Liver and alcohol are a dangerous combination. As you know, alcohol negatively affects all organs, but in particular it adversely affects the liver.

With the regular use of alcohol in unlimited quantities, the body is not able to neutralize alcohol and, as a result, is overwhelmed with toxins.

What further leads to terrible diseases like cirrhosis of the liver, hepatitis, and also to lethal outcome.

Forms and stages of alcoholic hepatitis

acute form disease is characterized by its rapid development. Symptoms of the disease develop rapidly. But chronic hepatitis does not begin to manifest itself so quickly and there are no symptoms in the early stages. And this threatens that the disease can lead to the development of cirrhosis, if you do not see a doctor in time.

The form of the disease depends on what kind of alcohol a person drinks and how much alcohol is consumed.

If a person worries about his health in time and seeks help from a hospital and at the same time stops drinking, then he has a chance to be cured and prolong his life.

Symptoms of active hepatitis:

• weakness in the body;
• yellowness of the skin and eye sockets;
• pain in the right hypochondrium;
• nausea.

Many alcoholics wonder how much alcohol can be consumed when they are sick? The answer is simple, not at all.

Stages of hepatitis:

1. Initial stage. You can notice the beginning of the development of the disease on examination by a doctor. There are no special symptoms at this stage, except for an enlarged liver.
2. Middle stage. At this stage, symptoms already appear. These include pain in the right hypochondrium, yellowing of the skin and eyes. In order to understand how the liver functions, the doctor resorts to using biochemical research blood. After the examination, the patient is prescribed a course of treatment. And, of course, drinking is not allowed during this period.
3. Difficult stage. It is very dangerous for a drunk person. Since itching appears, hair falls out, there is no sexual desire. If you do not pay attention to these symptoms and do not seek help in time, then a fatal outcome is possible.

Diagnosis and treatment of liver cirrhosis

It is difficult to diagnose an organ at an early stage. And all because the disease is hidden.

But still, you can detect the disease with the help of such studies as:

1. X-ray method.
2. CT scan.

The best way to detect the disease and its stage is the last option.

In order to assess how the liver functions, a radionuclide examination technique is used. And in order to make a definitive diagnosis, histological examination organ. To do this, use a puncture biopsy.

It is very important to forget about alcohol during the diagnosis and subsequent treatment, since there will be no result and the person will harm himself even more. And also you should take care of yourself and reduce the level of stress to a minimum and ensure peace.

Attention!

Drug treatment is prescribed for the middle and severe stages. If there are edema or ascites has developed, then the patient's water intake is significantly reduced. Nutrition is strictly regulated by the doctor. And in no case should there be salt in the dishes. At the discretion of the physician, diuretics such as Furosemide may be prescribed.

If liver cirrhosis progresses, then the same drugs are used in the treatment as in the treatment of chronic hepatitis. Sometimes the doctor will prescribe a course of antibiotics.

When treating, it is very important to follow all the recommendations of the doctor:

1. When you feel tired, give yourself a rest.
2. Don't lift weights.
3. Constantly be in the fresh air.
4. Control your weight.
5. Healthy food.
6. Never drink alcohol.

How long will the treatment last? It depends on the stage of the disease and on the efforts and desires of the patient.

And also after the patient undergoes a course of treatment, you can not take alcohol, as it can nullify all efforts. So it is worth giving up alcohol forever.

Prevention of cirrhosis of the liver

It is very important to follow a proper diet after treatment.

Should be avoided:

• alcoholic beverages;
• bakery products;
• sweets;
• salt;
• canned food;
• sausages and cheese products.

But it is also very important to stop smoking and maintain a sober lifestyle. It is also worth visiting a doctor 2 times a year.

Using all the advice of doctors, the patient will be able to prolong his life.

So, with alcohol abuse, a person can develop diseases such as hepatitis and cirrhosis of the liver. The consequences can be very different up to death. Therefore, it is worth considering how much alcohol you drink every day and whether it is worth your life.

Source: http://alcogolizm.com/pechen/alkogol.html

The harmful effects of alcohol on the liver

The well-known truth about the dangers of alcohol on the liver does not affect the population, they did not drink less. The use of alcoholic beverages such as vodka, wine, cognac, champagne, even non-alcoholic beer, will sooner or later lead to the destruction of the liver.

An organ that is responsible for the functioning of the whole organism by producing enzymes that cleanse the body of toxins.

What is harmful to the liver, non-alcoholic beer or a glass of champagne, you can find out by reading the medical literature and research scientists.

Alcohol kills the liver

Options alcoholic beverages that cause the most damage:

• An interesting fact is that even among strong alcoholic beverages, beer ranks first in harming the human body, mainly the liver. Whether alcohol is harmful or not, people drink it in liters, not realizing how dangerous it is. The essence of the principle of action - beer causes a strong diuretic effect due to its composition, therefore, its use in the amount of at least two or three bottles per day is harmful to the liver and the whole body as a whole. Non-alcoholic beer can be harmful when consumed in large quantities at a time, as the meager dose of alcohol in the composition adds up and backfires.
• Non-alcoholic in cans gives the impression of a completely harmless composition, moreover, it is convenient and easy to use. Harm is caused by special flavoring additives, which makes the drink less alcoholic. It is alcoholic cocktails that can turn off the psyche and common sense that are in second place in popularity. Non-alcoholic beer and cocktails are in the same row of alcoholic drinks that are equally harmful.
• The role of annually drunk champagne is noticeably exaggerated. It is believed that this drink is no less harmful than wine, but dangerous for the body in terms of rapid absorption into the body and intoxication. The use of this type of alcohol, like champagne, in the total amount of ethyl alcohol drunk, can lead to a hospital bed. The liver receives a load and cannot function normally, as a result of which the work of the pancreas and gallbladder is disrupted.

Drinking a moderate amount of alcohol will not be harmful to the body, the amount of ethyl alcohol drunk in total will correspond to a harmless dose on the liver.

alcohol in the body

The liver takes over protective function body that purifies the blood and removes harmful toxins. Which method is better for everyone individually, but it does harm overuse alcohol. Non-alcoholic beer or light white wine, all drinks contain ethyl alcohol, which destroys liver cells, leading to cirrhosis.

The defeat process goes like this:

1. Initially, alcohol enters the body, ten percent of which is excreted, and the remaining ninety percent is metabolized.
2. Alcohol turns into acetaldehyde, damaging the liver and causing hangovers.
3. The concentration of fatty acids increases.
4. The structure of the organ becomes oily, a person's well-being can deteriorate sharply.

The correct dosage when drinking alcohol, be it beer, wine, champagne or cognac, will reduce the risk of developing liver failure to a minimum. From what variety the alcohol will be, the meaning remains the same. Certain standards for the use of alcohol have been developed, for women up to ten grams of alcohol, for men twice as much - twenty grams.

Harm causes, in any case, the use of alcoholic beverages, but it must be reduced to a minimum. Tips for cleansing your body of alcohol are recommended to be performed daily, even non-alcoholic beer can be harmful if consumed frequently.

Uncontrolled alcohol consumption is a path to cirrhosis of the liver

Cirrhosis is known to be the last stage alcoholic binge, affecting liver cells, their death occurs, as a result of which a new organ may be needed.

The state of the initial stage of cirrhosis is accompanied by chronic fatigue, weight loss, ascites, pain in the hypochondrium, allergic reactions etc. Due to the course of the disease and liver damage, there may be no obvious signs of cirrhosis. Toxic organisms enter the organs, infecting them, the liver does not perform its cleansing function and portal hypertension occurs.

Even non-alcoholic beer, consumed regularly, can lead to cirrhosis if regularly consumed at a minimum dosage. Serious tests can be a biopsy and organ transplant. There are less lethal outcomes, previously accompanied by coma.

Initially, cirrhosis may arise from alcoholic hepatitis, which causes tissue necrosis and may not cause symptoms.

If there may be manifestations, then they are similar to other diseases - temperature, discoloration of feces, weakness, nausea, fatigue, etc.

Blood tests and palpation of the liver area can give a clear picture of the onset of alcoholic hepatitis, a precursor to cirrhosis.

Source: http://pechen1.ru/alkogol/vred-alkogolya-na-pechen.html

The abuse of alcoholic beverages, their daily use, has Negative influence on the liver.

If you drink for quite a long time, serious liver damage is guaranteed, because it is the body's filter that processes almost 90% of alcohol.

When the liver is overloaded with the use of alcoholic beverages, irreversible changes occur that lead to diseases such as fibrosis, alcoholic hepatitis, fatty liver. What is the effect of alcohol on the liver?

Alcoholic drinks are one of the worst foods that negatively affect the functioning of the liver.

The effect of low-quality alcohol on the liver

Alcohol in any quantity has a detrimental effect on a person, but the use of low-quality alcoholic beverages has a doubly effect on the entire body and internal organs.

There are many varieties of drinks that cannot be called healthy, but rather, on the contrary, they are much more dangerous than, for example, expensive wines or vintage cognac. Such drinks include: moonshine and "self-made" vodka, alcoholic substitutes, cheap tinctures and liquors.

In addition to harm to brain cells, heart, blood vessels, it can cause and lead to poisoning - instant or gradual, and even worse development serious illnesses that shorten the life span of an alcoholic.

Alcohol may contain dangerous genetically modified products in its composition, and, as you know, they are strictly prohibited for use in the manufacture and sale. These substances can destroy life, are dangerous in composition and effects on a healthy body.

Influence of beer

Beer refers to drinks with a small dose of alcohol, so it is considered harmless. However, the amount of alcohol and components - hops, preservatives, flavors, dyes - make up such a range of negative substances that sometimes it is not inferior to stronger alcohol in terms of negative properties.

Given that they drink beer not in small doses, but in liters, and moreover, regularly, its load on the liver becomes more and more harmful. Cells are overloaded and inflammatory process body - the temperature rises, general weakness, malaise appears, the skin of the face and body turns yellow, there is a violation of digestion.

Often such symptoms are attributed to other organs, other causes are found. feeling unwell and the disease progresses slowly. The worst thing that can happen to the liver is hepatitis C, which is difficult to treat with drugs. In particular difficult cases when treatment fails, only a liver transplant is possible.

This is the destructive effect of alcohol on the liver.

Nonalcoholic beer

Non-alcoholic beer is similar in taste to alcoholic beer, but does not contain alcohol and is low in calories in energy value. This allows you to drink it and not get drunk, drink and not be afraid to get better.

Encoded drinkers can drink this soft drink without experiencing cravings, which helps them keep their weakness at bay.

The drink also has its downsides. Not every manufacturer conscientiously follows the cooking technology, so it contains dangerous impurities, preservatives, phytohormones that adversely affect men and women. The male part of the population has beer bellies, problems with potency. Women are strongly discouraged from drinking non-alcoholic beer during pregnancy and breastfeeding.

