What is alcoholic cirrhosis of the liver and how quickly it can kill. How much do you need to drink to develop cirrhosis of the liver, how anesthesia works and why ammonia smells so strong

Alcoholic cirrhosis of the liver is a fatal disease. It is caused by regular alcohol consumption and quickly becomes chronic with constant drinking. alcoholic drinks, V international classification among the classifiers it has the ICD code K74. Nowadays, alcoholic drinks are often not something reprehensible and appear at any holiday. Meanwhile, not only those who drink frequently and heavily are susceptible to the disease. It is enough to drink every day or every other day, even if not a lot.

Alcoholic cirrhosis develops due to alcohol abuse

What is cirrhosis?

Any drink containing ethanol always leads to poisoning and subsequent destruction of a certain number of liver cells. Liver cells that die from drunkenness provoke alcoholic cirrhosis of the liver. This disease is not tied to gender, age or nationality; anyone who is addicted to ethyl alcohol can develop cirrhosis.

How much should you drink pure alcohol? Cirrhosis is extensive liver damage that develops as a result of drinking at least 40g of pure alcohol by a man and more than 20g by a woman over a long period of time. You need to drink this amount daily or every other day. It doesn’t matter what kind of alcohol a person drinks, the pure alcohol content is extracted from any drink. When people drink, some of the liver cells die, and after a while they cause the first symptoms of alcoholic cirrhosis of the liver.

Pathogenesis

Cirrhosis is the last stage of alcoholic liver disease and develops in approximately 20% of people who regularly take strong drinks. This pathology gives unfavorable prognosis, if a person does not completely give up the desire to drink and does not begin rehabilitation therapy and take vitamins. If the lifestyle does not change, the patient drinks as he drank, then the stages develop ahead of schedule and the person dies from cirrhosis within 7-10 years.

Symptomatic use of restorative medications in combination with complete abstinence from alcohol can prolong the patient’s life by several years, as well as significantly improve the quality of life.

When a person drinks a lot and often, the liver does not have time to cope

With the development of liver disease, the pathogenesis is closely related to the patient’s lifestyle. At first, the liver manages to process each new dose of ethanol quite successfully. But when a person drinks a lot and often, the liver does not have time to cope and gradually becomes covered with fatty tissue. The ability to process fluid is becoming less and less, and the walls of the organ are becoming thinner. Cells die and are replaced not by similar ones, but connective tissue. This process is called liver sclerosis and is quite dangerous.

This further affects the functioning of the liver and its ability to process alcohol. After a short time, the body cannot cope with the responsibilities assigned to it; ethanol, together with its breakdown products, poisons the body, affecting all internal organs and the circulatory system. Then the liver completely fails, the person becomes disabled and dies in a short time.

Symptoms of the disease

How to understand that alcoholic cirrhosis of the liver has begun? Signs of liver cirrhosis in alcoholics vary depending on the stage and resemble the symptoms of hepatitis. In the initial stages, usually no symptoms appear, except for a possible increase in liver volume. In other cases, it is almost impossible to notice the appearance of cirrhosis until the first signs of liver failure and atherosclerosis appear.

The first signs of liver cirrhosis usually appear 5-7 years after the replacement of liver cells with fatty and connective tissue begins.

The subcompensation stage is usually characterized by the organ’s attempts to maintain functional functions, and then the first symptoms of liver cirrhosis appear. Appetite becomes noticeably worse, weight decreases, fatigue. Against the background of frequent or constant weakness, symptoms of alcoholic cirrhosis appear, such as nausea, vomiting and enlargement of the organ in size.

At the next stage, all working functions of the liver gradually fade away. A whole complex of liver cirrhosis syndromes develops in women and men equally in various fields life. Asthenic syndrome manifests itself in rapid fatigue and indifference to what is happening, the appearance depressive states And total loss appetite. Complete exhaustion of the body develops quite quickly, the first manifestations of permanently reduced blood pressure and tachycardia. The cheeks, nose, palms and feet often become red with a purplish tint, the mucous membranes and skin become yellow, and bruises often appear.

Symptoms of liver cirrhosis in men appear in excess female hormones - obesity appears female type, while the arms and legs remain too thin. In this case, the male reproductive glands do not work, and infertility develops. The breasts enlarge, the fingers take on a characteristic appearance drumsticks with white streaks-scratches on nail plates. At this stage, it is critical to start treatment, otherwise changes appear in the body that can no longer be reversed. Varicose veins appear in the esophagus and rectum, which leads not only to changes in the veins, but also frequent bleeding of them. Such incidents dramatically worsen the condition of the body.

At the next stage it appears high blood pressure in the neck, a protrusion is found on the greatly enlarged abdomen - ascites. The veins are clearly visible, and the shape of the jellyfish on the stomach can be seen. Due to the strong increase in size of the liver, ascites can become inflamed and cause peritonitis.

At the last stage, hepatic encephalopathy develops as a result of toxins moving freely in the blood. They cause brain damage, disrupt consciousness and cause personality changes. In addition, this stage causes disruption of the heart, lungs, stomach, kidneys, intestines and nerve damage.

The stages of cirrhosis differ in severity and consequences

Functional disorders of the organ can be divided into three successive stages of cirrhosis, differing in severity and consequences. The first stage is the appearance of compensated alcoholic cirrhosis of the liver, in which there is no obvious signs diseases. Within this stage, the liver is able to cope with its duties, and the disease can only be detected by examining the organ tissue through a biopsy.

The second stage is called subcompensated and is accompanied by the first serious symptoms and consequences. It is at this stage that the first liver failure appears. The last stage is called decompensated cirrhosis and is characterized by complete failure of the organ. Besides, Alcoholism leads to poisoning of all internal organs humans and their toxic damage. At this stage, no conservative treatment will help; the only solution is a donor liver transplant.

However, we should not forget that before a transplant, patients awaiting surgery undergo a strict selection process - people who have not stopped drinking alcohol are not included on the transplant list. The doctors on the commission closely monitor compliance with the conditions. Most often, patients waiting for surgery do not live to see it, since the queue is much longer than the number of donor organs.

What complications can there be?

