How is cirrhosis treated? Is there a best cure for liver cirrhosis? Treatment methods for cirrhosis

They are carefully selected.

They undergo numerous scientific studies on volunteers and multiple in-laboratory tests. The safety of medications seems to be one of the most important aspects for any medicine.

The most important postulate of medicine: Do not harm the patient!

Any medicine that enters the body first reaches the liver. There it is biotransformed into an active form and begins its effect. Most drugs are neutralized in the liver and excreted from the body with the help of bile.

It has been proven that with liver cirrhosis, the vital abilities of the liver are lost, and it becomes vulnerable. Medicines used for liver cirrhosis are forced to have a high safety status.

Aphorism of ancient doctors: Everything is poison. Nothing is without toxicity. Only the dose makes the poison invisible.

It is also necessary to remember that any medicine carries not only beneficial features, but it can cause harm. There are known drug-induced liver disorders that can lead to progression.

Any pill taken can cause an unpredictable reaction, an allergic one, and also have a toxic effect. You should be careful when using any pills, even if they are vitamins.

There is no universal cure for liver cirrhosis.

General approaches to the treatment of liver cirrhosis are aimed at:

• Saving energy consumption by liver cells;
• Improving the quality of bile;
• Preservation of strength and regeneration of liver cell structure;
• Preservation of enzymatic systems;
• Preserving the normal metabolism of fats, carbohydrates and proteins;
• Reanimation of the detoxification ability of the liver;
• Improved antioxidant properties and reduced oxidative stress;
• Ensuring safety transport systems liver cells;
• Reduced programmed cell death;
• Participation in the formation of prostaglandins;
• Slowing down cirrhotic processes;
• Participation in differentiation, growth and regeneration of cells.

1. Treatment regimen. The treatment regimen is always careful, calm, protective. If it worsens, bed rest is prescribed. Limit physical activity and exclude in case of decompensation.

The benefit of bed rest is the supine position, which increases hepatic blood flow and activates recovery processes.

Carefully: take all other medications, especially sleeping pills, strong drugs, tranquilizers, painkillers. Any medicine for liver cirrhosis should be taken with caution.

Exclude: physiotherapeutic procedures, balneological treatment, thermal effects on the liver area, fasting, homeopathic remedies, mineral waters.

3. Improvement of liver cell metabolism.

Vitamins, representatives of group B. Name of representatives: B1, B2, B6, B12.

B1-thiamine is involved in the standard metabolism of fats, proteins and carbohydrates. It is necessary in the combined treatment of liver cirrhosis.

B2-riboflavin - has a positive effect on liver function.

Other vitamins: vitamin P (rutin), folic acid.

Other metabolic agents: Essentiale, lipoic acid (berlithione).

Heptral, Ursofalk are prescribed for cholestasis syndrome.

The names of these drugs are included in treatment regimens for subcompensated and decompensated liver cirrhosis. Dosages coincide with therapy for chronic hepatitis.

In case of compensated liver cirrhosis, inactive, treatment is not required.

Essentiale is a complex of essential phospholipids that has a hepatoprotective effect. The course of treatment takes about 2 months and is prescribed individually, separately for each patient. For decompensated and active cirrhosis, it is better to combine a course of treatment, intravenous injections with oral capsules.

4. Detoxification therapy is carried out with the joint administration of a 5% glucose solution with solutions of vitamins C, B6, cocarboxylase (CBC) and a solution of calcium gluconate. Or ready-made detoxification solutions (hemodes). The course of therapy is individual and usually lasts from one to two weeks.

5. Replacement therapy is applicable to replenish the necessary components. In case of protein loss - hypoproteinemia, hypoalbuminemia, edema or ascites, administration of native plasma or 20% albumin solution is recommended.

6. Etiotropic therapy is prescribed taking into account the etiology of cirrhosis. In case of viral cirrhosis, the causative agent is a virus, it must be treated with antiviral drugs.