What is the effect of red wine?

Dry red wine is put forward by some researchers as a cure for steatohepatitis.

IN clinical nutrition dry red wine plays a special role, because it is made from natural products, it is a source of trace elements, vitamins of groups B, C, D, H.

Magnesium, iron, chromium, calcium, zinc - minerals and elements so necessary for the heart, bone tissue, hemoglobin, enhance immunity. The polyphenols contained in it prevent the development of type 2 diabetes, resveratol is effective for the prevention of osteoporosis, astringents for intestinal disorders will help relieve spasms and relieve pain.

Red wine is drunk before meals in order to increase appetite, for the speed of digestion of heavy food, better metabolism, and prevention of obesity.

Its use in reasonable quantities can prevent non-alcoholic steatohepatitis - a chronic liver disease, the risk of its development becomes several times less. However, its maximum dose per day should be no more than 100 grams. In case of abuse, its action will adversely affect the body, from good to spoilage is one step.

Which alcohol is less harmful?

Which alcohol is less harmful is a rhetorical question. Considering that it causes damage both in the minimum and in the maximum amount, one can only try to divide all alcoholic beverages according to the strength of the harm done: the dose consumed, the degree of purification of alcohol, impurities and preservatives.

So, if you choose a certain volume and the most low-grade drink, it will be wine or beer in comparison with cognac, for example. If the volume of wine or beer is increased, then the amount of alcohol consumed will be greater, and the effect will be the same as that of cognac.

This misconception can quietly lead to the fact that one day a young guy wakes up addicted to alcohol.

The most dangerous alcohol is methyl alcohol. By-products formed during fermentation are esters, oils, from which cheap alcohol is made and will be very dangerous. It is the strongest neurovascular poison that causes deterioration general condition, blurred vision and requires immediate medical attention, otherwise death may occur.

Of course, where without dyes and flavors. These are all chemicals that affect the liver and pancreatic function. Low-alcohol drinks, liqueurs at a low cost will become products that are more harmful and merciless to your liver.

This group of products is designed for young people and women, so they are often the ones who suffer. Champagne, tincture, cider are all low-grade alcohol, but this does not mean that it is not so harmful to the liver. Here it will be important the amount of alcohol consumed, not the degree.

When choosing, be guided by good quality alcohol, thoroughly cleaned, preferably without additives and dyes, and, of course, know the measure in their use.

Safe dosage of alcohol

In the use of alcohol, the correct dosage is necessary so as not to suffer from diseases and not expose the liver to a “hit”. Men can drink only 20 g of alcohol per day, women up to 10 g of alcohol. Doses are conditional, since weight, height, age, gender, and health status must be taken into account.

If you increase the dosage, then you risk getting the first "bells" of the sore. If you already suffer from liver or cardiovascular diseases, then take care not to worsen the condition and it is better to completely refuse to drink alcohol.

In the event of a relapse, you risk getting into a hospital bed.

Diseases from alcohol

• Fatty liver (fatty liver). Obesity is caused by the accumulation of ethanol in the liver cells. Obesity provoking factors are overweight, previously transferred hepatitis C, drinking large amounts of alcohol, and eating fatty foods. Symptoms are expressed by weight loss, yellowing of the skin, pain in the liver area, and vomiting. Treatment for obesity will take a long time, requiring self-discipline and patience from the patient. In addition, the success of therapy will come with the observance of a therapeutic diet - table number 5, which must be observed for 1.5-2 years to improve the result. In an advanced case, if you do not apply for medical assistance, the tissue will scar and the organ will cease to function, which can lead to death.
• Fibrosis. Damage to liver cells. Liver fibrosis has 5 degrees or stages: F0, F1, F2, F3, F4. The progress of the stages depends on the patient himself and is determined by such factors as: male gender, the presence of diabetes, obesity, alcohol abuse. Treatment of fibrosis is possible in a therapeutic way, the latest drugs can prevent its further development. A favorable outcome of treatment is possible when taking medications, following the recommendations of the attending physician.

• Cirrhosis. Excessive alcohol consumption leads to the development of a chronic disease and changes in the structure of the liver. Men often suffer from it. The reasons are - viral hepatitis C, excessive alcohol consumption for a long time. Symptoms, as with hepatitis, are nausea, fatigue, lack of appetite, itching, jaundice. It occurs in alcoholics, it is difficult to treat, since this is already an irreversible process. In advanced cases, if treatment is refused, death is possible.
• Liver failure. Violation of one or more liver functions. There are acute and chronic. Acute liver failure progresses for several hours or days and needs urgent treatment. Chronic has a progressive character, provoking factors are alcohol, bleeding of the upper digestive tract, which can lead to the progression of liver failure ( hepatic coma). The outcome of treatment of hepatic coma depends on the timeliness of detection of the first signs of the disease. Success depends on well-prescribed and performed therapy.

Treatment of a liver damaged by alcohol

The liver is the most important organ that needs treatment after severe alcohol intoxication.

To restore the liver after long-term use alcohol, special medications are used, hepatoprotectors that protect, promote the treatment and restoration of the liver.

Drugs such as Liv 52, Karsil, Ursosan are aimed at preventing the development of pathological processes in the liver.

No less effective are homeopathic preparations based on medicinal plants. "Gepabene" - a drug based on milk thistle and fume medicinal, has choleretic action and improves its outflow to the intestines.

Assigned to 1 capsule 3 r / d. The drug "Galstena" has similar properties. It has antispasmodic and anti-inflammatory effects on the liver. Available in tablets and drops.

Only the attending physician selects the drug treatment and prescribes the duration of the course.

In order for the treatment to be successful, it is necessary to stop drinking alcohol, strictly follow a diet, refuse fatty foods and dishes, and observe the daily routine. With such harmony as taking medication, diet and avoiding alcohol, you are guaranteed a positive result in recovery.

Source: http://InfoPechen.ru/lechenie/dieta/vliyanie-alkogolya-na-pechen.html

The effect of alcohol on the liver

Knowledge of the harmful effects of ethyl alcohol does not reduce the number of alcoholics in the country.

The most surprising thing is that in recent years the number of such “elements of society” has been growing rapidly, and, accordingly, the death rate from alcohol intoxication has also increased.

In order to once again protect the civilian population from a fatal mistake, it is worth remembering what is the effect of alcohol on the liver, what are the consequences for health?

General idea of ​​the problem

The "human filter" of a drinking person is rapidly increasing in size, changing its color and habitual structure.

If you study the internal organs of a drinking person, it becomes quite obvious what the effect of alcohol on the liver is. The fact is that the "human filter" is rapidly increasing in size, changing its color and habitual structure.

Since ethanol provokes the appearance of extensive foci of necrosis, growth occurs connective tissue. In the space between the fibers, more fluid accumulates from the destroyed hepatocytes.

Therefore, you can immediately visualize the body of an alcoholic, distinguish it from a healthy body.

Of great importance for reflecting the real clinical picture is the answer to the main questions, how much a person drinks, what are the strong drinks in his daily use.

The pattern is obvious: the less you drink, the more likely you are to maintain the health and vitality of the liver.

If there is no sense of proportion for a person, among the complications, doctors distinguish not only fatty degeneration, but also fatty hepatitis, cirrhosis.

Liver health and love of beer

Many patients, realizing the seriousness of the consequences for their own health, try to find an answer to very actual question: "Which alcohol is less harmful." Some choose beer, but there are also a sufficient number of "pitfalls" that are worth talking about in more detail.

The danger of the diagnosis of beer alcoholism lies in the fact that it spreads to an age audience - adolescents and children, which is much more difficult to treat effectively.

In extensive medical practice, such a disease of the body as beer alcoholism is known. The danger of the diagnosis lies in the fact that it spreads to an age audience - adolescents and children, which is much more difficult to treat effectively.

This, it would seem, the most low-alcohol drink gradually poisons the liver, and the main criterion for evaluating is not the indicator of ethyl alcohol in the chemical composition, but how much beer was drunk at a time, per day.

Some doses even become lethal to humans.

It can be clarified that beer contains heavy metals, toxic compounds, toxins and formaldehydes, which can provoke alcohol poisoning.

Now it is clear what happens in the human body when he systematically abuses this alcoholic beverage.

The least dangerous way out is to control how much alcohol was drunk, regardless of its degree and percentage.

Liver-safe portions of alcohol

To eliminate the risk of liver damage, you need to know how much and what drinks can be consumed on occasion. Indeed, scientists have determined the least dangerous dose for the "human filter", moreover, they have found its tremendous benefits for the body. So, women can consume no more than 10 g of alcohol per day, while the daily norm for men is 20 g.

If you touch on specific alcoholic beverages, then it is permissible to use 0.25 beer, or 0.1 liters of wine (in the case of a female body). Nothing happens in the body, but this does not mean that such liberties can be allowed daily. Doctors recommend taking a three-day break after drinking a daily portion, but not turning beer into an important part of your daily diet.

It is allowed to drink 0.25 beer, or 0.1 liter of wine (in the case of a female body)

Consequences for the liver

If a person drinks alcohol or also beer, over time, an irreversible process occurs in his body, which is not always compatible with life. To avoid such fatal consequences, it is important to understand what kind of complications we are talking about. This:

• fatty degeneration of the liver;
• chronic alcoholism;
• alcoholic hepatitis;
• alcoholic cirrhosis of the liver;
• complete or partial poisoning of the body;
• liver cancer;
• increased risk of hepatitis C infection.

To protect the liver from serious complications in work, it is required to completely abandon the intake of alcoholic beverages, take a course of hepatoprotectors to clean the filter, sit on therapeutic diet and execute preventive vaccination from hepatitis. The most important thing is to forget about alcohol, or take it in strictly limited quantities and only on occasion.

Source: http://alkogolu.net/obshee/vliyanie-alkogolya-na-pechen.html

How alcohol affects the liver

When studying the effect of alcohol on the liver, one cannot fail to mention its toxic effect on hepatocytes (its cells).

According to statistics, in people who do not control the use of alcoholic beverages, cirrhosis develops much more often than in non-drinkers.

The main blow falls on the liver, as it is the main filtering organ, cleansing more than 700 liters of blood daily. It utilizes toxic substances, thereby preventing human poisoning.

Attention!

Regular drinking and frequent binges lead to the death of hepatocytes, which is accompanied by the appearance of typical signs of their damage. It can be weakness, nausea, the skin becomes yellowish, heaviness in the stomach worries. In this case, the patient has a liver pain after alcohol and eating fatty foods.

Note that only 10% of alcohol is excreted practically unchanged, the remaining 90% are destroyed in the liver.

FAQ

Alcohol and the liver can live in harmony for a long time until the number of dead hepatocytes exceeds a critical level. The rate and form of organ damage depends on many factors, namely:

• type of alcohol;
• frequency of feasts;
• daily volume of alcohol consumed;
• initial state of the liver;
• the person's age;
• availability concomitant diseases(obesity, pancreatitis).