The main complication is ascites. This is education in abdominal cavity fluid that cannot find its way out of the body. The accumulation of fluid provokes an increase in the volume of the abdomen, stagnation of blood in the body and an increase in pressure. This disease is not independent, it comes only with cirrhosis. It is ascites that worsens the chances of complete and speedy recovery, and also aggravates the course of the entire disease. This complication of cirrhosis increases the mortality rate of patients by 50% within two years.

A patient with ascites complains of sharp increase body weight, abdominal height and severe pain in the abdominal cavity. Discomfort is accompanied by the appearance of dilated veins and loss of appetite. The person quickly becomes full and tired, complains of nausea and constipation.

Serious and frequent complications of alcoholic cirrhosis of the liver are also peritonitis and the appearance of infection in the body. Often ascites is the cause of peritonitis and inflammation in the abdominal cavity. Symptoms of such complications are:

strong cutting pain in the abdominal cavity and hepatic colitis;
the appearance of high temperature;
constipation, gas retention in the body;
feeling unwell.

Treatment and preventive measures

The first thing a person who is determined to get rid of alcoholic cirrhosis of the liver will have to do is to give up alcohol forever. This path is the only one that leads to recovery. It is also important to arrange the correct and balanced diet in small portions. Leads to the development of cirrhosis and poor nutrition, if it has already been formed. Can I drink alcohol during treatment? Absolutely not, this is the first rule of treatment.

Most of the treatment of liver cirrhosis, especially not in the first degree, takes place in a hospital setting. The main task of specialists is to return the liver to its functions.

Impaired protein synthesis function is a dangerous consequence of liver dysfunction. Recovery in the blood required quantity albumin is performed using droppers.

In case of alcoholic cirrhosis of the liver at the decompensated stage, only an organ transplant can save a person

If there is ascites or normal swelling in the body, diuretics are prescribed, which are prescribed by the doctor individually, taking into account all the characteristics of the patient. During such therapy, it is important to monitor the patient's water balance. If the disease is accompanied by cholestasis, it is usually recommended to treat it with ursodeoxycholic acid. If such a complication occurs, unbearable skin itching and an increase in bilirubin levels appear.

In any case, a vitamin complex is prescribed, which helps the liver recover after serious disruptions in its functioning. It is impossible to cure alcoholic cirrhosis of the liver at the second or third stage, however, it is possible to maintain the functioning of the organ with the help of special medications. In this case, his life will be extended by several years. If alcoholic cirrhosis of the liver is detected at a decompensated stage, then only a donor liver transplant can save the person. This patient will also have to take certain medications for the rest of his life in order to live more than a year.

To provide preventive measures To combat liver cirrhosis of alcoholic etiology, you need to take several precautions that will not only protect you from the onset of the disease, but also add quality to a person’s life. These methods include:

Answer exactly the question, how long do alcoholics live with varying degrees cirrhosis of the liver, it is impossible, especially if they do not stop drinking. People who were accidentally diagnosed with alcoholic cirrhosis in the early stages live longer and better lives with it. Their lives are not accompanied by eternal pain, but otherwise the prognosis is very different. It all depends on whether the patient has stopped drinking strong drinks, since continuation of a normal lifestyle quickly leads to the development of the final stages of cirrhosis. Because if you take any kind of therapy and don’t give up drinking, your condition will only get worse. Do not develop cirrhosis, do not drink every day or in excess.

Young people who agree to adhere to high protein diet and all recommendations of the attending physician. If you are obese, the condition is somewhat worse. In some cases, an operation is prescribed and successfully performed - the spleen has to be removed or the liver has to be sutured. In all cases, without exception, it is necessary to consult a specialist. If you follow all the recommendations of doctors, your life expectancy will increase by at least 10 years.

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There are no safe doses of alcohol. According to WHO recommendations, up to 20–40 ml of ethanol for men and up to 20 ml of ethanol for women can be considered relatively safe doses of alcohol. A dose of 10 ml of ethanol is contained in 25 ml of vodka, 100 ml of wine or 200 ml of beer.

Signs indicating harmful influence alcohol on the liver, appear when drinking more than 80 ml of ethanol per day for five or more years.

For an adult man to develop alcoholic liver disease with a possible transition to cirrhosis, it is enough to drink alcohol in a dose of 50–80 ml of ethanol per day; for a woman this dose is already 30–40 ml, and for adolescents it is even lower: 15–20 ml per day. And this is only 0.5 liters of 5% beer every day!

According to WHO, more than 90% of the population drink alcohol, of which almost half do so monthly and for several days. 10% of men and 3–5% of women drink daily.

The myth about the harmlessness of “weak” alcohol

There is a common misconception that if you drink weak alcohol (beer, low-alcohol cocktails, etc.), it does less harm to the liver and the body as a whole. But is this true?

The effect and harm of low-alcohol drinks is equivalent to the effects of strong ones. AND main reason of such equivalence is quantity. Few people think about how much ethanol enters the body if you drink “only” a few bottles of beer a day.

You only need to drink three bottles of beer or two cans of low-alcohol cocktail to get the same amount of ethanol as is contained in a glass of vodka.

According to statistics, beer is consumed by more than half of the population of our country. And the popularity of beer does not lose ground due to its apparent “harmlessness”. The number of beer consumers is growing every year. Experts consider beer a legalized drug, to which physical and psychological dependence. Teenagers and women can become addicted to beer especially quickly.

Beer contains toxic compounds and heavy metals, which can change the hormonal status of the body and cause its poisoning.

“Beer makes you lazy, stupid and powerless,” said Bismarck, the first Reich Chancellor of Germany. And he knew a lot about beer firsthand.

Low-alcohol canned cocktails are also gaining popularity, especially among young people. Due to their sweetish taste, they are perceived as strong lemonade. But one can contains an amount of ethanol equal to 100 ml of vodka. And this is not counting various chemical additives (flavors, dyes) and sugar, which also harm the liver and cause poisoning of the body as a whole.

Therefore, we can confidently conclude that beer and other low-alcohol drinks are no less harmful than strong alcohol.