• With diagnosed viral, compensated cirrhosis B, with detection of viral DNA, treatment is prescribed with standard doses of interferon or lamivudine.
• For those suffering from decompensated cirrhosis B, the liver is treated with lamivudine in the replication stage.
• Treatment against viruses is carried out in case of viral cirrhosis of the liver C, in the replication stage with the aim of:
• Minimizing the development of consequences,
• Normalization of process activity,
• Achieve a sustained virological response.
• For viral hepatitis C in the worsening stage, antiviral treatment is not carried out.
• Autoimmune cirrhosis is treated with glucocorticoid medications, as well as this treatment applicable for hypersplenism. In the last stage of liver cirrhosis, this method has limitations due to the development of inflammatory complications, osteoporosis, the appearance of gastrointestinal ulcers and others.
• Therapy for alcoholic cirrhosis includes the use of repeated courses of hepatoprotectors, two-week courses, and antioxidant medications.

7. Treatment of developed complications.

8. Surgical methods of treating liver cirrhosis.

9. Liver transplantation and timely decision making.

Basics of treatment of complications in liver cirrhosis

Treatment of varicose veins of the esophagus and stomach in liver cirrhosis

Treatment is provided in a specialized department whose specialists deal with this problem. Using endoscopic methods, the occurrence of bleeding or the risk of its recurrence is clarified and the need for a particular treatment method is determined.

The risk of developing the first variceal bleeding is determined by the following factors:

• Diagnosis of “red identification marks”: red, cherry-raspberry spots and blood cysts are present in areas of the mucous membrane of the esophagus or stomach.
• The amount of expansion of varicose veins,
• The severity of liver cirrhosis.

The risk of bleeding occurs in 30% of patients.

When identifying the reasons for surgical treatment, key importance is attached to the functional capacity of the liver. If it is impossible to carry out a surgical procedure, drug treatment is prescribed.

Drug, preventive therapy that protects against the first variceal bleeding in liver cirrhosis.

Treatment is justified by taking non-selective beta blockers, they reduce pressure in the portal vein: propranolol, timolol, nadolol.

Propranolol is the most effective, used in maximum tolerated doses of 80-320 mg/day. The medication must be taken for life, so the dose is adjusted based on tolerability, the absence of side effects, and a 25% decrease in heart rate at rest is allowed.

Endoscopic treatment has no advantages over drug therapy to prevent the onset of the first variceal bleeding.

Prevention of recurrent bleeding from varicose veins in liver cirrhosis.

The risk of recurrent bleeding for the first time six months is very high. For this reason, therapy is started immediately. Implemented in three stages:

1. Pharmacological agents:

• non-selective beta blockers remain highly effective - propranolol and nadolol, to lower portal vein pressure. It is possible to reduce the risk of bleeding by 1/3, and mortality by 1/5.
• Long-acting nitrates are used together with beta blockers or separately.

1. Endoscopic techniques - ligation.
2. Surgical techniques are portosystemic shunting and transjagular intrahepatic portosystemic shunting.

Treatment of portal hypertensive gastropathy (PHGP) in liver cirrhosis

PHGP is established by typical changes in the gastric mucosa in liver cirrhosis. Recognized as one of the primary causes of bleeding. The threat increases when taking painkillers and NSAIDs.

Treatment uses somatostatin, which reduces gastric blood flow. Propranolol is also effective. In surgery, bypass surgery is used.

Treatment of portal hypertensive enteropathy and colopathy in cirrhosis

Microcirculation disorders characteristic of PHGP are not limited to the stomach, but spread throughout the digestive tube to the colon, small intestine, and rectum. Present in half or 2/3 of patients. Bleeding occurs less frequently.

Treatment involves subcutaneous administration of octreotide and oral propranolol. Surgery methods include ligation, cryotherapy of hemorrhoidal veins and sclerotherapy.

