation, mortality can be as high as 85% within 5 years.)
The most serious complications are associated with portal hypertension (increased pressure in the portal vein, which carries blood from the intestines to the liver). They include:

- Varicose bleeding(bleeding from the stomach and esophagus, due to rupture of blood vessels).

- Spontaneous bacterial peritonitis is a form of peritonitis (inflammation of the abdominal wall) associated with ascites. Other bacterial infections can also cause complications of liver cirrhosis.

- Hepatic encephalopathy(brain dysfunction). Loss of the liver's ability to neutralize harmful substances can lead to brain dysfunction and coma. Hepatic encephalopathy is manifested by various disorders of consciousness, intelligence, behavior, neuromuscular disorders. In severe cases, hepatic encephalopathy progresses to a coma.

- Liver cancer. Long-term and progressive development of cirrhosis is a serious risk for the occurrence of liver cancer and other serious complications in the course of the disease. Hepatitis B and C, alcoholism, hemochromatosis, primary biliary cirrhosis and other causes of cirrhosis are fundamental factors that provoke the development of cancer. Cirrhosis of the liver due to hepatitis C is one of the most common causes of hepatocellular carcinoma.

- Ascites. This is an accumulation of fluid in the abdomen caused by a combination of portal hypertension (high pressure in the blood vessels, liver) and low albumin levels. Albumin is a protein produced in the liver. Ascites can also lead to poor breathing and other functions. By itself, it does not pose a mortal danger, but can be a harbinger of severe and serious processes occurring in the body.

- Hepatorenal syndrome is associated with severe kidney damage resulting from a sharp reduction in blood flow to the kidneys in response to altered blood flow to the liver. This is a life-threatening complication in the late stage of liver damage that occurs in patients with ascites. Symptoms include darkening and decreased urine volume, yellowish skin, bloating, mental changes (eg, delirium and confusion), muscle twitching, nausea, and vomiting.

- Bleeding from varicose veins. One of the most serious consequences of portal hypertension is the development of varicose veins. Due to the fact that the normal blood flow through the liver is disturbed, the veins passing through the esophagus and stomach become an alternative route for transporting blood. However, thin-walled and deformed veins are at high risk of rupture and bleeding, which is life threatening. Symptoms include bloody vomiting or black and tarry stools.

- Hepatic encephalopathy. Psychiatric disorders are typical manifestations in patients with cirrhosis of the liver. In severe cases, the disease causes encephalopathy (brain dysfunction), with mental symptoms that range from confusion to coma and can eventually lead to death. Hepatic encephalopathy is caused by a buildup of harmful intestinal toxins, particularly ammonia, in the blood, which then accumulates in the brain. Encephalopathy can be caused by many different factors, including internal bleeding, infections, constipation, and dehydration.
Early manifestations of hepatic encephalopathy include confusion, forgetfulness, and trouble concentrating. Sudden changes in the patient's mental state, including agitation or confusion, may indicate pathological conditions. Other symptoms include bad breath and tremors. In the later stages, symptoms of encephalopathy are stupor and eventually coma.

- Kidney failure. Portal hypertension and spontaneous bacterial peritonitis can lead to a number of secondary complications, including renal failure. Non-steroidal anti-inflammatory drugs - such as ibuprofen, naproxen, and aspirin - can also cause kidney failure in patients with cirrhosis.

- Osteoporosis. Many patients with cirrhosis of the liver can develop osteoporosis, a condition characterized by a progressive decrease in bone density, thinning, and a tendency to fracture. Osteoporosis can be caused by an unbalanced diet, hormonal deficiency, or old age. Regular exercise and vitamin and mineral supplements can reduce and even prevent bone loss.

- Insulin resistance and type 2 diabetes. Cirrhosis of the liver often causes insulin resistance, resulting in excess sugar (glucose) and its accumulation in the blood, leading to type 2 diabetes. In turn, type 2 diabetes is also a risk factor for non-alcoholic fatty liver disease, which is one of the causes of liver cirrhosis.

- Heart problems. Cirrhosis of the liver can increase the risk of heart failure and other cardiovascular complications.