Liver and alcohol

The effect of alcohol on the liver is direct. After entering the body, part of the alcohol is eliminated through the skin, lungs and kidneys. The main “blow” and harm (and this is about 90% of consumed alcohol) is taken by the liver, where further processing of the alcohol consumed occurs.

First, under the influence of a special enzyme - alcohol dehydrogenase - ethyl alcohol is oxidized and converted into acetaldehyde. Further acetaldehyde through complex chemical reactions oxidizes and decomposes to the final substances - carbon dioxide and water. But this only happens when the amount of alcohol is small and the liver enzymes are sufficient to completely complete the cycles of converting ethanol into breakdown products that are not harmful to the body and do not cause poisoning.

If a lot of alcohol is consumed, a deficiency of enzymes occurs and the process of processing ethanol into different stages. There is an accumulation of intermediate products of its oxidation and breakdown in the liver. Acetaldehyde is tens of times more toxic than ethanol; its excess causes, in addition to its direct damaging effect, disruption of the normal outflow of bile, accumulation of fats in the liver, and general poisoning of the body. And ethyl alcohol, which does not oxidize due to excess, causes the development of connective tissue in the liver, which leads to fibrosis.

The liver has amazing regenerative functions and the ability to heal itself. But these liver abilities are not endless, and, in the end, this potential is exhausted. Liver cells begin to be replaced by fibrous tissue with a restructuring of their functions and transition to cirrhosis.

What mechanisms and risk factors cause alcoholic liver damage?

First of all, this is chronic alcohol abuse. Sometimes the quantity and quality of liver enzymes that metabolize alcohol can be genetically impaired.

It has been noted that women are more susceptible to alcohol and their addiction develops faster.

When combining alcohol intake with drugs metabolized in the liver, the harmful effect on hepatocytes increases several times.

The lifestyle that a person drinks alcohol leads also matters. It is known that the shortage nutrients(malnutrition, dieting) and alcohol are incompatible.

If there is viral hepatitis, then the negative effect of alcohol on the liver increases with its consumption. Vaccination against hepatitis helps prevent the disease. In a quarter of patients diagnosed with alcoholic liver disease, antibodies to chronic hepatitis C are detected, which indicates increased risk infection with this type of virus.

Vaccination against hepatitis - for or against?

IN recent years Distorted opinions are formed in society related to the supposed harm of vaccinations against dangerous diseases on the body. Therefore, I would like to separately touch on the topic of vaccination against hepatitis.

Currently, there are vaccinations against two types of viral hepatitis: A and B.

Hepatitis A is considered a “disease of unwashed hands”, the main route of transmission is household.

Hepatitis B is transmitted primarily through blood. To transmit the virus, a drop of blood that remains, for example, in a syringe needle is enough. But one should not think that this is a disease only of drug addicts or socially disadvantaged elements. The spread of hepatitis B has become an epidemic in recent years.

Hepatitis B in most cases progresses to chronic process, which can lead to the development of cirrhosis and even liver cancer.

Vaccination against hepatitis B is included in the vaccination schedule for children. Adults are given this vaccination if they wish and consent. Typically, the vaccination schedule looks like this: 0 – 1 – 6. That is, the vaccination should be repeated after 1 and 6 months.

Many people have questions about the effect of alcohol on the effectiveness of hepatitis vaccination. Consumption of alcoholic beverages in permissible doses has no effect on vaccination. But you will still need to stop drinking alcohol for three days after vaccination due to the fact that each vaccination has its own side effects, which alcohol intake can aggravate.

This is also true for vaccination against other pathogens. The exception is the rabies vaccination, after which it is recommended not to drink alcohol for 12 months.

Alcoholic liver disease

It develops as a result of long-term poisoning of the entire human body with alcohol (ethyl alcohol).

During its course, three successive stages of development are distinguished:

Liver steatosis ( fatty degeneration; fatty hepatosis);
Alcoholic hepatitis;
Cirrhosis.

Hepatosis (steatosis)

The initial stage, or fatty hepatosis, is characterized by the deposition and accumulation of fat cells in the liver parenchyma. Occurs in people who abuse alcohol in more than 90% of cases. It is usually asymptomatic, there may be symptoms of dyspeptic disorders, a feeling of heaviness in the right hypochondrium, weakness, yellowness of the skin and mucous membranes. Liver steatosis is a reversible process, and with abstinence from alcohol and treatment, a complete cure is possible. If further exposure to ethanol occurs on hepatocytes, alcoholic liver damage progresses to the second stage - alcoholic hepatitis. In this case, there is more deep defeat hepatocytes with impaired functionality.

Alcoholic hepatitis

The course of alcoholic hepatitis can be in the form of a persistent (stable course, usually without or little symptoms, relatively reversible changes in the liver) or a progressive form (transition from the previous phase in case of further alcohol abuse; an unfavorable course, as a rule, turns into cirrhosis).

Hepatitis can occur with an acute onset or have a latent, and then - chronic course. Acute form hepatitis is usually observed after a long, often repeated, binge in an alcohol abuser, when the body is poisoned with large doses of alcohol.

There are several types of acute alcoholic hepatitis, but the most common is the icteric variant. In this case, in addition to jaundice, pain in the right hypochondrium, severe weakness, loss of appetite, nausea, vomiting, prolonged loose stool, noticeable weight loss. The liver is enlarged, has a dense structure, and is painful.

Chronic hepatitis is often relatively asymptomatic. Only laboratory and additional methods research. The liver also enlarges significantly, reaching enormous sizes.

Cirrhosis

The third stage is cirrhosis of the liver. This is a completely irreversible stage when normal liver tissue is replaced fibrous cords, connective tissue fibers and, as a result, a profound violation of all its functions develops. Cirrhosis occurs, according to statistics, in 15–20% of patients with chronic alcoholism. Worsening of the symptoms and course of cirrhosis is observed when combined with chronic viral hepatitis B or C, obesity, and being female.