Treatment is based on following a regimen and diet with a limit of table salt. Ultimately, thanks to salt restriction, it is possible to achieve good results, losing more than two kg of body weight. When body weight decreases to two kg, potassium-sparing diuretics are added. If there is no result, loop diuretics are added to treatment.

Loop diuretics work productively and impair the reabsorption of sodium, chlorine and potassium. Their use with potassium preparations (panangin, asparkam) or aldosterone antagonists is recommended. Examples: furosemide (Lasix), hypothiazide, uregit (ethacrynic acid), chlorothiazide.

Potassium-sparing diuretics are less productive than loop diuretics, but retain the necessary potassium. Examples: spironolactone, aldactone, triamterene. In case of renal failure, they are combined with loop ones, due to the risk of developing hyperkalemia.

General requirements for diuretic treatment.

• Start with initial doses to prevent the development of side effects.
• Slowly builds up the diuretic effect to prevent the loss of important microelements.
• Monitoring: body weight, abdominal circumference, checking laboratory tests (creatinine, sodium, potassium), daily diuresis, neuropsychic well-being.

In complex treatment, protein solutions are used to eliminate hypoproteinemia and hypoalbuminemia, maintaining colloidal and osmotic pressure of plasma. Therapy is carried out by administering native concentrated plasma or a 20% albumin solution.

If ineffective drug treatment resort to paracentesis or placement of a peritoneojugulant shunt.

An alternative, if the positive effect is insufficient, is transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation.

Therapy of spontaneous bacterial peritonitis in liver cirrhosis

Spontaneous bacterial peritonitis (SBP) is considered to be a sudden infectious peritonitis, without previous trauma to the gastrointestinal tract, in patients with cirrhosis of the liver. SBP is a severe complication with a poor prognosis.

Treatment is carried out with broad-spectrum antibiotics until sensitivity culture results are ready.

The most effective: cefotaxime, ceftriaxone, ampicillin/tobramycin, amoxicillin/clavulonate, for anaerobic infection metronidazole, both monotherapy and combination.

Depending on the situation, an albumin solution is added to treatment to prevent the development of renal failure.

Therapy of hepatic encephalopathy (HE) in liver cirrhosis

PE belongs to the pathology of the brain, in the process of formation of liver cirrhosis and the development of liver failure, has various symptoms and severity. There are 4 stages of deviations from minor to severe, which lead to coma.

Patients in serious condition require constant monitoring and monitoring of vital signs.

Important: to notice the liver “signs” of trouble - this is a typical liver odor, the occurrence of psychoneurological disorders, indicating a worsening of the condition and the approach of coma.

In the tests, liver enzyme levels decrease, which indicates severe depression of liver function and worsening of its condition.

Acute liver failure is treated in the intensive care unit:

Therapy of hepatorenal syndrome in liver cirrhosis

With this syndrome, renal failure associated with liver cirrhosis occurs in the absence of previous kidney disease.

• Liver transplantation is extremely productive.
• Treatment of causally significant diseases, infectious diseases, correction of circulating blood volume.
• Avoid nephrotoxic drugs, especially non-steroidal anti-inflammatory drugs.
• There is evidence of good outcomes with shunt placement.

Patients receive many necessary medications for liver cirrhosis free of charge.

1. Take treatment only as prescribed by a doctor. Do not overuse self-medication!
2. Any treatment is productive when the cause is identified.
3. If the positive effect of treatment is insufficient, you should inform your doctor.
4. Do not take all the tablets by the handful. When taking more than three medications at the same time, drug interactions are unpredictable.
5. Follow what is indicated in the recipe: dosage, frequency of administration, time of day, attitude towards food intake.
6. When a sudden side effect or allergic reaction, cause ambulance, and then inform your doctor.
7. It is better to drink it with water unless there are special instructions or restrictions.
8. Carefully read the instructions for use of the drug, and if you have any questions, consult your doctor.
9. Do not take a medicine to which you have had an adverse reaction in the past.
10. Do not take medications with known hepatotoxicity if you have liver pathology.
11. Monitoring of adverse reactions from the liver when prescribing new drugs by monitoring liver parameters.