How does alcohol affect the liver?

Each drink, which contains ethanol in its composition, adversely affects hepatocytes. Despite the ability of the latter to regenerate, the number of functioning cells gradually decreases, which is manifested by liver failure. The fact is that alcoholic beverages disrupt the process of organ recovery, so sooner or later a person will be diagnosed with cirrhosis.

Pathological processes that are observed in the liver of an alcoholic:

1. alcohol after entering the body is sent to the liver for disposal, where it destroys the membrane of hepatocytes. While the number of dead cells is small, and a person rarely pampers himself with alcoholic beverages, his condition remains practically unchanged;
2. with an increase in the dose of alcohol and the frequency of its use, in addition to the decay products, unprocessed ethanol begins to enter the bloodstream, which is accompanied by damage nervous system;
3. the lack of cellular regeneration in the liver leads to disruption of metabolic processes and the accumulation of fat in the organ. Thus, hepatosis develops;
4. dead cells are replaced by connective tissue, which is an irreversible process.

The danger of alcoholism lies in a long asymptomatic course, when a person is unaware of liver damage and is in no hurry to see a doctor. Periodic discomfort in the right side or dyspeptic symptoms can be regarded by a person as a digestive disorder, which can be dealt with by taking the next dose of alcohol.

How does beer affect the liver?

Oddly enough, it is beer that affects the liver to a greater extent. Not knowing about it, people drink it in liters, while intoxication grows in the body. The fact is that the pronounced diuretic effect that the drink has leads to the removal of fluid and its replacement with a toxic product.

A large volume of beer does not have time to be processed by hepatocytes, as a result of which alcohol enters the bloodstream and affects the internal organs. In addition, the drink disrupts metabolism, which contributes to weight gain.

As for non-alcoholic beer, it is no less harmful than the above. Its large volume, which a person drinks at a time, has a toxic effect on hepatocytes both with a summing dose of ethanol and with various flavoring additives necessary for masking and long-term storage drink.

What is more harmful to the liver: beer or vodka?

All strong drinks contain alcohol to a greater or lesser extent. Despite its higher concentration in vodka than in beer, the latter is more toxic to the body.

This is due to the fact that a person drinks several bottles of beer at a time, while not feeling very intoxicated. When taking vodka, the depression of consciousness comes faster, so he simply physically cannot drink more.

In addition, beer today is made from non-natural components, which leads to disruption of not only the liver, but also other internal organs.

Especially toxic is acetaldehyde, which is formed during the breakdown of alcohol. It is he who leads to the death of hepatocytes and causes liver failure.

In modern medicine there is the concept of "beer alcoholism". Many people cannot imagine a day without drinking beer. This is becoming an addiction that should be fought not only by gastroenterologists and hepatologists, but also by psychiatrists.

safe dose

Based on the results of numerous studies, it has been established that alcohol can be safe if its volume and frequency of consumption are strictly controlled. This will help to avoid the development of diseases and prevent the onset of alcoholism.

Note that 20 g of ethanol is contained in 500 ml of beer or 200 ml of wine. It is important to remember that these doses are calculated for people without concomitant liver disease, and also not for daily use. There should be at least three days between meals.

Consequences of alcoholism

Prolonged alcohol abuse leads to disruption of the hepatocytes, as well as their death. The pathological process in the liver can be manifested by such diseases as steatosis, alcoholic disease, cirrhosis and malignant degeneration of tissues.

Fatty degeneration

The breakdown of alcohol is carried out with the help of special enzymes. The resulting toxic products disrupt the course of physiological reactions in hepatocytes, especially lipid metabolism.

Thanks to compensatory capabilities, a small amount of alcohol is quickly disposed of, and metabolic processes- self-repair. When the recommended doses are exceeded, a persistent metabolic disorder is observed, which leads to the accumulation of fat in the cells.

At the same time, they increase and lose their functionality. The unaffected liver utilizes alcohol with the help of alcohol dehydrogenase, however, over time, the activity of the enzyme decreases, which is associated with the depletion of hepatocytes. As a result, the barrier and detoxification functions of the organ are disrupted.

A greater risk of steatosis is observed in people with obesity, after hepatitis, and also with malnutrition. Clinically, the disease does not manifest itself for a long time. Over time, a person begins to notice:

1. malaise;
2. poor appetite;
3. decreased concentration, memory;
4. nausea;
5. irritability, apathy;
6. heaviness in the right side;
7. bitterness in the mouth;
8. yellowness of the skin.

Fatty degeneration of an organ is a good ground for the onset of an inflammatory process, therefore, with continued alcoholism, hepatitis develops, which is still quite possible to cope with.

Alcoholic hepatitis

To date, the inflammatory process in the liver is quite common problem hepatologists and gastroenterologists. It develops as a result of uncontrolled intake of alcohol. The risk group includes people who abuse alcohol for more than 5 years.

Symptomatically, the disease is manifested by the above signs, as well as new ones, such as:

• hepatomegaly (enlargement of the liver);
• pain in the right side, which is associated with inflammation and swelling of the parenchyma of the organ, which leads to stretching of its capsule, which has nerve endings;
• sleep disturbance;
• decreased libido and erectile dysfunction;
• the appearance of spider veins on the skin.

Restoration of the liver structure at this stage is still possible, but it is necessary to completely abandon the use of alcohol and undergo a treatment course.

cirrhosis

Cirrhotic liver damage in 45% of cases is diagnosed in people with alcohol experience of more than 10 years. The development of the disease is based on the massive death of hepatocytes, which are gradually replaced by connective tissue. As a result, the body loses its functionality up to a complete failure.

In the compensated form, the disease is manifested by severe weakness, pain in the right side, nausea, flatulence, spider veins, swelling of the extremities and sudden mood swings.

With the transition of cirrhosis to a decompensated form, the appearance of complications is observed:

1. ascites (accumulation of fluid in the abdominal cavity);
2. pronounced edema of the extremities, chest, back;
3. increased bleeding, which is associated with a deficiency of coagulation factors;
4. encephalopathy. The person becomes aggressive, and later there are signs of inappropriate behavior, delirium and hallucinations;
5. jaundice.

At this stage, the volume of the liver may decrease, so the intensity of the pain syndrome decreases.

Maintenance and restoration of the liver

A complete rejection of alcohol is an almost unrealistic task for a person. However, by controlling its volume and frequency of use, it is possible to avoid the development of diseases and prevent liver failure. Here are the basic rules:

1. after taking alcohol, a course of hepatoprotectors is necessary;
2. proper nutrition is a good help to the liver;
3. regular examination (ultrasound 1-2 times / year).

Medical treatment

Hepatoprotectors help the liver after alcohol. They include herbal ingredients(artichoke, milk thistle), phospholipids, amino acids and others. Their main task is to restore the structure of cells, protect them from negative environmental factors, as well as normalize metabolic processes.

They are taken for a long time, are well tolerated by the patient and rarely cause adverse reactions. Among the known hepatoprotectors, we highlight:

• Antral;
• Heptral;
• Phosphogliv;
• Glutargin;
• Ursofalk (including increases the synthesis of bile and improves its outflow);
• Essentiale forte N.

In addition to hepatoprotectors, the body needs vitamins and enzymes that facilitate digestion. If necessary, antispasmodics are prescribed, for example, Duspatalin. Their action is directed to the bile ducts. By expanding them, the drugs accelerate the outflow of bile.

1. rasters of albumin and amino acids (Aminosol, Gepasol) - with protein deficiency;
2. Rheosorbilact, Sodium chloride, Neogemodez - for detoxification;
3. hemostatic drugs (Tranexam, Etamzilat) - with increased bleeding;
4. fresh frozen plasma;
5. erythrocyte mass (with anemia).

Alternative methods of protecting the liver from alcohol

Many folk remedies are successfully used to restore the liver, but it is important to remember that they can only help at the initial stage of the disease and are used exclusively in combination with medications. To this end, it is recommended:

1. honey - you need to take 5 g three times. This will reduce inflammation in the liver;
2. burdock juice - 10 ml once / day;
3. milk thistle is widely used to restore hepatocytes and cleanse the body of toxic products. It should be taken as a powder in a dry form, as under the influence high temperature beneficial features plants disappear;
4. oats can be drunk in the form of a decoction, infusion or jelly. For cooking, it is enough to pour 120 g of grains with 460 ml of water, leave for 12 hours and boil for 25 minutes. Next, the broth is half a day, then diluted with water to obtain 550 ml. We drink 100 ml three times;
5. 15 g of artichoke, St. John's wort, as well as knotweed should be poured with 1 liter of boiling water and left for 25 minutes. We take 70 ml twice a day.

For cleansing purposes, you can use mineral water, sorbitol, magnesia or rose hips. In addition to removing toxic substances, the cleansing procedure improves bile flow and facilitates the work of the liver.

diet

To facilitate the work of the liver, you need proper nutrition. It plays an important role in the process of recovery of the body after alcohol. Here are some basic dietary guidelines:

• prohibited foods include fatty, fried foods, peppery seasonings, smoked meats, pickles, convenience foods, fast food, creamy sweets, fresh pastries, soda, rich soups, cabbage soup and chocolate;
• dishes should be warm, in puree or liquid form;
• you should eat often, in a small amount with a maximum interval between meals - two hours;
• dishes should be prepared by boiling, stewing or baking ingredients;
• the daily volume of liquid must exceed two liters;
• preference should be given to fruits, vegetable oil, vegetables, cereals (oatmeal, buckwheat, rice, millet), lean meat, low-fat milk and fish.

Pumpkin, oats, turmeric, avocados, apples are especially useful for the liver, from which you can cook delicious dishes.

Through a comprehensive solution to the issue of protecting and restoring the liver after alcohol, you can achieve the desired result and avoid the development of organ failure.

Sergey Korsunov

There are no safe doses of alcohol. According to WHO recommendations regarding safe doses alcohol can be considered up to 20–40 ml of ethanol for men and up to 20 ml of ethanol for women. 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 bad influence alcohol on the liver appear when more than 80 ml of ethanol is consumed per day for five or more years.

In order to develop alcoholic liver disease with a possible transition to cirrhosis for an adult male, it is enough to take alcohol at a dose of 50–80 ml of ethanol per day, for a woman this dose is already 30–40 ml, and for adolescents even lower: 15–20 ml per day. And that's just 0.5 liters of 5% beer every day!

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

The myth of the harmlessness of "weak" alcohol

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

The effect and harm of low-alcohol drinks is equivalent to the effects of strong ones. And the main reason for this 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 need to drink only three bottles of beer or two cans of low-alcohol cocktail to get as much ethanol as there is in a glass of vodka.