Symptoms of cirrhosis can be quite meager, especially against the background long term diseases. The patient is concerned about fatigue, weakness, painful sensations in the liver area, asthenia (weakness, fatigue). A characteristic “hepatic” erythema (redness) appears on the palms, and small capillaries expand over the entire surface of the body. The liver is enlarged or, conversely, reduced, may already be painless, its surface is bumpy. Signs of ascites, an enlarged spleen are revealed, as a result of which the abdomen becomes enlarged with an enlarged venous network on its surface. Symptoms of portal hypertension appear. The functions of other organs and systems are impaired as a result of poisoning by toxic products that are not neutralized by the liver.

The course of cirrhosis is unfavorable. The disease is combined with progressive liver failure, up to hepatic coma, which leads to death. There is also a high probability of malignancy - the occurrence of hepatocellular carcinoma.

The diagnosis is confirmed by laboratory, ultrasound or radioisotope research, computed tomography. If necessary, carry out diagnostic laparoscopy and liver biopsy.

How is alcoholic liver disease treated?

The most important condition is the patient’s complete abstinence from alcohol. At some stages of alcoholic liver damage, complete regeneration of liver tissue can occur. But it should be noted that, unfortunately, no more than a third of patients follow this recommendation. Another percentage simply reduces the amount of alcohol they consume, while the rest completely ignores it and continues to lead their normal lifestyle.

The second condition is a complete energy diet with high content squirrel. The calorie content of such a diet should be at least 2000–3000 kcal per day. Protein content is about 1 g per 1 kg of patient weight. It is necessary to be saturated with vitamins, especially group B. An example of such a diet would be table No. 5.

Drug treatment

Hepatoprotectors, glucocorticoids, agents that improve microcirculation and similar drugs. Of course, the necessary treatment in each case is prescribed by the doctor individually after full examination and taking into account the identified violations.

If conservative treatment is ineffective, the issue of liver transplantation is decided.

Attention! Information about drugs and folk remedies treatment is presented for informational purposes only. Under no circumstances should you use the medicine or give it to your loved ones without medical consultation! Self-medication and uncontrolled use of drugs are dangerous for the development of complications and side effects! At the first signs of liver disease, you should consult a doctor.

The use of site materials is permitted only with prior approval from the editor.

Alcoholic liver disease: the price of pleasure

Of all the foods consumed by humans, alcohol is the most common cause of addiction. There is a direct connection between alcohol addiction and liver damage. Alcohol abuse sooner or later leads to the development of alcoholic liver disease (ALD).

How dangerous is alcohol for the liver?

Alcoholic liver disease manifests itself in three main forms - steatosis, hepatitis and cirrhosis. Alcohol is a direct hepatotoxic agent; its safe and dangerous doses have been determined. But no one will tell you how much you need to drink for your liver to “shrink.”

How much alcohol do you need to drink to get sick?

Many researchers believe that drinking grams of ethanol per day for ten to twelve years increases the risk of developing alcoholic liver disease. From severe lesions About half of those who drink alcohol in dangerous doses suffer from liver cirrhosis and hepatitis. This indicates that in the pathogenesis of alcoholic disease, in addition to the direct toxic effect of ethanol, hereditary factors and environmental factors. Features of ABP:

the disease occurs due to various violations functional ability and structure of the organ - due to prolonged and regular consumption of alcoholic beverages;
in terms of prevalence and social significance (after acute and chronic liver diseases of viral etiology), ALD ranks second;
there is a clear relationship pathological changes in the organ depending on the dose of alcohol and the duration of its use;
alcoholic liver damage at the initial stage is reversible;
any treatment method is ineffective if alcohol consumption continues;

What happens with ALD

Alcoholic liver disease is manifested by symptoms:

heaviness appears in the right hypochondrium;
biochemical liver tests were not changed;
the liver enlarges;
the gastrointestinal tract is affected;
heartburn occurs due to inflammation of the esophagus;
the esophagus ruptures;
bleeding;
gastritis;
stomach and duodenal ulcers;
the pancreas suffers;
frequent diarrhea;
severe acute pancreatitis, which must be treated surgically;
stomach ache;
the brain suffers;
degeneration of the nervous system;
the functioning of the peripheral nervous system is disrupted;
numbness;
sensitivity in the limbs is impaired;
the heart is affected;
blood pressure increases;
heart failure occurs;
the functioning of skeletal muscles is disrupted;
blood cells change;
skin is affected;
a peculiar alcoholic ornament appears.

Even if liver damage is hidden, the patient denies the fact of alcohol abuse, the doctor is able to specified symptoms correctly diagnose chronic alcohol disease.

How to treat alcoholic liver disease

The main and most effective method The treatment for alcoholic liver disease is to completely stop drinking alcohol. Quitting alcohol at the stage of fatty liver will completely restore the size and structure of the liver. For severe acute alcoholic hepatitis it is prescribed hormonal drugs.. Drugs indicated:

corticosteroids (in case of severe alcoholic hepatitis);
anabolic steroid;
insulin, etc.

An essential component of treatment is the restoration of deficiency of vitamins and microelements, a nutritious balanced diet.

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10 main myths about cirrhosis

1. Real danger liver cirrhosis is greatly exaggerated by doctors and the media. An ordinary horror story for weaning oneself away from bad excesses.

Unfortunately, there is no exaggeration in the expression “drank the liver.” The facts of her death from alcohol abuse were recorded by doctors ancient india. And the term “liver cirrhosis” (“red liver”) appeared in medicine at the beginning of the century before last, and the clinical picture of the disease was described at the same time. Not much has changed since then. Chronic alcohol intoxication- the cause of half of all cases of cirrhosis. On average, every third alcoholic gets sick, usually within a year of starting the abuse. Among these sufferers twice more men than women (guess why).

The essence of cirrhosis is the destruction of liver tissue due to necrosis and fibrosis of hepatocytes (that is, the death of liver cells and their replacement with collagen fibers). As a result, the liver ceases to be a blood purification factory and becomes a useless accumulation of connective tissue.

2. Cirrhosis threatens those who drink all sorts of nasty things, because it is not the alcohol itself that is harmful, but the poisonous fusel oils. Drink high-quality vodka - and your liver will only thank you.