In conclusion, it should be noted that there is no universal cure for liver cirrhosis. Treatment is prescribed by the doctor after examination. The treatment is complex and long-term. It is important to be attentive to yourself and your health in order to avoid health problems. All in our hands!

Liver cirrhosis is the most severe pathology of this organ, in which it ceases to perform its functions. Having heard the diagnosis, patients are interested in whether it is possible to cure cirrhosis of the liver and prolong the life of the sick person. Unfortunately, not many doctors can take the liberty and give encouraging prognoses to patients suffering from cirrhosis. A certain role here is played by the reasons that provoked the pathology, as well as complications that developed against the background of cirrhosis. In most cases, patients die from hepatic coma, gastric bleeding or ascites.

Doctors talk about liver cirrhosis when the cells of this organ - hepatocytes - undergo irreversible pathological changes. During an inflammatory process of any etiology, dead hepatocytes are replaced by connective tissue cells that do not perform the function of hepatocytes. Doctors consider this process to be immunoinflammatory, since the liver’s own cells kill the liver, making it a threat to human life.

Destruction of hepatocytes is the initial stage of liver cirrhosis. These cells are involved in many metabolic processes; they neutralize toxins in the blood. In addition to the fact that with cirrhosis, the liver is “switched off” from the digestive process, it also ceases to be a barrier to the blood, allowing poisons and toxins to pass through. As a result, intoxication of the body develops, threatening all systems and organs.

Liver cirrhosis is still one of the leading diseases causing a high mortality rate. Liver cirrhosis occurs predominantly in men, but there is also a small percentage of women suffering from this disease. Men develop alcoholic cirrhosis if they drink alcohol excessively. Liver cirrhosis in women is diagnosed more often when leading an antisocial lifestyle. The main problem in diagnosing liver cirrhosis is weak symptoms in initial stage diseases when patients can be helped to preserve the organ and stop the pathological process. Because of this, doctors predominantly diagnose cirrhosis at a late, decompensated stage. Here there is no longer a question of treatment; it is important to relieve symptoms, prevent complications and prolong the patient’s life as long as possible.

Complications of liver cirrhosis are a number of serious diseases that worsen the patient’s quality of life.

Conservative treatment of the disease

Liver cirrhosis is one of the most complex pathologies, since it provokes severe changes in all systems and organs. Therefore, it cannot be said that there are narrowly targeted drugs that can cure cirrhosis of the liver. To improve the patient's health, complex therapy is carried out, consisting of several areas.

The compensated stage of cirrhosis can be treated at home, on an outpatient basis. At this stage, the patient may be given a third group disability and exempted from certain types of work. The hepatologist treating the patient will tell you where to treat the decompensated stage.

This can be done either in specialized clinics or in medical research institutes dealing with the problems of cirrhosis. At the decompensated stage, the patient is placed in a clinic where he will have to stay in the intensive care ward.

Lifestyle and dietary nutrition

At the initial stage of liver cirrhosis, patients need to reconsider their lifestyle and eliminate the factors that provoked cirrhosis. For example, doctors categorically insist on quitting smoking and drinking alcohol. It is worth giving up those medications that have a toxic effect on the liver. Among them are some psychotropic drugs, antibacterial agents, and cytostatics.

It is also worth changing the regime - in the compensated stage, adequate physical activity is indicated, but in case of decompensation, bed rest is necessary. This will activate blood circulation in the liver and will help improve the patient’s condition.

Dietary nutrition is mandatory - the organ needs to be decongested as much as possible so that the liver produces as little bile as possible. If at the compensated stage bile excretion is still possible, although in limited volumes, then already at the stage of decompensation the liver completely fails to cope with its function and stops producing bile. The function of digestion is taken over by the pancreas, which, if overloaded, can also become inflamed.