According to statistics, more than half of the population of our country drink beer. And the popularity of beer does not give up its positions because of the seeming "harmlessness". The number of beer consumers is growing every year. Experts consider beer a legalized drug, which quickly develops physical and psychological dependence. Teenagers and women can become addicted to beer especially quickly.

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

"Beer makes people lazy, stupid and powerless," said Bismarck, Germany's first chancellor. And he knew firsthand a lot about beer.

Also gaining popularity, especially among young people, low-alcohol canned cocktails. Due to their sweetish taste, they are perceived as strong lemonade. But one jar contains the 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 immediate. 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 the alcohol consumed) is taken by the liver, where the alcohol is further processed.

First, under the influence of a special enzyme - alcohol dehydrogenase - ethyl alcohol is oxidized and converted into acetaldehyde. Further, acetaldehyde is oxidized by complex chemical reactions and decomposes to final substances - carbon dioxide and water. But this happens only when the amount of alcohol is small and liver enzymes are sufficient to complete the cycles of converting ethanol into decay 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 decay in the liver. Acetaldehyde is ten times more toxic than ethanol, its excess causes, in addition to its direct damaging effect, a violation of the normal outflow of bile, the accumulation of fats in the liver, and general poisoning of the body. And ethyl alcohol, which is not oxidized 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 abilities of the liver are not endless, and, in the end, this potential is depleted. Liver cells begin to be replaced by fibrous tissue with the restructuring of their functions and the transition to cirrhosis.

What mechanisms and risk factors cause alcoholic liver damage?

The first is chronic alcohol abuse. Sometimes the quantity and quality of liver enzymes that metabolize alcohol can be genetically impaired.

It is noted that women are more susceptible to alcohol and the development of dependence in them occurs faster.

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

The lifestyle that a person who consumes alcohol also matters. It is known that nutritional deficiencies (malnutrition, diets) and alcohol are incompatible.

If there is viral hepatitis, then the negative effect of alcohol on the liver is enhanced by its use. Vaccination against hepatitis can prevent the disease. A quarter of patients diagnosed with alcoholic liver disease have antibodies to chronic hepatitis C, which indicates an increased risk of infection with this type of virus.

Vaccination against hepatitis - for or against?

In recent years, distorted opinions have been formed in society related to the alleged 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 way of its transmission is household.

Hepatitis B is transmitted mainly through the blood. To transmit the virus, a drop of blood is enough, which remains, for example, in the needle of a syringe. 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 epidemic in recent years.

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

Hepatitis B vaccination is included in the vaccination calendar for children. Adults are vaccinated with their desire and consent. Usually the vaccination schedule looks like this: 0 - 1 - 6. That is, the vaccination should be repeated after 1 and 6 months.

Many people have a question about the effect of alcohol on the effectiveness of the hepatitis vaccine. The use of alcoholic beverages in acceptable doses does not affect the vaccination. But you will still need to stop drinking alcohol for three days after the vaccination, due to the fact that each vaccine has its own side effects, which drinking alcohol can exacerbate.

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 prolonged poisoning of the entire human body with alcohol (ethyl alcohol).

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

1. Liver steatosis (fatty degeneration; fatty hepatosis);
2. alcoholic hepatitis;
3. Cirrhosis of the liver.

Hepatosis (steatosis)

The initial stage, or fatty hepatosis, is characterized by the deposition and accumulation of fat cells in the liver parenchyma. It occurs in people who abuse alcohol in more than 90% of cases. Usually asymptomatic, there may be symptoms of dyspeptic disorders, a feeling of heaviness in the right hypochondrium, weakness, icterus of the skin and mucous membranes. Liver steatosis is a reversible process, and if alcohol is given up and treatment is carried out, a complete cure is possible. If there is a further effect of ethanol on hepatocytes, alcoholic liver damage passes into the second stage - alcoholic hepatitis. This creates more deep defeat hepatocytes with a violation of their functionality.

Alcoholic hepatitis

The course of alcoholic hepatitis can be in the form of persistent (stable course, usually asymptomatic or asymptomatic, relatively reversible changes in the liver) or progressive form (transition from the previous phase in case of further alcohol abuse; unfavorable course, as a rule, turns into cirrhosis).

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

There are several varieties of the course of acute alcoholic hepatitis, but the icteric variant is the most common. At the same time, in addition to jaundice, pain in the right hypochondrium, severe weakness, loss of appetite, nausea, vomiting, prolonged loose stools, and noticeable weight loss are observed. The liver increases, has a dense structure, is painful.

Chronic hepatitis is often relatively asymptomatic. Severe organ damage can only be indicated by laboratory and additional research methods. The liver also increases significantly, up to a huge size.

cirrhosis

The third stage is cirrhosis of the liver. This is a completely irreversible stage, when normal hepatic tissue is replaced by 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. The worsening of the symptoms and course of cirrhosis is observed when combined with chronic viral hepatitis B or C, obesity, female gender.

Symptoms of cirrhosis can be quite scarce, especially against the background of a long course of the disease. The patient is concerned about fatigue, weakness, pain in the liver, asthenia (weakness, fatigue). A characteristic “hepatic” erythema (redness) appears on the palms, small capillaries expand on the entire surface of the body. The liver is enlarged or, conversely, reduced, may already be painless, its surface is bumpy. Signs of ascites, enlargement of the spleen are revealed, as a result of which the abdomen increases with an expanded venous network on its surface. Symptoms of portal hypertension appear. There is a violation of the functions of other organs and systems as a result of poisoning with 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.

Diagnosis is confirmed by laboratory, ultrasound or radioisotope research, computed tomography. Carry out if necessary diagnostic laparoscopy and liver biopsy.

How is alcoholic liver disease treated?

The most important condition is the complete refusal of the patient from alcohol. At some stages of alcoholic liver damage, complete regeneration of the liver tissue can occur. But it should be noted that, unfortunately, this recommendation is fulfilled by no more than a third of patients. Just as many simply reduce the amount of alcohol consumed, and the rest completely ignore it and continue 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. The protein content is about 1 g per 1 kg of the patient's weight. It is necessary to saturate with vitamins, especially group B. Table number 5 can be an example of such a diet.

Medical treatment

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

With the ineffectiveness of conservative treatment, the question of liver transplantation is decided.

Attention! Information about drugs and folk remedies is provided for informational purposes only. In no case should you use the medicine or give it to your loved ones without medical advice! Self-medication and uncontrolled reception drugs is dangerous for the development of complications and side effects! At the first sign of liver disease, you should consult a doctor.

©18 The editors of the portal "My Liver".

The use of site materials is permitted only with prior agreement with the editors.

Alcoholic liver disease: the price of pleasure

Of all the foods that humans consume, alcohol is the most addictive. There is a direct link between alcohol addiction and liver damage. Alcohol abuse sooner or later leads to the development of alcoholic liver disease (ALD).

Why alcohol is dangerous 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 how much you need to drink in order for the liver to “sat down”, no one will tell you.

How much alcohol does it take to get sick

Many researchers believe that taking grams of ethanol per day for ten to twelve years causes a risk of developing alcoholic liver disease. About half of those who drink alcohol in dangerous doses suffer from severe liver damage - cirrhosis and hepatitis. This indicates that in addition to the direct toxic effect of ethanol, hereditary factors and exposure factors are involved in the pathogenesis of alcoholic disease. environment. ABP features:

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

What happens with ABP

Alcoholic liver disease is manifested by symptoms:

• there is heaviness in the right hypochondrium;
• biochemical liver tests are not changed;
• the liver is enlarged;
• the gastrointestinal tract is affected;
• heartburn appears due to inflammation of the esophagus;
• rupture of the esophagus occurs;
• bleeding;
• gastritis;
• stomach ulcer and 12 duodenal ulcer;
• the pancreas suffers;
• frequent diarrhea;
• severe acute pancreatitis that needs to be treated surgically;
• stomach ache;
• the brain suffers;
• degeneration of the nervous system;
• the functioning of the peripheral nervous system is disrupted;
• numbness;
• impaired sensitivity in the limbs;
• the heart is affected;
• blood pressure rises;
• heart failure occurs;
• the work of skeletal muscles is disrupted;
• blood cells change
• the skin is affected;
• a kind of alcoholic ornament appears.

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

How to Treat Alcoholic Liver Disease

The main and most effective method treatment of alcoholic liver disease is the complete cessation of alcohol intake. Refusal of alcohol at the stage of fatty degeneration of the liver will completely restore the size and structure of the liver. In severe acute alcoholic hepatitis, hormonal drugs are prescribed .. The drugs are shown:

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

An essential component of treatment is the restoration of vitamin and microelement deficiency, a complete balanced diet.

Only registered users can leave comments

Top 10 Cirrhosis Myths

1. Real danger cirrhosis of the liver is greatly exaggerated by doctors and the media. The usual horror story for weaning 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 the doctors of ancient India. And the term "cirrhosis of the liver" ("red liver") appeared in medicine at the beginning of the century before last, and at the same time the clinical picture of the disease was described. Since then, little has changed. Chronic alcohol intoxication is the cause of half of all cases of cirrhosis. On average, every third alcoholic falls ill, usually a year after the onset of 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 filth, because not alcohol itself is harmful, but poisonous fusel oils. Drink high-quality vodka - and your liver will only thank you.

Leave this statement on the conscience of the manufacturers alcoholic products. The liver destroys ethanol by itself, even the purest and highest quality. It has the unpleasant ability to activate fibrogenesis in liver tissues. In other words, it is under its influence that the cells begin to produce collagen and the viable liver tissue is replaced with completely useless connective tissue. The dangerous dose of alcohol has long been well known - g of ethanol (g of vodka) per day - depending on individual features organism. 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 poisonous muck is added to ethanol, the risk increases.

3. Who does not 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 soon. The duration and quality of life depends on the origin of cirrhosis, the degree of destructive changes in the liver, the treatment being carried out and, of course, the stage of the disease - the earlier the diagnosis is made, the more favorable the prognosis. With alcoholic cirrhosis, lifelong refusal of alcohol in the early stages and modern treatment lead to recovery, with viral cirrhosis, they stop the development of the process and contribute to long-term remission.

So don't wait clinical symptoms- swelling of the liver, jaundice and blood from the nose. These are not signs of the beginning, but of an advanced stage. Donate blood for biochemical analysis and undergo an ultrasound of the liver for any diseases gastrointestinal tract or fever of unknown origin. Especially if there are risk factors in your life - past 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.

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

But (see paragraph 4) we repeat once again: at an early stage of alcoholic cirrhosis, timely measures taken can lead to the restoration of liver tissues. If it came to the irreversible destruction of the liver tissue, even under the happiest set 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 drug, 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 - 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 destroyed cell membranes. However, at present, many researchers believe that the effectiveness of lecithin is slightly exaggerated (only half of the administered phospholipids are fully incorporated into cell membranes and actually restore the liver). And most importantly, it cannot work a miracle and restore tissues in which irreversible changes have already occurred (see paragraph 5).