Leave this statement to the conscience of the manufacturers alcoholic products. The liver is destroyed by ethanol itself, even the purest and highest quality. It has the unpleasant ability to activate fibrogenesis in liver tissue. In other words, it is under its influence that cells begin to produce collagen and functional liver tissue is replaced with completely useless connective tissue. A dangerous dose of alcohol has long been well known - g ethanol (g vodka) per day - depending on individual characteristics body. It is also known that the likelihood of cirrhosis after 15 years of heavy drinking is 8 times higher than after 5 years.

Although there is still some truth in the judgments of lovers of high-quality vodka: if any toxic stuff is added to ethanol, the risk increases.

3. Those who don’t drink will not die from cirrhosis.

4. Cirrhosis is fate, and it is useless to fight it. You won't live long without a liver.

But you can’t give up too early. The duration and quality of life depends on the origin of cirrhosis, the degree of destructive changes in the liver, the treatment performed and, of course, the stage of the disease - the earlier the diagnosis is made, the more favorable the prognosis. In case of alcoholic cirrhosis, lifelong abstinence from alcohol in the early stages and modern treatment lead to recovery; in case of a viral infection, they stop the development of the process and promote long-term remission.

So don't wait clinical symptoms- liver swelling, jaundice and nosebleeds. These are signs not of the beginning, but of an advanced stage. Donate blood for biochemical analysis and undergo an ultrasound of the liver for any diseases of the gastrointestinal tract or fever of unknown origin. Especially if there are risk factors in your life - previous viral hepatitis or contact with such patients, blood transfusions, surgical interventions and, of course, a harmful addiction to alcohol.

5. For modern medicine, coping with cirrhosis is not a problem.

Unfortunately, changes in liver tissue with advanced cirrhosis are irreversible - this unpleasant fact must be taken into account. According to one of the classifications accepted in medicine, cirrhosis can end: improvement, stationary condition, deterioration, death. The word “recovery” is, alas, missing from this list. You can only get rid of cirrhosis together with the liver, and only incorrigible optimists can hope for its successful transplantation.

But (see point 4) we repeat once again: in the early stages of alcoholic cirrhosis, timely measures taken can lead to restoration of liver tissue. If it comes to irreversible destruction of the liver tissue, even under the happiest combination of circumstances, the most favorable outcome is reaching the stage of an inactive and non-progressive course of the disease.

6. But there is a miracle medicine, it is even shown in advertising - it restores the structure of the liver.

Do you mean "Essentiale Forte", "Essentiale-N" or "Essliver"? That's right, these are hepatoprotectors. Their active substance- essential phospholipid lecithin - is part of the membranes of liver cells - hepatocytes. It is usually prescribed intravenously and orally to patients with alcoholic liver damage to restore damaged cell membranes. However, at present, many researchers believe that the effectiveness of lecithin is slightly exaggerated (only half of the administered phospholipids are completely integrated into cell membranes and actually restore the liver). And most importantly, it cannot work a miracle and restore tissues that have already undergone irreversible changes (see point 5).

7. Any hepatitis will sooner or later lead to cirrhosis of the liver.

It's not all so sad. First, acute viral hepatitis must turn into chronic with a high degree of activity, which, with proper and timely treatment doesn't always happen. And even then, only half of cases end in cirrhosis. According to medical statistics, cirrhosis develops on average within 5 years in approximately 1% of patients who have had a symptomatic or anicteric form of hepatitis B or C. Unfortunately, hepatitis D and G viruses are more harmful and significantly increase the risk of developing cirrhosis, but do not prevent it into fatal inevitability.

8. Cirrhosis of the liver affects those unfortunate geese that are force-fed by ruthless farmers and then make foie gras from their livers for soulless gourmets.

Not really. The poor birds actually have a hose inserted down their throat and super-calorie food is poured into their stomach through it. But this mockery only leads to an enlarged and fatty liver. By the way, gourmets would probably reject cirrhotic liver - it’s too tough. Hence the conclusion (except for refusing foie gras for moral reasons): if you eat a lot, tasty and fatty, you still won’t be able to die from cirrhosis of the liver. Most likely, the vessels or pancreas will be the first to fail. On the contrary, malnutrition with a deficiency of proteins and fats can lead to the so-called nutritional cirrhosis, but for this you need to sit for many years on a very meager diet of fruits and cereals.

9. With cirrhosis, the liver atrophies, and the unfortunate person dies quietly, civilly.

Not really. The final stage is usually: encephalopathy and hepatic coma, gastrointestinal bleeding or ascites followed by peritonitis. Sounds confusing? For those who are curious, here are the details.

Encephalopathy is a complex of neuromuscular disorders caused by severe liver failure. It all starts with decreased activity and apathy. Then the patient becomes aggressive and unkempt, commits senseless acts. At the next stage, confusion, muscle cramps, and loss of coordination of movements develop. The last stage is hepatic coma, first with periods of clear consciousness and excitement, then without reflexes and sensitivity to pain. From this point on, the decline can truly be considered quiet and cultural.

Gastrointestinal bleeding occurs as follows. In healthy people, about 1 liter of venous and 0.5 liters of arterial blood per minute. Both flows unite in the liver and come into intense contact with the villi of hepatocytes - this is blood purification by the liver. Fibrosis of the liver tissue (replacement of healthy cells with connective tissue) causes difficulty in normal blood flow, the blood begins to look for workarounds: to form connections where veins and arteries are located close to each other - in the mucous membrane of the esophagus and rectum, on the anterior abdominal wall. As a result, a “jellyfish head” vascular pattern, characteristic of patients with cirrhosis, is formed on the abdomen above the navel, and when the anastomoses rupture, life-threatening gastrointestinal bleeding(vomiting dark venous blood or tarry stools).

Ascites is a disorder water-salt metabolism, as a result of which up to 3-6 liters of liquid accumulate in the stomach, and sometimes more (practically a bucket of water). This fluid can spontaneously become infected with bacteria from the intestine, and then ascites progresses to peritonitis, the mortality rate of which reaches %.

10. Even if I die early, I will remain a real man until the end.

It's unlikely. In patients with cirrhosis (especially those of alcoholic origin), changes in the hormonal sphere often occur, resulting in an excess of estrogen or a deficiency of testosterone. The result is gynecomastia (breast enlargement to women's sizes) or impotence and testicular atrophy.

