Abuse of alcoholic beverages entails many diseases. The liver suffers most of all, which loses the ability to neutralize poisons. Therefore, addicted to alcohol often reveals alcoholic hepatitis, which can develop into cirrhosis.
Alcoholic hepatitis
Alcoholic toxic hepatitis in medicine is called clinical jaundice, accompanied by laboratory syndromes of cytolysis and cholestasis. This is a combination of inflammatory and degenerative processes in the body, the development of which is due to prolonged intoxication.
The risk of alcoholic hepatitis increases with increasing doses and the duration of drinking alcohol. The strength of drinks in this case does not matter.
Toxic hepatitis is formed gradually and very slowly, so it is very rarely detected at the initial stage. Initially, fatty liver dystrophy is formed, and jaundice subsequently develops. If the disease is not treated, eventually it will flow smoothly into cirrhosis with a real threat to life.
Alcoholic hepatitis is a threat to the patient, but for the surrounding danger is not. Unlike viral forms of the disease, it is not transmitted with blood.
Reasons for
Toxic hepatitis is a disease characteristic of chronic alcoholics. Therefore, its main reason to identify is simple: the damage of the liver with ethanol and the products of its decay.
Organisms are all different, so some people risk getting sick even if they are abused on an ad-hoc basis. However, it will not be possible to escape from the disease if there is regular drunkenness for 5 years and drinking a day from 100 grams of alcohol in terms of pure alcohol. The more a person drinks, the harder hepatitis will be.
There are 4 main causes of liver damage as a result of alcohol abuse:
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- Rapid death of hepatocytes.
- Deficiency of cell nutrition.
- Intensive formation of connective tissue.
- Suppression of protein production in hepatocytes.
When entering the body of ethanol, the liver begins to actively extract enzymes involved in the detoxification of toxins. However, with large amounts of alcohol, the body does not cope with its functions.
Because of the narrowing of the vessels that causes alcohol, blood circulation deteriorates. The liver loses oxygen, so its cells shrivel and die. The connective tissue is replaced by scar tissue.
In addition, alcohol blocks the production of protein in hepatocytes, as a result of which they recruit water and swell. The liver eventually increases in size.
There are also a number of factors that significantly increase the risk of serious liver damage and the development of
toxic hepatitis:
- A one-time drink of a large amount of alcohol.
- Regular abuse for 5 years and longer.
- Genetic predisposition.
- Lack of protein food in the diet.
- Systematic overeating.
- Obesity.
- Viral hepatotropic infections.
On the influence of alcohol on the liver:
Forms
The intensity of development distinguishes between acute and chronic hepatitis, and the nature of the flow - persistent and progressive. The amount of alcohol consumed and the initial state of the organism affect the form of the disease.
The first signs appear after leaving a long drinking-bout. The severity of symptoms depends on the stage of the disease. Initially, the disease often does not manifest itself in any way, but in the absence of treatment complications develop that develop into cirrhosis.
Persistent
Alcoholic hepatitis in a persistent form is detected only by results of laboratory tests. Symptoms are poorly expressed, therefore the person for a long time does not guess about the illness. This causes the difficulties of timely diagnosis.
To few signs of persistent toxic hepatitis include:
- severity under the ribs on the right;
- mild nausea;
- belching;
- feeling of discomfort in the stomach.
Symptoms appear periodically and disappear by themselves. In this regard, the patient usually takes them for the usual malaise and does not see the need to go to the hospital.
If the patient does not seek medical help, persistent hepatitis changes into a progressive form.
Progressive
Progressive form of the disease is detected in 20% of all patients with toxic hepatitis. The general well-being of a person is significantly worsened, and foci of necrosis are formed in the hepatic tissue. At this stage it is very important to begin treatment, otherwise serious complications will develop.
Characteristic symptoms of progressive toxic hepatitis are:
- jaundice of mucous membranes and skin;
- diarrhea;
- vomiting;
- fever;
- pain under the ribs on the right.
Symptoms may be stronger or weaker, depending on the stage - mild, moderate or severe. Without qualified treatment, cirrhosis develops, and the risk of death due to acute liver failure increases dramatically.
With timely access to the hospital, it is possible to achieve stabilization of inflammatory processes. However, the residual phenomena will remain forever.
Acute
Acute hepatitis occurs usually against the background of a prolonged course of other hepatic diseases - cirrhosis, chronic hepatitis, in which a person continues to drink alcohol. The disease can occur in icteric, fulminant, latent and cholestatic forms.
In most cases, jaundiced toxic hepatitis is diagnosed, in which favorable soil is formed for the development of bacterial infections.
The disease is accompanied by characteristic symptoms, among which:
- yellow coloration of mucous membranes and skin;
- general weakness;
- pain under the ribs;
- nausea with vomiting;
- stool disorders;
- significant weight loss.
During the latent period, toxic hepatitis is poorly expressed. At this time, the detection of the disease is possible only according to the results of laboratory tests. In the blood there is an increased concentration of hepatic transaminases, and a biopsy confirms the presence of a progressive inflammatory process.
With cholestatic flow of the disease, jaundice is accompanied by itching. The feces of the patient lightens, and urine - on the contrary, darkens.
Chronic
The cause of chronic alcoholic hepatitis is the systematic exposure of ethyl alcohol to the liver.
The main symptoms of the disease include:
- bloating;
- nausea;
- lack of appetite;
- pain under the ribs on the right;
- sleep disorders;
- decreased libido;
- increase in liver size;
- decreased production of androgens;
- breast augmentation in men;
- fever.