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

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

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

Not certainly in that way. Poor birds are indeed inserted into the throat of a hose and through it, super-caloric food is poured into the stomach. But this mockery only leads to an increase and fatty liver. By the way, gourmets would certainly reject cirrhotic liver - too tough. Hence the conclusion (except for the rejection of 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 the pancreas will not withstand the first. On the contrary, malnutrition with a deficiency of proteins and fats can lead to the so-called alimentary cirrhosis, but for this it is necessary to sit on a very meager diet of fruits and cereals for many years.

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

Not certainly in that way. The final stage is usually: encephalopathy and hepatic coma, gastrointestinal bleeding or ascites followed by peritonitis. Sounds incomprehensible? For the curious - the details.

Encephalopathy is a complex of neuromuscular disorders caused by severe liver failure. It all starts with a decrease in activity and apathy. Then the patient becomes aggressive and untidy, commits senseless acts. At the next stage, confusion, muscle cramps, and impaired coordination of movements develop. The last stage is a hepatic coma, first with periods of clear consciousness and arousal, then without reflexes and sensitivity to pain. From this point on, the fading can really 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 flows through the liver per minute. Both streams are connected in the liver and intensively contact with the villi of hepatocytes - this is the purification of blood by the liver. Fibrosis of the liver tissue (replacement of healthy cells with connective tissue) causes difficulty in normal blood flow, 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 cirrhotic patients forms on the abdomen above the navel, and when the anastomoses rupture, life-threatening gastrointestinal bleeding begins (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 fluid accumulate in the stomach, and sometimes more (a bucket of water is practically). This fluid can spontaneously become infected with bacteria from the intestine, and then ascites progresses to peritonitis, with a mortality rate of up to %.

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

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

I'm writing in case it's useful to someone. My husband had cirrhosis of the liver of the 4th degree, after suffering hepatitis C. The virus, a year and a half ago, was removed with a drug, Vikeyropak. ”My husband was treated for cirrhosis by a well-known doctor in our city, Odushko Igor Nikolaevich. Once every half a year they did an elastography. Fibrosis has halved. My husband is 61 years old. He is efficient. For 1.5 years I have never been ill .. And they say cirrhosis is not treated. We even got rid of type 2 diabetes. Thanks to Igor Nikolaevich. His naturopathy is patented. This is Bionorm.” I will be glad if my advice helps someone. In his site there is a photo of analyzes (elastography).

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

Very scary article.

Also very informative, I didn't know much.

Still, we must take care of ourselves, we have one life and it is not worth an extra glass of alcohol.

You can also get vaccinated against hepatitis. In my opinion, there is only hepatitis B, but it partially protects against hepatitis C. Not that much money is worth. Health is still more expensive.

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

A friend was diagnosed with fatty liver, everyone around him wound up that it was already cirrhosis.

But as far as I understand, this is the initial stage, if not treated, it will definitely turn into cirrhosis.

Am I right or wrong?

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

An interesting article, but I agree that cirrhosis can be earned not only from alcohol, it will rather exacerbate the situation. But there are examples when people already in adulthood begin to actively use the result of death is cirrhosis. You have to be more careful.

I agree with the third paragraph of the article.

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

You feel in such situations your impotence and lack of logic in life. It all somehow depresses me.

Because it is simply not possible to protect ourselves from all possible infections, we communicate with people and live in a society full of different bacteria and viruses.

Should drink less!

This question is not very relevant in Russia.

Well, not everything is so critical, Andrei. Russia is not the most drinking country! And what does the whole of Russia have to do with it, it’s 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. From all these horrors and horror stories, you don’t even want to look at alcohol. not like drinking enough of it to get cirrhosis ..

So you have to take care of yourself, life is one and only.

many don't drink.

But many, and the statistics say otherwise.

In my opinion, you do not own the information, Andrey, but simply write off everything for stamps. if you still look at the statistics, you will understand that Russia is far from the most drinking country.

It is not necessary to thoughtlessly repeat some common phrases, and even more so such. I am 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. Take care of your health and exercise.

And the assertion that we are all drunkards is dismissed 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 half effective, it still does not 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 use it.

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

After I had jaundice at the age of 18, I follow my liver cardinally.

Yes, hepatitis is a serious disease, the consequences of which remain for life. So 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 already have the opportunity to protect yourself and take care of your liver, then why not do this . especially since the price issue is not so great.

Well, if you have already managed to get sick, then of course you will have to treat yourself with special attention and taking care of your liver, that's right ..

The moral of this fable is this - you need to monitor your health, and ideally, besides, do not drink 🙂

Yes, health is very fragile and it is necessary to support your body in every possible way every day, not to be lazy to undergo an examination at least once every half a year.

Well, do not drink at all, probably it will not work and there is no such urgent need. I think that a glass of good wine on a festive day is quite acceptable. But no 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 on the person, of course.

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

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

This is indeed a scary article.

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

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

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

Everyone hopes so.

The unfortunate liver passes everything through it, it processes everything so that there is no cirrhosis, your liver must be protected.

Yes, nature has not provided reserve organs to man, and we live with one set all our lives. Well, the liver is the most important organ, sung in myths. All you have to do is take care of yourself! :)

And we load her so much every day, it’s even amazing how she copes with all this.

Fatty food, spicy food, alcohol, she needs to pass all this through herself and at the same time remain healthy herself.

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

What is terrible about cirrhosis, that it begins asymptomatically ..

it's a terrible disease

Yes, cirrhosis is one of the worst diseases.

But if it is detected in time, then there is a chance to save yourself, prolong life, but not everyone will be constantly examined, and when it comes it is already too late.

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

My friend died of cirrhosis - the doctors could not save.

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

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

So it's probably just a transplant.

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

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

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

Yes, and we ourselves do not monitor precious health on an ongoing basis, alas.))

Testicular atrophy is an argument

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

And who did not immediately understand, there is an opportunity to read more than once, add to bookmarks and always remind yourself ..

Promotion

Materials published with permission from Rodale Press, Inc. All rights reserved. Any reproduction of materials or fragments from them in any language is possible only with the written permission of Moscowtimes LLC. «Partner of Rambler»

Lev Belonovsky 05/14/2017

Five questions about medicine
How much you need to drink to get cirrhosis of the liver, how anesthesia works and why ammonia smells so strong

Why does ammonia have such a strong smell?

When answering this question, first of all, one should start from two conditional classifications of substances:

First, substances are non-volatile and volatile. Substances with a large molecular weight, that is, either having a complex structure (most organic substances) or composed of heavy elements of the periodic table (most inorganic substances), are non-volatile, but light substances with a low molecular weight are, on the contrary, volatile, that is, individual molecules substances are easily split off from its liquid and even solid state of aggregation.

What generally causes smell? - precisely the volatility of the substance. The evaporated substance molecule binds to the olfactory receptors in the nose, which are protein molecules with such a structure that each of them fits only a certain form of the molecule, or at least only a molecule with a certain site in its structure can approach the receptor.

Secondly, substances are non-poisonous and highly toxic. Not toxic substances may not affect the body at all or affect it, but to a small extent, and only in large concentrations, while toxic substances disrupt physiological processes even in small quantities.

Ammonia is an aqueous solution of ammonia. Ammonia It is a highly volatile toxic substance. It is so volatile that a small concentration of ammonia in the air already creates a suffocating smell. Inhalation of a slightly higher concentration or a long stay in the atmosphere of that small concentration will necessarily lead to dizziness, nausea, and then other disturbances in normal life, since in toxic concentrations it depresses the respiratory center in the brain, and death occurs from suffocation. In low concentrations, on the contrary, it activates the respiratory center, due to which it is used for fainting. In fact, with an increase in concentration, it still activates it, but already so strongly that the center cannot withstand overexcitation and turns off.

But this is a preface. Now let's remember what else smells bad? Feces containing sulfur and ammonium compounds smell bad. Other thiols also smell bad, which include the most disgusting smelling substance - so much so that the laboratory that synthesized it, sorry, vomited. Some other substances that are, attention ... volatile poisons also smell bad. Why volatile and why poisons? If they weren't volatile, they wouldn't smell at all. As for poison...

From this moment begins the answer to the question. Over the course of epochs, various receptors for odorous substances were formed in living organisms, ways of delivering a nerve impulse in the form olfactory nerves different structure and all sorts of effects of the body's perception of certain odors, various complexes of olfactory sensations - and evolution fixed those that led to the survival of the organism or at least did not harm it, and eliminated those that could and did kill it. And it is precisely those complexes of receptors, pathways and olfactory sensations (namely, extremely unpleasant from irritating to nauseating) that we have for various volatile poisons that have become entrenched in us as an instrument of protection against them.

Ammonia (and other nitrogen and sulfur compounds) accompanies us throughout the evolutionary path, being present in harmful products metabolism, excreted from the body (urine, feces), and in decaying bodies, which are dangerous and harmful to eat for obvious reasons. That's why it smells So.

How does anesthesia work?

Answer: If you want for a superficial acquaintance and briefly: during anesthesia, nerve transmission is disturbed through various mechanisms and in different points applications. If you want to really understand the essence of anesthesia, then get ready for a long and complicated reading.

To begin with, let us clarify that anesthesia(from the Greek narcosis (νάρκωσις) - numbness / numbness), or general anesthesia(from the Greek an-estesia (ἀναισθησία) - without feelings) - this is a decrease in the sensitivity of the body up to the complete cessation of its perception of information both about the impulses of the environment and about its own state.

In order not to use terms that are unfamiliar or not entirely clear to the reader in the answer, let's look at the most important of them (explanations for rarely encountered terms are given in a footnote at the end of the answer):

Neuron- This is a nerve cell, which is a structural and functional unit of the nervous system, which is electrically excitable and transmits, processes and stores information using electrochemical impulses. What means structural unit? The body has a nervous system, mostly made up of nerve cells. The car has a gearbox, the transmission in which is carried out by gears. What means functional unit? In the same example, it is the gears that carry out the transmission, not the sheath, and it is the neurons that transmit the nerve impulse, and not the Schwann cells covering the processes of the neuron, and not the glia between the neurons. What means electrically excitable? This means that a neuron, unlike, for example, a fat cell, will respond to a change in the surrounding balance of ions that carry an electric charge, by the same change in the balance of ions in itself, that is, transfer the electrochemical charge further.

It is clear that anesthetic substances that violate the sensitivity, which is due to nerve transmission from the peripheral receptors of the body to the central nervous system, will affect precisely the nerve cells that carry out this transmission. So we are looking into this.

The neuron has processes: dendrites and axon. Dendrites are usually short, and axons are long (up to a meter). A neuron receives a signal along one or several dendrites and transmits a signal along only one axon. Between the axon of one neuron and the dendrite of another or another cell (for example, muscle) that receives an electrochemical impulse, there are synapses.