I’m writing in case it’s useful to someone. My husband had stage 4 liver cirrhosis after suffering from hepatitis C.” The virus was removed a year and a half ago with the drug Vikeyropak.” A well-known doctor in our city, Odushko Igor Nikolaevich, treated my husband for cirrhosis. Elastography was done once every six months. Fibrosis decreased by half. My husband is 61 years old and able to work. For 1.5 years I have never been sick.. But they say cirrhosis cannot be cured. We even got rid of diabetes mellitus 2 types. We are grateful to Igor Nikolaevich. His naturopathy is patented. This is Bionorm.” I will be glad if my advice helps someone. His website contains photos of tests (elastography).

I liked about good vodka)))))))

Very scary article.

And also very informative, there was a lot I didn’t know.

Still, we need to treat ourselves with care, we have one life and it’s not worth an extra glass of alcohol.

You can also get vaccinated against hepatitis. In my opinion, it only protects against hepatitis B, but it partially protects against hepatitis C. It doesn’t cost that much money. Health is still more valuable.

So you need to regularly monitor the condition of your liver and eat right.

A friend was diagnosed with fatty liver, and everyone around him thought it was cirrhosis.

But as far as I understand it initial stage, if left untreated, it will definitely turn into cirrhosis.

Am I right or wrong?

You just need to take care of her and sometimes take hepoprotective drugs. Or use materials from MN, which talk about food products used to gently cleanse the liver. Take care of your health from a young age.

Interesting article, but I agree that cirrhosis can be caused not only by alcohol, it will most likely aggravate the situation. But there are examples when people already in adulthood begin to actively use the result from death to cirrhosis. You need to be more careful.

I agree with the third point of the article.

Yes, probably the saddest of all myths, and it’s even a pity that it’s not true. It turns out that it doesn’t matter whether you lead a healthy lifestyle or whether you take care of your liver, but still, everyone has a risk of developing cirrhosis. Somehow this is not right.

In such situations you feel powerless and lack of logic in life. This all somehow depresses me.

Because to protect everyone possible infections It’s simply not possible, we communicate with people and live in a society full of different bacteria and viruses.

You need to drink less!

This issue is not very relevant in Russia.

Well, not everything is so critical, Andrey. Russia is not the most drinking country! And what does all of Russia have to do with it, we are talking about a specific person who is able to choose his own path and can decide for himself whether to drink or not to drink. Although after reading this article, in my opinion, the answer is obvious. All these horrors and horror stories make you don’t even want to look at alcohol. It’s not like drinking so much of it that you get cirrhosis..

So you need to take care of yourself, there is only one life.

many don't drink.

But many, and statistics say the opposite.

In my opinion, you don’t have the information, Andrey, but simply write off everything as cliches. If you look at the statistics, you will understand that Russia is far from being the most drinking country.

You don’t need to mindlessly repeat some common phrases, especially such ones. I’m proud that I live in Russia and I think that our population is quite sober and sane, many people lead a healthy lifestyle and look great. They carefully monitor their health and play sports.

And the assertion that we are all drunkards is spread by those who envy us.

Periodically, for prevention, you need to take hepoprotective drugs, it certainly won’t hurt.

I also think that even if they are only half effective, it still wouldn’t hurt to take them periodically. After all, even if we do not abuse alcohol, our environmental situation leaves much to be desired.

And the nutrition of many of us is far from ideal, alas.

so if there is an opportunity to support the liver, then you need to take advantage of it.

I think that there should be food products that will contribute rapid recovery liver.

After I suffered from jaundice at the age of 18, I take great care of my liver.

Yeah, it's hepatitis serious illness, the consequences of which remain for life. I decided to play it safe and get vaccinated against hepatitis B, it seems to protect a little from hepatitis C. Of course, you can’t protect yourself from everything, but if you have the opportunity to protect yourself and take care of your liver, then why not do it . Moreover, the price issue is not so great.

Well, if you have already been ill, then of course you will have to deal with it for the rest of your life. special attention and taking care of your liver, that’s right..

The moral of this story is that you need to take care of your health, and ideally, don’t drink :)

Yes, health is very fragile and you need to support your body every day in every possible way, and don’t be lazy to get examined at least once every six months.

Well, it’s probably not possible to not drink at all and there is no such urgent need. I think that a glass of good wine on a holiday is quite acceptable. But nothing more!

I grew up in a wine region, so there is a certain drinking culture there. And despite the fact that there is a lot of wine in every home, there are not as many drunks or alcoholics as one might expect.

So it all depends on the culture and the person, of course.

Well, yes, my mother is a doctor by profession.

The article describes terrible realities, I hope that they will stop someone in time

This is truly a scary article.

I just wanted to run and get blood tests. Check the condition of the liver somehow. Although I don’t seem to abuse alcohol and lead a healthy lifestyle.

But it turns out you can get cirrhosis simply because of some viral or bacterial infections, from which no one is safe.

The worst thing is that the disease is asymptomatic, almost until the last stages ((((.

Everyone hopes so.

The unfortunate liver goes through everything, it processes everything so that there is no cirrhosis, you need to take care of your liver.

Yes, nature has not provided humans with spare organs, so we live with one set all our lives. Well, the liver is the most important organ, glorified in myths. You just need to take care of yourself!))

And we put so much pressure on her every day, it’s amazing how she copes with it all.

Fatty foods, spicy foods, alcohol, she needs to get through all this and at the same time remain healthy.

It’s a pity that in most cases we only think about it when some kind of pain appears or is determined by analysis.

What's so scary about cirrhosis is that it starts asymptomatically...

this is a terrible disease

Yes, cirrhosis is one of the most terrible diseases..

But if it is detected in time, then there is a chance of saving oneself, prolonging life, but not everyone will be constantly examined, and when it arrives, it is already too late.

Maintaining a healthy lifestyle is much better, but it is not always feasible.

A friend of mine died of cirrhosis - the doctors couldn’t save him.

Well, if I understood everything correctly, then at serious stages it is almost impossible to recover.