When treating cirrhosis, patients are recommended to follow diet No. 5; the doctor can recommend various options. Patients with cirrhosis should not get carried away with proteins - their breakdown products are too heavy for the liver. You also need to limit your salt intake, and if you have ascites, avoid it altogether. Alcoholic cirrhosis of the liver requires the complete exclusion of any alcoholic beverages from consumption.

Treatment with medications

For liver cirrhosis, several groups of drugs are indicated that have different purposes. We list the main ones:

1. means for improving metabolism in the liver and stabilizing the cell membrane of hepatocytes - these are drugs Essentiale, Heptral, glutamic and lipoic acids, Hepa-Merz, fortified supplements and others;
2. transfusion therapy - involves blood transfusion to patients suffering from cirrhosis. This is important for hemorrhagic syndrome, liver failure, and ascites. It is best to transfuse fresh blood, but it is possible to use blood plasma and albumin solution;
3. in the compensated stage, patients are prescribed glucocorticoids according to indications. This group of drugs is especially valuable for liver failure and an increase in the size of the spleen. The list of drugs and dosages are prescribed strictly individually.

The drug Essentiale is one of the most effective hepatoprotectors today

Detoxification

Since the liver ceases to perform its functions during cirrhosis, the body begins to suffer from poisoning by toxins that enter from the outside and are formed as a result of metabolism. Therefore, it is very important to carry out detoxification therapy, which would relieve the body of stress.

First of all, you need to prescribe medications to improve digestion. If the gastrointestinal tract works smoothly, then toxins will not linger in the intestines and will no longer be absorbed into the blood. To normalize digestion, you can use Pancreatin, Creon, Mezim. If there is a painful feeling in the stomach, the use of enterosorbents, for example, activated carbon, is indicated.

Treatment of complications of the disease

Liver cirrhosis, in addition to treating the underlying cause, also requires eliminating the symptoms of the pathology that appear during its development.

Ascites

Ascites is one of the most serious complications of cirrhosis. When this symptom develops, patients are subject to hospitalization, especially if ascites appears for the first time. In a hospital setting, doctors will determine the factors that contributed to the appearance of fluid in the abdominal cavity. Along with this, additional studies of the organs of the excretory system will be carried out. For ascites, the doctor prescribes a salt-free diet to reduce water retention in the body and eliminate swelling.

If bed rest and diet do not lead to positive dynamics in the first days of treatment, then doctors prescribe diuretics. In order to normalize the chemical balance of the blood, after eliminating ascites, a blood transfusion is performed. The most common complication in such cases is potassium deficiency in the body, which is excessively excreted in the urine. This leads to the development of alkalosis and encephalopathy. If such a situation is detected, diuretics are canceled, the intake of protein in the body is limited, and a course of therapy with hepatoprotectors is carried out.

Severe ascites in a patient with cirrhosis of the liver with dilated veins

In severely ill patients with liver cirrhosis, ascites is quite difficult to cure. The best result that can be achieved in patients with ascites is a step-by-step removal of fluid in an amount of no more than two liters per day, so as not to provoke a deterioration in health.
Stomach bleeding

Prevention of gastric bleeding takes a leading place among the complications of cirrhosis. To prevent severe symptoms, doctors infuse blood clotting drugs as well as fresh blood. Patients receive Vasopressin intravenously, which perfectly constricts small blood vessels and helps reduce portal vein pressure. If the patient has already developed gastric bleeding, he should be hospitalized immediately. Doctors use balloon tamponade, after which emergency ligation of the dilated veins is performed.

Liver failure

Another serious complication that accompanies liver cirrhosis is liver failure. In fact, this is the result of a disease when liver cells are simply unable to perform their function. The small number of hepatocytes remaining to function cannot adequately compensate for the loss of cells replaced by connective tissue. In this case, doctors talk about the development of liver failure.