Synapse consists of the synaptic space between the presynaptic and postsynaptic membranes. Membrane- this is a cell membrane, consisting primarily of phospholipids that can passively pass only fat-soluble molecules, so that water-soluble substances do not enter the cell uncontrollably. Pre and post means before and after. presynaptic membrane located on the axon and marked in yellow in the figure; postsynaptic- on a sensitive cell, green. Transfer between these membranes is carried out chemicals - neurotransmitters, or neurotransmitters, or both without the prefix "neuro-" in the appropriate context.

Both membranes have receptors and transporters. Receptors- these are high-molecular compounds of a protein nature, capable, when interacting with a substance specific to them (mediator), to change their shape or structure (that is, conformation), as a result of which they transmit a signal to one or another intracellular system and change its state. First of all, intracellular systems include conveyors, and to them - channels that pass substances along a concentration gradient (a substance from a concentrated mixture will tend to a dilute one, that is, along a gradient, like a person from a crowd on Fresh air), or passing these substances in response to others, or while consuming ATP energy (in the last two cases, it is possible to move against the concentration gradient, as in a tank with the consumption of fuel into a crowd of zombies).

FROM nerve cell and synaptic transmission sorted out. Let's move on to the mechanism of action of anesthetic substances.

The mechanism of action of each particular anesthetic is different depending on their chemical structure and physical properties. Depending on the same parameters, anesthetics can be used inhalation and non-inhalation, but the general mechanisms depend on the method of administration only in the last place. So, drugs according to modern ideas may have different application points in the neural network:

• Change physiochemical properties proteins and lipids* of neuronal membranes;
• Disrupt the function of receptors, including both reactivating them and blocking them;
• Disrupt the function of ion channels;
• Disrupt the function of other enzymes on the membrane;

Including displacing cofactors from the connection with proteins (which are both receptors, channels, and other membrane enzymes), without which the work of the protein is not carried out, or penetrating into the cavities of the protein molecule, thereby violating its internal and intermolecular bonds.

Depending on the combination of which groups of application points and which particular application points (for example, to all or many ion channels, or, on the contrary, only to muscarinic-sensitive cholinergic receptors of the first type, or to several enzymes, or in general to all proteins in the synapse or even not only in it), various therapeutic and side effects occur, in the subtleties of which we will not go into, so as not to get away from the essence of the issue and the essence of anesthesia.

Obviously, the mechanism of action depends not only on the point of application in the synapse, but also on the localization (location) in the nervous system - they can be as follows:

• Polysynaptic systems of the CNS: cerebral cortex (in which there are tens of trillions (!) synapses), hippocampus, thalamus, reticular formation, spinal cord, the action on which determines hypnotic effect anesthesia; - in addition to the respiratory (it is clear what is responsible for) and vasomotor (affecting vascular tone and the frequency and strength of contractions of the heart) centers, which are inhibited only with the introduction large quantities anesthetic, and are turned off - when excessive, which causes the toxic effect of anesthesia in the event of an error in the selection of concentration;
• Afferent¹ synapses on from the peripheral receptor to the peripheral nervous system and from it to the central one, that is, they bring a signal, which causes a loss of sensitivity during anesthesia.
• Efferent² synapses, that is, carrying away the signal, the blocking of which causes muscle relaxation during anesthesia.

So really during anesthesia, nerve transmission is disrupted through various mechanisms and at different points of application. But now you also understand what it means and what variety is hidden under “different” mechanisms and points.

Notes:

*Lipids are a group of substances defined from the reverse: all water-insoluble substances that have biological origin; examples are fats, waxes, cholesterol derivatives, fat-soluble vitamins, and so on - the principle is clear.

¹Afferent - bringing. How to remember it? Remember affect - a state of overexcitation that develops, for example, on some strong emotional stressor.

²Efferent - taking away. How to remember it? Think about the effect - the result of some action. Actions rather than perceptions. An active process, not a passive one.

+ A small general example for those who understand the essence well.

Many anesthetics activate glycine and gamma-aminobutyric acid receptors - the main inhibitory neurotransmitters of the nervous system - that open channels for chloride ions, and block nicotine-sensitive cholinergic receptors and N-methyl-D-aspartate receptors associated (associated) with channels for sodium and potassium ions and calcium.

Chlorine has an inhibitory effect already inside the cell, just as sodium, potassium and calcium ions have an excitatory effect inside the cell. The fact is that the transition of a cell from a state of rest to a state of action requires a transition on its membrane of the rest potential to the action potential, and the rest potential is due to negative charges, and the action is positive, respectively, the more negatively charged ions in the cell, the more it is at rest. , and the more positive, the closer to action. At the same time, there is more sodium outside, and more potassium inside, therefore, when the channels are activated, sodium enters, which increases the sign of the cell charge, and potassium leaves, which compensates for this increase. However, when the cell goes into action, additional channels for sodium are activated, which causes additional accumulation positive charge cell and the spread of action through it.

As a result of activation and blockade of the above receptors, the entry of sodium and calcium decreases, but the entry of chlorine increases, which leads to an increase in cell rest, or its hyperpolarization, as well as to a decrease in the release of mediators through calcium-sensitive channels.

This will cause the oppression of consciousness and conduction in both directions, including the oppression of sensitivity.

How long do you have to drink to get cirrhosis of the liver?

Answer: In various textbooks and recommendations, you can find different numbers and terms, but on average you can come to the following: alcoholic cirrhosis of the liver develops as a result of prolonged use alcohol (more than 10 - 15 years) in large doses, which, when converted to ethanol (pure alcohol), is 40 - 60 g or more per day for men, and 20 g or more per day for women, because their liver cells have an increased sensitivity to endogenous toxins due to a different hormonal background with men. At the same time, at some conferences of gastroenterologists and hepatologists, one can hear similar statements: "Daily consumption of 80 g of ethanol for 10 years will lead to alcoholic cirrhosis of the liver with a 100% guarantee."
In any case, one can never give an unambiguous answer to such a question, because there are too many factors that somehow affect the final result. genetic predisposition, the state of the liver before a person began to abuse alcohol, his lifestyle, diet and bad habits (in addition to alcohol dependence), age, history of life and the presence of chronic diseases, all the more forcing to take any drugs, for example, if you drink and use paracetamol in large doses, then cirrhosis will come much faster, and here even the psychological state of a person, being in constant stress, and so on, will play a role, all this also affects hepatobiliary system, plus the same anomalies of the constitution and the nature of the blood supply to the liver in a single individual.
So, based on all the information, we can say that someone will develop cirrhosis in a couple of years, and someone may not develop at all, many have heard stories about alcoholics, at the autopsy of which, the liver is in a very good condition. But these are rather unique cases, and most likely this person simply died from something else and he did not have time to develop cirrhosis, but he definitely had fatty degeneration of the liver, plus, as a rule, these are all the stories, they say: “My grandfather smoked for 40 years, and at the autopsy his lungs were like those of a baby ”- in practice they do not stand up to criticism.

What happens if you put tea-brother through a vein?

Answer: Don't die. Surprised? If not the whole cup and slowly, say, through a dropper, then still nothing. Of course, the tea must be sterile, otherwise there will be septic shock. The condition of sterility is well observed when brewing with boiling water. By the way, it's better to use green tea, because it becomes black after exposure to bacteria, their remnants may be contained there. Your heart rate may increase as tea contains caffeine. Breathing will deepen. I can’t say anything about the other components, but they will also contribute to the reaction. Therefore, do not brew it for a long time, otherwise it will end badly. And you should not repeat the procedure, because your immunity has already set its sights on this tea and upon repeated contact there will be anaphylactic shock - a systemic destructive reaction, a terrible battle between the body and tea, as a result of which both can die (mortality rate up to 20%). Don't try to repeat. And the first time, too, I do not advise - you never know.

What is the difference between hitting a person with a pistol caliber bullet (eg 9 mm) and a rifle caliber bullet (eg 5.56 mm)?

Answer: And who told you that the rifle caliber is 5.56? With Russian (Soviet) weapons, in general, everything is not so simple. For example, the Tokarev Pistol (TT) was sharpened for 9 mm caliber - a kind of micro-howitzer. Exactly the same caliber was originally provided for the Makarov pistol (cartridge of the 1951 model). Although there were modifications for 5.6 mm. The same story with the Stechkin pistol.

However, at the beginning of the last century, a huge amount of ammunition was 7.62 mm cartridges, which simultaneously fit

a) to Mosin rifles (“three-rulers”)

b) machine guns of the Maxim system;

c) revolvers of the Naganov system.

And their stock, even at the end of World War II, was so huge that even Kalashnikov assault rifles (AK-45 and modifications) were (and now) sharpened precisely for this caliber.

For some time, carbines of 5.6 caliber were (and are still being) in service, but this is already a rarity, except for commandant regiments and guards of honor.

Now to the question itself. When a 9 mm caliber bullet enters the body, it penetrates into the cavity with multiple ruptures of internal organs (due to the low speed of the bullet). The 7.62 mm caliber bullet has the highest (by our standards) kinetic energy. In addition, the standard Soviet-made 7.62 bullet has a specific geometry.

Its penetrating ability is extremely high, the aiming range of the Nagant revolver or the Mauser pistol is about one and a half (!) Kilometers. For comparison, the effective range of the Makarov pistol is 25-75 meters.

A 5.6 mm caliber bullet has an extremely low initial velocity - the result of firing: it is useless in long-range combat, in close combat it is a torn belly of the enemy with a huge hole. Wounds "to take off" as a rule does not happen. Due to its qualities, the question of the final removal of the caliber from service is being considered.

In contact with

Alcoholic cirrhosis of the liver or toxic is a diffuse severe liver damage with the replacement of its functional cells with fibrous tissue. First, liver cells are affected by alcohol toxins, then they die. Alcoholic liver cirrhosis accounts for 50% of all detected cirrhosis.

When taking alcohol, the liver always becomes a target, but only a third of alcoholics develop cirrhosis. How many years do you need to drink to reach cirrhosis? At least 10-15 years old.

For the development of cirrhosis, there must be a combination of several factors: alcohol consumption must occur regularly for at least 15 years; the dose of alcohol must exceed allowable norms: for women it is 20 grams of ethanol per day, for men - 40-60.

In addition, there should be a hereditary predisposition to the disease, female sex, deficiency of proteins and vitamins, addiction to fatty and spicy. For toxic effects, it doesn’t matter what kind of alcoholic drinks were drunk, everything is determined by the level of ethanol in them.

The prevalence of cirrhosis varies from country to country. There are countries where cirrhosis is almost impossible: Tibet, Nepal, China, Iran, Saudi Arabia, Norway, the countries of Oceania - in them the level of alcohol consumption per capita per year is only 5 liters. Just imagine: only 5 bottles a year!