In the article they write that only improvement is possible... but apparently not for everyone...

And so, probably, only a transplant.

But it seems everyone has already seen enough films about how people wait for years for organ transplants, because not everything is so simple.

And there was no way to transplant part of the liver from a relative. then you will have to wait for a donor organ, and of course, you may not wait.

The liver is indeed capable of regeneration, but... diagnostics in our medical institutions not up to par.

And we ourselves do not monitor our precious health on an ongoing basis, alas.))

Testicular atrophy is an argument

The article is a bomb. Anyone who didn’t understand something didn’t read it very carefully.

And for those who didn’t immediately understand, you can read it more than once, add it to your bookmarks and always remind yourself..

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If you consume 80 g of pure ethanol per day, cirrhosis will develop in almost half of the cases

“To drink or not to drink?” - Many of us ask ourselves this question. However, there is still no consensus on the effect of alcohol on health in the scientific community. Often scientific research, proving the benefits of red wine or even vodka, are covered by statements that all this is from the evil one.

But experts, including world organization health care, they are increasingly talking not only about the benefits, but at least about the low harm of alcohol in small doses. MK found out how much you can drink without it going unnoticed by the liver.

With what's in large doses alcohol does nothing but harm, no one argues. Doctors even say that there is not a single organ on which alcohol does not have a bad effect. And yet, most often in the context of alcohol, the liver is mentioned, which takes the blow first. It is in this organ that the most large number biochemical reactions (1 billion per second!), it is here that they are neutralized toxic substances and all metabolic products, including medications and alcohol, are processed.

Liver dysfunction can be acute or chronic. Acute ones are much less common. They can be caused, for example, by taking any medications.

— The reason acute lesion liver disease, which may even require a liver transplant, can even occur with a single dose of a non-steroidal anti-inflammatory drug, such as aspirin or paracetamol. By the way, up to 10% of liver transplants are associated with liver damage by these drugs,” says Professor Igor Bakulin, head of the hepatology department of the Moscow Clinical Scientific and Practical Center, chief Moscow gastroenterologist.

However, most often liver diseases (both viral and alcoholic) remain silent for decades. And the appearance of the first symptoms may indicate cirrhosis, when it is either impossible to help with anything, or an urgent transplant is required. “The liver does not hurt, and if any symptoms of the disease appear, they are most often mistaken for gastritis or pancreatitis and are not paid attention to. Muscovites rarely turn to gastroenterologists for liver diseases. Moreover, last year there were 5,367 hospitalizations for cirrhosis, and mortality from liver cirrhosis was 2,039 cases. Last year, only 45 liver transplants were performed in the city. For comparison, in America, 800-900 are performed annually in just one center,” continues our expert.

But the worst thing is that liver diseases are often missed even by doctors. The fact is that it is difficult to diagnose liver pathology using ultrasound, and biochemical blood tests do not always show that the destruction process has begun. “The other day, a 32-year-old woman came to us; she was diagnosed with cirrhosis, the stage is close to terminal. Before coming to us for a consultation, she had not complained about her health, she worked, was an exemplary mother, but cirrhosis develops over decades! Now only a transplant can help her. Another patient came in regarding a slight excess biochemical parameters blood. And she has complete liver damage due to uncontrolled use of painkillers. A few days later we transferred her to intensive care with a hepatic coma. Such cases are not uncommon in our practice. Fortunately, she was lucky, Moscow doctors were able to give her a liver transplant,” admits Igor Gennadievich.

The vast majority of cirrhosis that is diagnosed in Muscovites (and Russians as well) is caused by alcohol consumption. However, close friendship with the “green serpent” is the cause of 35% of deaths in. By this indicator, by the way, we are one of the first in the world. The growth curves of ethyl alcohol production in the country and the mortality rate of Russians, as they say, go hand in hand. “You can treat this as you like, but from 1985 to 1989, during the anti-alcohol campaign, life expectancy among men in our country increased by three years, and mortality from liver cirrhosis decreased threefold,” says Professor Bakulin.

However, few who drink or drink occasionally think about the harm it causes to the liver. Moreover, many have heard about the existence of safe doses of alcohol - a glass of red wine or a glass of vodka a day. And although few people limit themselves to such doses, knowing about safe doses warms the soul.

— There are no harmless doses of alcohol, this is a myth. And our doctors spoke about this back in 1915 at the Pirogov Congress. At the same time, it was stated that alcohol does not cure any disease. And in our bookstores there are a lot of books from the series “Treatment with vodka”, “Treatment with moonshine”, “Treatment with beer,” Igor Bakulin is sure. — The European Association for the Study of the Liver also states: there is no reason to assume the existence of safe doses of alcohol. But sometimes even cardiologists recommend their patients to take a glass “for blood vessels.”

Some people believe that only adulterated or homemade alcohol can cause harm. Doctors cite an aphorism from Abraham Lincoln: “Alcoholism does not come from drinking bad vodka, but from abusing good vodka.” Igor Bakulin warns that the path from a romantic evening with a glass or two to the pathology table can be very short: “I now have two patients in the department, 25-year-old girls, with alcoholic cirrhosis of the liver in the terminal stage.”

And yet, in the case of treating patients with alcoholism, doctors today set the goal of at least transferring them to small doses (foreign statistics say that half of alcoholics with liver problems are ready for only partial abstinence). This is up to 30 g of pure ethanol per day for men and up to 20 g for women. If you drink in such doses, only every third person will develop alcoholic hepatitis after 5 years. If you drink 80 g of pure ethanol per day, almost half of the cases will develop cirrhosis, and every tenth person will develop liver cancer.

In general, doctors call doses of 40-80 g of pure ethanol toxic to the liver, which corresponds to 100-200 ml of vodka, 400-800 ml of dry wine or 800-1600 ml of beer. These doses are designed for men; for women they are half as much.

- This is not safe doses, No. But alcohol in such quantities brings much fewer health risks. The study found that switching to low-dose alcohol consumption reduces the risk of developing coronary disease heart and the risk of mortality from it by 15%. By the way, the effect is comparable to some medications,” says the chief gastroenterologist in Moscow.

