the disease, which can be characterized by the growth or hardening of the connective tissue. Typically, this process is a response to the impact of any irritants toxins, including excessive amounts of alcohol infections of various etiologies, including viral hepatitis, uncontrolled intake of drugs. In such cases, it may happen necrosis or degeneration of the tissues of the body. Uncontrolled disease can lead to cirrhosis of the liver.
Fibrosis of the liver in the initial stage is an asymptomatic process, the essence of which is to effect the protective properties of the body in order to maintain full activity of the structure of the affected organ. All actions aimed at recovery of cells and the elimination of scars. However, due to chronic damage to the regeneration process broken, and, as a consequence, an increase in tissue exceeds the rate of its destruction. Thus, there is a violation of the architectonics of the liver, leading to
Accordingly, fibrosis of the liver possible for all diffuse disease with a chronic course, which is a sign of constant development of the disease. The determination of the stage of liver fibrosis is an important criterion for the purpose of therapeutic treatment and conclusions regarding the prognosis of the disease. The importance of a correct assessment of the stage of liver fibrosis determines the consequences of its development, its conventionally divided into three types
- violation of intracellular metabolism between liver and blood. Ejection of the blood from bringing vessels into the hepatic vein leads to the movement of blood past the liver cells. The liver is unable to perform its basic functions
- chronic liver disease in the stage of progression in the direction of cellular metabolism leading to cirrhosis of the liver. Reduces the effectiveness of therapeutic interventions
- successfully performed the therapy with the elimination of exposure to the pathogen (hepatitis viruses of different kinds), alcohol can lead to regression of fibrosis.
Based on the reasons that led to the emergence of the disease, fibrosis of the liver are distinguished in three main types
nezirroticski portal fibrosis, possible hepatitis, toxic and
and as a consequence
and various infections
- periportally caused by infection with schistosomiasis
- congenital hepatic fibrosis is caused by a violation of metabolism transmitted genetically.
On which area of the liver slices started the process of the disease based on the causes and distribution fibrosicistica process, fibrosis of the liver are divided into forms
- perivenular and venular fibrosis. Affects the Central part of the lobules. Usually found in chronic cardiac failure, chronic alcoholic hepatitis
- pericellular affects the tissues around the liver cells (hepatocytes). Usually found in alcoholic liver disease and chronic viral hepatitis
- septal arises from multiple necrosis of the liver cells, resulting in an interruption of the blood supply, leading to necrotic events. This can happen in viral hepatitis. The result of the violation of the structure of the lobules of the liver
- portal and periportal fibrosis was the hallmark of chronic hepatitis of various types and forms
- peridocially fibrosis process in which a concentrated fibrous tissue grows around the bile canaliculi. Possible with sklerosiruuschem
- mixed the most common form of fibrosis. It mixed many of the features of all forms in different ratios
- cardiac fibrosis of the liver, often found in diseases cardiologic, especially of the right ventricle of the heart.
The process of development of liver fibrosis is very slow. For several years signs of liver fibrosis itself does not show. Typically, the first complaints appear after 5 years from the onset of the disease. One of the first manifestations of a lesion of the spleen that can lead the doctor astray. It is therefore necessary to conduct a complete examination of the patient, to make medical history and only the results it is possible to diagnose hepatic fibrosis. For the initial stage is characterized by a decrease in the level of leukocytes, erythrocytes and platelets and enlarged spleen. The patient pronounced anemia and thrombocytopenia. If the disease moves into a stage of liver cirrhosis, there is varicose veins in the esophagus and bleeding from them. Sometimes you can see the enlarged liver and this can be attributed to positive predictions, as it is still valid and is opposed to damaging factors, using available reserves. When stages of cirrhosis of the liver size is greatly reduced.
When the disease is liver fibrosis, which is the causative agent of schistosomiasis (Schistosoma mansoni), the first symptoms manifest themselves after 10 years after infection. In this case, the patient’s enlarged spleen and liver, occasional vomiting bloody discharge. The General condition is satisfactory. Fibrosis of the liver, the symptoms of which manifest themselves only many years later, requires a comprehensive treatment.
Diagnosis of liver fibrosis is intended to establish the type of fibrosis and the cause that led to the development of fibrosis. Assume fibrosis is possible if the patient has chronic liver disease. This can be based on the data of biochemistry and ULTRASOUND studies. The degree of liver fibrosis can be determined by biopsy of the damaged organ.
Treatment of liver fibrosis are needed, after the diagnosis and diagnosis. Immediate execution of complex therapeutic interventions due to the fact that the disease may for six months to evolve to the state of cirrhosis.
Diet for fibrosis of the liver is one of the priority assignments. Need to make a balanced menu, eliminating all the foods that make liver work harder, as recommended by the doctor to limit salt intake. It is obligatory to refrain from taking alcoholic beverages of any strength. The possible refusal of a number of medical drugs that have been used by the patient before.
Drug therapy includes the elimination of the causes of the disease and minimize the pathologic processes. Usually prescribed
- hepatoprotectors (drugs of different groups)
- immunomodulators (mainly preparations of thymus)
- immunosuppressants (glucocorticoids and cytotoxic agents).
If necessary, by the decision of the physician and may treated with antibiotic therapy (to exclude primary infection), the treatment of alcohol dependence, obesity, normalization of glucose in the blood, stabilization of the cardiac system.
In some cases, possible surgery. To prevent bleeding from veins of the esophagus spend sewing them by gastrotomy or endoscopic sclerosing. And in severe hypersplenism is necessary to remove the spleen. Liver fibrosis, the prognosis of which depends on the species, more favorable than the prognosis of cirrhosis. Regular preventive maintenance is necessary. These activities include the elimination of causes that have a negative impact, can trigger the development of the disease. It is necessary to exclude drugs that can cause liver damage. A course of treatment for viral hepatitis in the chronic form of the flow, eliminate alcohol (if necessary, consult a specialist for help), to normalize lipid metabolism, and any disorders of metabolic processes in the body. Regularly use therapy.
Prevention of shistosomozy is in compliance with hygienic measures. It is necessary to avoid pools of standing water. For drinking it is necessary to use purified water or boiled. Prevention of congenital hepatic fibrosis is to research through genetic testing families with hereditary predisposition. That is, in cases where there are relatives with the disease is liver fibrosis or Wilson’s disease, deficiency of alpha-1-antitrypsin, galactosemia, phenylketonuria, tyrosinemia, hemochromatosis, glycogenosis (III, IV, VI, IX and X types).