The American continent, Finns, Swedes, Japanese, Azerbaijanis and Italians - 10 liters per capita. There is a low level of cirrhosis. Romanians, Moldovans, French and Portuguese - 15 liters per year. The numbers of cirrhosis are average.

And ahead of the rest - Ukrainians, Belarusians and Russians - some 19 liters per capita. Here the highest percentage of cirrhosis and live, apparently, the most hardy. Well, what to do, the Slavs love to kiss and not think about the consequences.

Processes in the liver when taking alcohol

As hepatocytes become toxic, they are destroyed and begin to be replaced by fibrous tissue. Surviving hepatocytes begin to multiply intensively and chaotically, trying to compensate for the deficiency of cells, while they often mutate and transform into atypical cells.

As hepatocytes die, the liver can less and less perform the function of detoxification. It no longer cleanses the body of toxins, it no longer participates in lipid-carbohydrate metabolism, protein metabolism, it does not participate in hematopoiesis. Unoxidized products accumulate in the blood, skin icterus appears.

The work of the entire gastrointestinal tract is fundamentally disrupted. The shape, size, and density of the body's main laboratory changes completely. It becomes small, bumpy, hard. Liver failure occurs due to the destruction of hepatocytes and portal hypertension.

The portal or portal vein is the main vein of the gastrointestinal tract; it is she who collects all the spent oxygen-depleted blood from all parts of the digestive tract and carries it to the liver for purification.

Disease pathogenesis

During the first time of drinking alcohol, the liver has time to process the poison, it produces special enzymes that process ethanol and its decay products. But when people live mindlessly and continue to drug themselves with liquor, over time it becomes exhausted and its work of detoxification is disrupted.

Why it happens? Because during the neutralization of the decomposition products of ethanol, toxic radicals are formed that damage the membranes of hepatocytes, violate vascular structure liver, destroy cells, cause vasospasm. Tissue hypoxia develops in the liver, cell death increases even more under such conditions.

Cells are filled with fat, because there is a constant poisoning of the body. There is fatty hepatosis, then alcoholic hepatitis and alcoholic cirrhosis of the liver. Already here, hepatocytes begin to gradually break down, and alcohol that comes in regularly destroys them further and more.

Connective tissue begins to grow - this is the beginning of the end. Why? Because this process is already irreversible. First it will lead to disability, then to death. The defeat of 70% of liver cells leads to the death of the patient.

Causes

Although it is believed that there are harmless doses of alcohol, but this is very conditional. Toxic action alcohol persists even at small but regular doses.

How much alcohol can be consumed without harm to health? Among alcoholic beverages, the following doses for men are called harmless: dry wine and champagne wines - 200 ml; cognac and vodka - 50 ml; beer - up to 0.5 liters. In women, respectively: 100 ml - 30 ml - 300 ml.

Stages of cirrhosis and forms

Hepatic cirrhosis is divided into 3 forms:

1. Small-nodular cirrhosis or micronodular (lat. Nodus - node) - almost identical small nodules less than 3 mm in size are formed in the liver.
2. Large-nodular cirrhosis or macronodular - here the size of the nodes reaches up to 5 cm and they are all different.
3. Mixed form - nodes of different sizes.

By functional disorders and the severity of cirrhosis is also divided into 3 classes:

1. Compensated or compensated cirrhosis - class A - there is no clinic at this stage; the liver works, although it has disorders; they can only be detected by biopsy. This type of cirrhosis is the closest to normal.
2. Subcompensated, i.e. not fully compensated - class B - liver failure begins to appear; diagnosis reveals the onset of the disease. Gradually, the clinic begins to emerge (violation of general well-being and the first signs in the form of altered urine, the appearance of blood in the gums, telangiectasias.
3. Decompensated cirrhosis - class C - the appearance of final irreversible hepatic lesions. Completed all the appearance of liver failure. Ascites appears, encephalopathy develops, bleeding from the veins of the esophagus and gastrointestinal. Only transplantation can save the patient.

Symptomatic manifestations

Alcoholic liver disease: how long do the symptoms last? The development of pathology is slow and gradual, long time the person doesn't notice. The initial stage of cirrhosis is always sluggish. Patients live and do not suspect anything. Before the appearance of the first symptoms from the moment of fibrosis, after which the pace of the disease only increases, another 5 years pass.

The first signs of liver cirrhosis in alcoholics always appear asthenic manifestations: depression of mood, fatigue, tendency to splash out aggression, lack of appetite and weight loss to the point of exhaustion. Later, vomiting and diarrhea join, they become constant companions.

Alcoholic liver cirrhosis includes the following syndromes:

1. Asthenic syndrome - it was mentioned above.
2. "Small" hepatic signs (hepatocellular insufficiency syndrome). It includes palmar and plantar erythema.
3. Vascular "asterisks" (telangiectasias) on the face and body.
4. Feminization of appearance in men - effeminate general outlines: thin legs, fat folds on the abdomen and hips. Baldness of the pubis and armpits; breast growth (gynecomastia), impotence and testicular atrophy.
5. The appearance of the so-called. symptom of a "hamster" on the face - expansion of the cheekbones of the face with hypertrophied parotid glands.
6. The face becomes constantly hyperemic due to the expansion of capillaries.
7. The frequent appearance of bruises on the body is a manifestation of hepatic hemorrhagic diathesis.
8. Under the skin, a fibrous thickening is formed (Dupuytren's contracture).
9. Shortening of the palmar tendons.
10. Icteric skin and sclera, skin itching.
11. The appearance of leukonychia (thin stripes on the nails of white color).
12. Thickening of the fingertips and bulge of the nails are a symptom of "drumsticks" and "watch glasses".
13. Exhaustion develops up to cachexia.
14. Symptoms of liver cirrhosis are also manifested in a decrease in the ratio of AST to ALT - less than one (De Ritis coefficient).
15. Systolic pressure becomes constantly less than 100 mm Hg.
16. Symptoms of dyspepsia: anorexia, rumbling and gases in the abdomen; pain around the navel; persistent nausea and frequent vomiting.
17. Portal hypertension syndrome: splenomegaly, varicose veins of the esophageal veins, the appearance of abdominal fluid (ascites).
18. Paraumbilical veins dilate (symptom of "jellyfish head").
19. Peripheral polyneuropathy - atrophy of the skin and muscles in the zone of peripheral nerves (especially on the limbs).

If the patient stops drinking, his condition improves markedly. The aggravation will again be sharply manifested by the use of alcohol.

Diagnostic measures

Diagnostics includes:

• collection of anamnesis and its analysis and physical examination;
• laboratory data: o.a.k. - signs of anemia and thrombocytopenia; leukocytosis with neutrophilia;
• blood biochemistry for liver enzymes, alkaline phosphatase, total blood bilirubin - all indicators are increased;
• Ultrasound of the abdominal organs - the size of the liver and spleen and their structure are assessed;
• EFGDS - will reveal varicose veins of the esophagus;
• according to indications, a liver biopsy by puncture;
• spiral CT - a series of x-rays are taken at different depths to determine the structure of the organ.
• elastography - the degree of fibrosis is determined by a special apparatus.
• retrograde cholangiography - introduction contrast agent into the biliary excretion system, to identify the cause of the deterioration of the outflow of bile; this procedure is performed only with symptoms of cholestasis.

Principles of treatment

The beginning of treatment is the complete exclusion of alcohol from the patient's life. Then comes diet therapy: table No5. How long do they keep the diet? In this case, for life.

Meals 5-6 times a day, in small portions and in a warm form. It is necessary to abandon fatty and fried foods, smoked meats, canned food, exclude fiber and salt up to 3 g / day.

The protein norm rises to 1.5 g/kg of body weight. If encephalopathy has developed, the protein is reduced to 30 g / day. Fortified meals with high content minerals.

Medical therapy

Treatment of alcoholic cirrhosis of the liver is mostly symptomatic:

1. Hepatoprotectors: of these, milk thistle is especially preferred; it not only contains vitamins, but also exhibits stimulating properties.
2. Ademetionine preparations: it improves bile excretion; protects hepatocytes, helps to neutralize toxins entering the liver; stimulates the recovery of hepatocytes; improves mood. These include Heptral, Ademetionine, S-Adenosylmethionine and others.
3. Ursodeoxycholic acid (UDCA) preparations - prevent the death of liver cells.
4. Vitamins A, C, E, B.
5. GCS - reduce inflammation, prevent the development of fibrosis; suppress the production of liver-damaging antibodies.
6. ACE inhibitors - lower blood pressure, reduce inflammation and prevent fibrosis.
7. Protease inhibitors - also prevent the formation of fibrosis in the parenchyma.

It should be borne in mind that the measures taken do not cure the patient, they only improve the condition and maintain the strength of the patient, helping to stop the destruction of the liver and delay complications. It is no longer possible to restore dead liver cells, as well as to cure the patient.

Syndromic treatment

With an increase in the spleen, blood elements are actively destroyed in it (hypersplenism). Therefore, for the treatment of splenomegaly, it is prescribed:

1. Leukopoiesis stimulants.
2. GCS (they increase the growth of white and red blood cells, platelets). Treatment of ascites: GCS antagonists - they reduce the formation of ascites;
3. Diuretic.
4. The introduction of albumin in / venously. These water-soluble proteins retain and attract fluid and then abdominal ascites decreases.
5. Puncture of the abdominal cavity (abdominal paracentesis) with the removal of fluid from it. This fluid can be examined diagnostically. Also, the removal of part of the fluid brings relief to the patient, since the compression of other organs is reduced.

Treatment of portal hypertension:

1. Pituitary hormones - reduce hepatic blood flow and portal hypertension; this also occurs due to stenosis of the arterioles of the gastrointestinal tract.
2. Nitrates dilate veins and arterioles. Blood accumulates in them and less enters the liver.
3. Beta-blockers - reduce heart rate and blood output. This also reduces blood flow to the liver.
4. Somatostatin and its analogues - constrict arterioles and thereby reduce portal hypertension.
5. Diuretics.
6. Lactulose preparations - they remove toxins from the intestines, preventing them from affecting the brain.
7. Antibacterial therapy - is prescribed as needed if a pathogen is detected in the body.

Encephalopathy is treated with lactulose and infusions - detoxification therapy.

Surgical treatment of cirrhosis

Can alcoholic cirrhosis be treated? surgical method. This is a liver transplant. The transplant is scheduled for total absence effect of conservative therapy. Transplantation is carried out from a close relative of the patient. For the operation, six months before it, all alcohol intake is completely stopped.