When diagnosing pathology, it is very important to prevent the patient from developing hepatic coma - a borderline condition in which the risk of mortality approaches 90 percent of cases. In cases of severe cirrhosis, patients are hospitalized and the main indicators of organ function are monitored daily. With a sharp drop in the level of AST and ALT - specific liver enzymes - one can suspect the onset of the development of a coma.

In this situation, protein foods are completely excluded from the patient’s diet; nutrition is provided through a tube or by intravenous administration of glucose. Hepatoprotective and detoxifying drugs are administered - Ornitsetil, Essentiale, lipoic acid, arginine. To suppress the development of pathological microflora, patients receive antibacterial drugs - Apicillin, Polymyxin, Tetracycline, Kanamycin. Only after a week, when the threat of hepatic coma subsides, the patient is allowed proteins in small quantities.

Surgical treatment of the disease

Surgical intervention is performed primarily when there is a threat of portal hypertension or its presence. To eliminate complications of cirrhosis, several methods can be used:

• vascular anastomosis;
• artery ligation;
• splenectomy.

If portal hypertension is detected and the choice is made possible solution situation, it is important to consider whether the functional state of the liver allows this operation to be performed. In some cases, it is surgical intervention that provokes liver failure after surgery, so this risk also needs to be taken into account and be prepared for it.

A contraindication to surgery in this case is the patient’s age (it is not recommended to perform surgery on people over 55 years of age) and increasing jaundice. Also, doctors always take into account the stage of cirrhosis - with a compensated stage, operations to prevent bleeding are quite successful, they are carried out as planned. But in the decompensated stage, surgery is resorted to only in case of an immediate threat of bleeding.

If a patient is taken by ambulance for surgery with existing bleeding, then in this case the risks of hepatic coma increase in direct proportion to the bleeding time. It should also be taken into account that any intervention can provoke a coma. In this case, doctors most often perform a gastrotomy and stitch the veins of the cardiac region. After surgery, it is important to monitor the patient and prevent postoperative complications.

With significant improvements, liver cirrhosis continues to be treated at home.

Folk remedies in the treatment of disease

Treat liver cirrhosis folk remedies quite problematic, since herbal preparations are extremely weak and cannot promote the regeneration of hepatocytes. It is also worth considering that most inflammatory processes in the liver at an early stage are asymptomatic, so pathology is detected even when folk remedies cannot cope with it.

However, there are several ways to eliminate some of the symptoms of cirrhosis, making the disease easier. Thus, popular remedies in the treatment of liver cirrhosis are the juices of Norman Walker, which he proposed with the aim of removing toxins from the liver and improving its functioning. The first juice recipe is three parts of carrots, part of spinach and beets, passed through a juicer and squeezed out of the pulp. The second recipe is carrot juice with spinach in a ratio of three to two. And the third recipe is a glass of pure carrot juice with a few teaspoons of black radish. All these juices will help remove decay products and toxins retained in the liver due to the impossibility of its normal functioning.

Carrot juice is the basis for all Norman Walker drink recipes

Also, for cirrhosis, you can take milk thistle, which has a good regenerative effect. Tea is prepared from it - the grass and seeds are mixed and brewed in a 200 ml glass. After fifteen minutes, the dry residue is filtered off, and the liquid is drunk as tea. You can sugar it a little. It is recommended to drink milk thistle three times a day before meals. In addition to milk thistle, you can also use other herbs that your doctor will recommend if there are no contraindications to them.

Liver cirrhosis is one of the most severe diseases of this organ. The last stage is the development of hepatocarcinoma, which is fatal for patients with cirrhosis of the liver. Therefore, it is very important to prevent the development of the disease, to follow all measures to prevent viral hepatitis, not to abuse alcohol and to eat right. Only in this case can the development of cirrhosis be avoided.

This question is often asked by patients to their treating doctors after diagnosis. The answer, unfortunately, is not encouraging: it is impossible to completely get rid of this disease. But it is possible to stop the development of cirrhosis.

Liver cirrhosis is an irreversible process of replacement of normal liver tissue with connective tissue. It must be said that there are a lot of reasons that trigger cirrhosis.