Signs of alcoholic hepatitis in both men and women vary significantly in each case, making diagnosis difficult. There may be multiple signs or only one, and in some cases, the disease is not manifested. The diagnosis is based on a medical examination, during which an increased amount of transaminases in the blood and changes in the liver are recorded.
Diagnostics
In the process of diagnosis of alcoholic hepatitis, laboratory and apparatus methods of investigation are used. The choice of specific activities is determined by the form of the course of the disease. For example, with a latent flow, a biopsy of the liver is required to confirm the diagnosis, and in case of chronic course it is necessary to perform ultrasound of the peritoneal organs.
The patient is assigned the following laboratory tests:
- general blood test;
- general urine test;
- blood biochemistry;
- liver samples;
- coagulogram( evaluation of blood coagulability);
- lipidogram( blood test for cholesterol).
In the presence of toxic hepatitis in the blood, a reduced concentration of leukocytes, platelets and hemoglobin, as well as accelerated sedimentation of erythrocytes. The urine of the patient becomes alkaline, the protein content is found in it.
From instrumental diagnostic methods, before assigning treatment to a patient, prescribe:
- ultrasound.
- MRI.
- CT.
These diagnostic methods are not very informative for alcoholic hepatitis, as they do not allow to determine the cause of the disease. So you can only determine the severity and extent of liver damage: see the inflammatory process, fatty degeneration of hepatocytes, fibrosis and congestion in the biliary tract. The most effective for the diagnosis of alcoholic hepatitis is liver biopsy.
Treatment of
Can alcoholic hepatitis be cured? It depends on many factors. However, the main condition should be a complete refusal to drink alcoholic beverages. Otherwise, even the operation will become meaningless.
In reality, only one third of patients stop using alcohol, about another third reduce the number of drinks consumed. However, all others ignore medical recommendations. This is a characteristic reaction of a chronic alcoholic, so in this case it is necessary to treat not only the liver, but also dependence on alcohol.
Treatment should be comprehensive, including a special high-calorie diet with a high protein content and taking medications. In difficult cases, the patient is prescribed an operation.
Diet
As a result of years of abuse of alcohol, normal digestion is disrupted. Also in the patient's body there is an acute deficiency of vitamins, microelements, nutrients. In this regard, he needs a balanced diet, including a large number of useful carbohydrates and proteins.
Patient is assigned a diet number 5( according to Pevzner).It implies consumption of 2000 Kcal every day, as well as 1 g of protein for every 1 kg of weight.
Also, a patient with alcoholic hepatitis, when treated at home, should consume a lot of food rich in Group B vitamins and folic acid.
These items in large quantities contain:
- nuts;
- seeds;
- beans;
- green vegetables;
- sour-milk products;
- cereals;
- eggs;
- by-products;
- chicken.
The patient should eat 5-6 times a day in equal portions. Food can not be fried, it is recommended only to cook and bake.
Stale meat and vegetables with coarse fiber should be wiped. When cooking soups, it is prohibited to use meat, mushroom and fish broths, vegetable and fruit soups are welcomed.
You can not eat sickly, fatty and cold with sick toxic hepatitis. Salt is allowed, but in small quantities. Of drinks, you must first of all exclude alcohol, as well as coffee, cocoa, soda and juice from grapes.
Medication
As a part of medicamentous therapy of toxic hepatitis, the patient is prescribed 3 groups of drugs:
- Hepatoprotectors.
- Vitamins.
- Antibiotics.
Hepatoprotectors are natural preparations that promote the protection and regeneration of liver cells damaged by ethanol. Many of them are based on milk thistle, essential phospholipids and ademethionine.
If the disease is severe, the patient is prescribed antibiotics. They are used to prevent the development of infectious processes.
Surgical intervention
Surgical treatment of hepatitis involves a donor organ transplant. It is performed only in severe cases, when the patient is diagnosed with the last degree of liver failure. In this case, only surgery can prolong a person's life.
In reality, transplantation is very rare, as this is a very complex and expensive procedure. A donor can only be an absolutely healthy person, more often a relative becomes such. He is taken 60% of the liver, which is then restored to its original size.
After the transplant, the patient is shown immunosuppressors to prevent organ rejection. Also, he should regularly take tests and do ultrasound. After successful transplantation, a person returns to active life, restores working capacity, can go in for sports.
The prognosis for the patient after transplantation is difficult to give. However, according to statistics, half the life of patients is prolonged for 10 years or more. During the year, a prognosis favorable for 83% of people who underwent surgery.
Prophylaxis and consequences of
If treatment begins at an early stage, compliance with all doctor prescriptions and elimination of alcohol will lead to complete liver recovery and recovery. Otherwise, the disease will progress, develop cirrhosis, as well as kidney failure. All this can lead to serious complications - for example, liver cancer, resulting in patients often die.
The only way to prevent alcoholic hepatitis and long-term treatment, as well as relapse of the disease - is to take preventive measures. The main thing at the same time is to completely abandon alcohol-containing drinks.
The likelihood of developing toxic hepatitis in a person who periodically drinks alcohol depends on lifestyle, genetic predisposition, the amount of alcohol consumed, and nutrition.
Since most patients suffer from chronic alcoholism, it is important to start treatment of addiction on time.
To avoid toxic hepatitis and its relapse, it is also important to eat properly. This involves the rejection of oily, spicy and smoked food, as well as canned food. In general, food should be saturated with vitamins and nutrients.