Another study among 10 thousand people with alcohol dependence proved that reducing the days of heavy drinking from 23 to 11 per month reduces cases of illnesses and injuries by 6813, pancreatitis by 2016, strokes by 152, and cirrhosis by 873. What would have happened if these people didn’t drink at all!..

“Even for those who drink alcohol in small quantities, I would advise you to think about your health and undergo liver diagnostics. In the early stages, even cirrhosis is reversible, and today there are methods to treat it, says Igor Bakulin.

In order to encourage people who drink a little (or more) to undergo diagnostics, the “Check Your Liver” program has even been developed. In accordance with it, clinics in 60 Russian cities, including Moscow, are opening “ Healthy liver", where you can do an ultrasound and go biochemical research blood. Thanks to this program, doctors hope that the detection of liver diseases will increase significantly. Another task, notes Igor Bakulin, is to introduce mass medical practice modern methods diagnostics - elastometry (a study using a special parting) and fibrotests (high-tech blood tests). Until they, alas, compulsory medical insurance policy not covered...

We don't want to scare you, but we're not going to joke either. We would really be offended if even one of the Men’s Health readers accidentally passed away because his liver turned into a rotten sponge. So read all the material carefully and try not to upset us.

1. The real danger of liver cirrhosis is greatly exaggerated by doctors and the media. An ordinary horror story for weaning oneself away from bad excesses.

Unfortunately, there is no exaggeration in the expression “drank the liver.” The facts of her death from alcohol abuse were recorded by doctors of ancient India. And the term “liver cirrhosis” (“red liver”) appeared in medicine at the beginning of the century before last, and the clinical picture of the disease was described at the same time. Not much has changed since then. Chronic alcohol intoxication is the cause of half of all cases of cirrhosis. On average, every third alcoholic gets sick, usually 10-15 years after the start of abuse. Among these sufferers, there are twice as many men as women (guess why).

Leave this statement to the conscience of alcohol producers. Ethanol itself, even the purest and highest quality, destroys the liver. It has the unpleasant ability to activate fibrogenesis in liver tissue. In other words, it is under its influence that cells begin to produce collagen and functional liver tissue is replaced with completely useless connective tissue. A dangerous dose of alcohol has long been well known - 40-80 g of ethanol (200-400 g of vodka) per day - depending on the individual characteristics of the body. It is also known that the likelihood of cirrhosis after 15 years of heavy drinking is 8 times higher than after 5 years.

Although there is still some truth in the judgments of lovers of high-quality vodka: if any toxic stuff is added to ethanol, the risk increases.

3. Those who don't drink won't die from cirrhosis.

4. Cirrhosis is fate, and it is useless to fight it. You won't live long without a liver.

But you can’t give up too early. The duration and quality of life depends on the origin of cirrhosis, the degree of destructive changes in the liver, the treatment performed and, of course, the stage of the disease - the earlier the diagnosis is made, the more favorable the prognosis. In case of alcoholic cirrhosis, lifelong abstinence from alcohol in the early stages and modern treatment lead to recovery; in case of viral cirrhosis, they stop the development of the process and promote long-term remission.

Therefore, do not wait for clinical symptoms - liver swelling, jaundice and nosebleeds. These are signs not of the beginning, but of an advanced stage. Donate blood for biochemical analysis and undergo an ultrasound of the liver for any diseases of the gastrointestinal tract or fever of unknown origin. Especially if there are risk factors in your life - previous viral hepatitis or contact with such patients, blood transfusions, surgical interventions and, of course, addiction to alcohol.

5. For modern medicine, coping with cirrhosis is not a problem.

6. But there is a miracle medicine, it is even shown in advertising - it restores the structure of the liver.

Do you mean "Essentiale Forte", "Essentiale-N" or "Essliver"? That's right, these are hepatoprotectors. Their active ingredient - the essential phospholipid lecithin - is part of the membranes of liver cells - hepatocytes. It is usually prescribed intravenously and orally to patients with alcoholic liver damage to restore damaged cell membranes. However, at present, many researchers believe that the effectiveness of lecithin is slightly exaggerated (only half of the administered phospholipids are completely integrated into cell membranes and actually restore the liver). And most importantly, it cannot work a miracle and restore tissues that have already undergone irreversible changes (see point 5).

7. Any hepatitis will sooner or later lead to cirrhosis of the liver.

It's not all so sad. First, acute viral hepatitis must turn into chronic with a high degree of activity, which does not always happen with proper and timely treatment. And even then, only half of cases end in cirrhosis. According to medical statistics, cirrhosis develops on average within 5 years in approximately 1% of patients who have had a symptomatic or anicteric form of hepatitis B or C. Unfortunately, hepatitis D and G viruses are more harmful and significantly increase the risk of developing cirrhosis, but do not prevent it into fatal inevitability.

8. Cirrhosis of the liver affects those unfortunate geese that are force-fed by ruthless farmers and then make foie gras from their livers for soulless gourmets.

9. With cirrhosis, the liver atrophies, and the unfortunate person dies quietly, quietly.

Gastrointestinal bleeding occurs as follows. In healthy people, about 1 liter of venous and 0.5 liter of arterial blood flows through the liver per minute. Both flows unite in the liver and come into intense contact with the villi of hepatocytes - this is blood purification by the liver. Fibrosis of the liver tissue (replacement of healthy cells with connective tissue) causes difficulty in normal blood flow, the blood begins to look for workarounds: to form connections where veins and arteries are located close to each other - in the mucous membrane of the esophagus and rectum, on the anterior abdominal wall. As a result, a “jellyfish head” vascular pattern, characteristic of patients with cirrhosis, is formed on the abdomen above the navel, and when the anastomoses rupture, life-threatening gastrointestinal bleeding begins (vomiting of dark venous blood or tarry stools).

Ascites is a violation of water-salt metabolism, as a result of which up to 3-6 liters of liquid accumulate in the stomach, and sometimes more (practically a bucket of water). This fluid can spontaneously become infected with bacteria from the intestines, and then ascites turns into peritonitis, in which the mortality rate reaches 80-100%.

10. I may die early, but I will remain a real man until the end.