Complications and consequences of cirrhosis

Complications include:

1. Ascites - it becomes refractory, i.e. does not respond to the introduction of drugs. Such patients periodically undergo paracentesis. It is difficult to say how many times it will be done, it all depends on the course of the process. Such patients live from procedure to procedure.
2. Peritonitis.
3. portal hypertension.
4. Varicose veins of the esophageal and gastrointestinal veins; when bleeding occurs, melena (black stools) appears from them, hematemesis and tachycardia more than 100, hypotension less than 100/60.
5. encephalopathy.
6. The emergence of hepatic oncology.
7. Coma development.
8. Renal failure due to severe intoxication of the body.
9. Hypoxemia.
10. Gastropathy is a disorder of the stomach.
11. Colopathy.
12. Infertility.

What are the forecasts

Alcoholic cirrhosis of the liver is always the fault of the patient himself. After all, probably, for so many years of alcoholism, his relatives and friends did not applaud his drunkenness and did not throw up their caps from happiness. The prognosis is better in young patients, with sufficient body weight and with timely full treatment. In addition, the disease in men flows more favorably.

It is impossible to cure cirrhosis conservatively. How many live with him? In degree C, the life span does not exceed six months.

The only way to help such patients is to carry out a liver transplant if possible. With a successful transplant, the patient gets rid of cirrhosis forever, but the operation is prohibitive in terms of amount, technically very complex and accessible only to a few.

The number of donor organs is always limited. So is it worth it so thoughtlessly to stick to the bottle and try to compete with other patients. According to some reports, people with cirrhosis live up to 3 years. But we are talking about compensated cirrhosis.

Prevention includes a complete rejection of alcohol (to live without alcohol always and everywhere), treatment of hepatitis, a balanced diet, an active lifestyle. You should exclude work in hazardous production, do not take medicines at your own discretion. Prophylactic intake of vitamins and minerals, vaccination against hepatitis B is necessary.

reference

The liver is the largest organ in the human body. Its mass reaches 1500 g - approximately 1/50 of the mass of the whole body. Anatomically, the liver is divided into two lobes - right and left. Right lobe almost 6 times larger than the left.

The liver acts as a filter in the human body.

Aversion to work as a symptom of illness

THE HERO OF Jerome K. Jerome's book "Three Men in a Boat, Not Counting the Dog" once went to the London Public Library, took a medical reference book, read it, found all sorts of ailments in himself and came out a deeply ill man. Among all other diseases, he identified the presence of problems with the liver by the main symptom - "aversion to work." On the one hand, this may seem ridiculous, on the other hand, the compiler of the reference book, apparently, knew a lot about diagnostics, because, oddly enough, often the only complaint in liver diseases is asthenic syndrome, that is, decreased performance, weakness, excessive sleepiness.

Unwillingness to do something may be the only thing, but hallmark. Another thing is that it is nonspecific and occurs in a host of other diseases. If we talk seriously about the symptoms that clearly indicate liver disease, this is jaundice, itchy skin, baldness, reddening of the palms, in women - a disorder menstrual cycle; heaviness in the abdomen, nausea, belching, unstable stool.

In the later stages, there may be an increase in the abdomen due to the accumulation of fluid in it (ascites), darkening of urine (it becomes the color of beer), discoloration of feces, subcutaneous bleeding. In order not to bring to such a state, it is necessary at the first adverse symptoms take care of yourself. In this sense, the liver is a grateful organ - with proper care, it recovers well, and healthy cells can work for themselves and their injured comrades.

What happens in cirrhosis? A healthy liver is made up of liver lobules. In cirrhosis, there is a change in the structure of the liver, the liver contains a large number of connective tissue, and instead of lobules, nodules of different sizes appear, overgrown scar tissue compresses blood vessels, as a result, blood circulation is disturbed. The loss of normal liver cells leads to the fact that the liver is unable to synthesize proteins and other substances necessary for the body, as well as to neutralize toxins, that is, to perform its functions.

What will help to make a correct diagnosis? First of all, a visit to a gastroenterologist, who, in addition to a visual examination, can use following methods diagnostics:

• a biochemical blood test that will show an increase in liver enzymes, an increase in the amount of bilirubin;
• Ultrasound of the liver and other abdominal organs will reveal a change in the size and structure of the liver, the presence of fluid in the abdominal cavity;
• gastroscopy is useful for assessing the condition of the veins of the esophagus and determining the risk of bleeding;
• blood test for markers of viral hepatitis;
• in some cases, a liver biopsy is performed (for this, under local anesthesia with a special thin needle, the skin is pierced directly above the liver, a piece of tissue is taken);
• study of the liver vessels (angiography, splenoportocavagraphy) using a special contrast agent under X-ray control is necessary when planning surgical treatment.

It's never too late to stop drinking

The MOST common causes of liver cirrhosis are alcohol abuse and viral hepatitis (primarily hepatitis B and C). Less often they become poisoning toxic substances(for example, the poison of the pale toadstool, some drugs), diseases of the gallbladder and bile ducts, accompanied by prolonged jaundice.

The growth of environmental pollution, the increase in the use of various preservatives, alcohol, the uncontrolled use of drugs increase the load on the liver.

According to experts, the next 10 years will be marked by an increase in chronic liver pathology associated with the hepatitis C virus.

As for the effect of alcohol on the liver, in terms of "normal" drinkers and quality alcoholic beverages, the time that must elapse from the start of drinking until the development of liver disease depends on many factors. Firstly, on how much a person drinks, and secondly, who drinks - a man or a woman. In a woman, ceteris paribus, the disease will develop faster and at lower doses. It is believed that for men the maximum allowable dose- 60 g of pure alcohol per day: this is 3 bottles of beer, or 3 glasses of dry wine, or 3 glasses of vodka. Anything more than this, the liver cannot process without harming itself. In women, liver damage can develop even with a constant intake of 20 g of alcohol per day.

On average, from the beginning of systematic drunkenness to the appearance of classic alcoholic cirrhosis, at least 8-10 years pass. In women and adolescents, this period may be shorter - about 5 years. Alcoholic liver damage can be asymptomatic for a long time. A person drinks and drinks until the liver is no longer able to drive blood through itself, stagnation occurs in the portal vein system, increased pressure in it, and as a result - ascites - accumulation of fluid in the abdomen. Often, patients come to the doctor for the first time only at this stage - the stomach began to increase due to the fact that liquid appeared there. This is a very important symptom and a serious prognostic sign. Often, if ascites appears, the patient's life expectancy is estimated at several years. If a person does not stop drinking at the same time, this gap will rapidly decrease. However, if the patient can be persuaded to give up alcohol, then despite the fact that he came to the doctors already at the stage of ascites, they can observe him for 10 years or more without further deterioration. Why? Because he stops drinking, there is no progression of the cirrhotic process, and the restoration of liver functions under these conditions may well occur. Therefore, it is never too late to stop drinking alcohol.

How to protect the liver?

There are a lot of medicines on the market. Some of them stimulate the production of essential phospholipids - substances necessary to restore the integrity of the liver tissue. Others already contain essential phospholipids in finished form, moreover, of natural origin, easily absorbed by the body.

Even if the process in the liver ends with recovery, the damage still does not go unnoticed and can make itself felt with a certain functional inferiority, one degree or another of hepatic dystrophy. To avoid this, the doctor may recommend hepatoprotectors - drugs that help the liver restore its structure and protect it from adverse influences. Now in our pharmaceutical market there are about 30 types of hepatoprotectors: herbal, homeopathic, synthetic. Most of all herbal preparations, including homeopathic ones. Doctors prefer to prescribe them because these drugs have a wide spectrum of action, a minimum number of side effects and an acceptable price.

As far as liver cirrhosis is concerned, the results of its treatment are both disappointing and encouraging. The disturbed architectonics of the liver in cirrhosis of the liver is never restored, but the ability to recover in liver cells is so good that even with cirrhosis, improvement in liver function can be achieved.

Of course, the choice of the optimal treatment regimen for a particular patient can only be made by a doctor, but a lot also depends on the patient himself. It is important how he will behave during treatment, whether he will be able to follow all the recommendations both in terms of drug treatment and diet, etc. If you have been diagnosed with liver cirrhosis, carefully follow the doctor's advice. In addition, take care of yourself: rest as soon as you feel tired. Do not lift weights: a sharp increase in pressure in the abdominal cavity can provoke gastrointestinal bleeding. Watch the frequency of your stool (the optimal frequency of stool is 2 times a day).

It is necessary to be treated, because the complications of cirrhosis of the liver are very serious. Hepatic encephalopathy - damage to the brain by toxic products that are not neutralized by the liver as a result of its damage. It can manifest itself in various disorders of consciousness, intellect, behavior, neuromuscular disorders. Another possible complication is ascites, the accumulation of fluid in the abdominal cavity. In addition, patients with cirrhosis of the liver are more susceptible to bacterial and viral infections than healthy people. The most common infections in these patients are those of the respiratory tract and urinary tract.

What can a patient with cirrhosis of the liver complain about?

• Increased fatigue.
• Weight loss.
• Various disorders of consciousness and behavior (decreased concentration, daytime sleepiness, disturbed night sleep, etc.).
• Decreased appetite and abdominal discomfort (bloating, feeling full quickly when eating).
• Jaundice (staining of the skin, sclera in yellow).
• Lightening or discoloration of feces, darkening of urine.
• Stomach ache.
• Swelling of the legs and (or) an increase in the size of the abdomen due to free fluid in the abdominal cavity (ascites).
• Bleeding: nasal, gastrointestinal, from the gums, hemorrhoidal, and subcutaneous hemorrhages.
• Frequent bacterial infections (respiratory tract, etc.).
• Decreased sex drive.
• In men - often gynecomastia (enlargement of the mammary glands).

It is advisable to exclude the use of mineral waters containing sodium.

Since alcohol contributes to the development of cirrhosis of the liver, its use in any form and quantity is prohibited.

With fluid retention in the body (edema, ascites), it is necessary to limit the intake of table salt to 0.5 g per day, liquids - up to 1000 - 1500 ml per day. Ideally, food should be cooked without adding salt. Salt-free bread, crackers, biscuits and crispbreads, as well as salt-free butter are used.

Seasonings such as lemon juice, orange peel, onion, garlic, salt-free ketchup and mayonnaise, pepper, mustard, sage, cumin, parsley, marjoram, bay leaf, cloves, and yeast extract (low in salt) help make meals more palatable.

Any products containing baking powder and baking soda are excluded (cakes, biscuits, cakes, pastries and regular bread).

Pickles, olives, ham, bacon, corned beef, tongues, oysters, mussels, smoked herring, canned fish and meat, fish and meat pate, sausage, mayonnaise, various canned sauces and all types of cheeses, as well as ice cream are excluded.

Salty canned foods are excluded.

Allowed 100 g of beef or poultry, rabbit or fish and one egg per day. One egg can replace 50 g of meat.

Milk is limited to 1 glass per day. You can eat low-fat sour cream.

You can eat boiled rice (without salt).

Any vegetables and fruits are allowed fresh or in the form of home-cooked dishes.