Among the causes include viral hepatitis, alcoholic hepatitis, primary and secondary biliary cirrhosis, autoimmune diseases, fatty liver degeneration and others.

Liver cirrhosis is more common in men. Is it possible to stop the development of cirrhosis at the initial stage and how to treat if the diagnosis is made in the later stages? The answers to these questions are not clear-cut.

IN three components can be distinguished:

1. Compliance with the daily routine and...
2. Taking medications.
3. Surgery.

How can you alleviate the patient’s condition and stop the process with the help of a daily routine and diet?

1. Compliance with the daily routine and limitation of physical activity and exercise is primarily recommended for patients with sub- and, in severe cases of the disease, semi-bed rest is prescribed.
2. Diet is one of the main points in the treatment of liver cirrhosis. It is necessary that the energy value of food is approximately 35 kcal/kg of the patient’s weight. 75% of the diet should come from carbohydrates, 23% from fats. Protein is limited to 1 g per kg of patient weight. This is the prevention of cachexia.
3. You should completely stop drinking alcohol and smoking.
4. For ascites, it is recommended to limit the consumption of table salt to 2 g per day.
5. If hepatic encephalopathy occurs, the protein content should be reduced to 25 g per day. Then, after the condition has stabilized, increase the amount of protein in food every three days by ten grams.
6. It is necessary to take multivitamins and microelements. For alcoholic cirrhosis of the liver, you need to take additional thiamine and folic acid.
7. Recommended for consumption: wheat bread of the 1st and 2nd grade and stale rye bread made from peeled flour, unsweetened baked goods with cottage cheese, apples, low-fat milk and cheese, non-sour berries in raw form, boiled and baked, compote, jelly, marmalade, dried fruits, soups with vegetable broth, vegetable cabbage soup and borscht, baked egg white omelette, lean beef, turkey, lean pork in small quantities, pilaf with boiled meat, various dishes from any cereals, preferably buckwheat and oatmeal, raw, baked, boiled vegetables form, boiled onions, weak tea, all types of fruit and berry juices and compotes, wheat bran decoction, boiled or baked lean fish, vegetable oil.

Excluded from the diet: very fresh bread, puff pastry products, baked goods, high-fat milk, ice cream, cakes, sour berries, chocolate, fish broths, mushroom soups, fried and hard-boiled eggs, mustard, horseradish, fatty meats: beef, lamb, duck, goose, pork, legumes, garlic, mushrooms, pickled vegetables, radishes, onions, cocoa, black coffee, smoked and salted fish, fatty fish, cooking fats, lard.

Different groups are used for treatment. Cirrhosis cannot be cured with medications, but clinical signs of the disease can be eliminated or reduced.

Let's consider the most common signs of the disease and medicinal methods eliminating them:

1. To treat itchy skin use:

• cholestyramine: reduces skin itching in 90% of patients. Itching decreases a couple of days after starting treatment. But this medicine has side effects: constipation, increased gas formation, skin rashes, vomiting, increased libido, nausea. Contraindications for use are allergic reactions to this drug, phenylketonuria and complete obstruction of the bile ducts. Second-line drugs include colestipol hydrochloride (ammonium resin), ursodeoxycholic acid;
• If you are intolerant to cholestyramine, ammonium resin can be used. It tastes much better than cholestyramine;
• daily exposure to ultraviolet light for approximately 10 minutes per day.

1. To reduce signs of bile stagnation, protect liver cells from increased amounts of bilirubin in the blood Ursodeoxycholic acid is used. It has been proven that this drug increases the quality and life expectancy of patients with cirrhosis, reduces the risk of ascites and jaundice, varicose veins of the stomach and esophagus. The medicine is well tolerated and has no toxic effect. The dose and frequency of taking this drug must be prescribed by a doctor.

Side effects: loose stools or constipation, calcification of gallstones, abdominal pain, allergic reactions.

Contraindications for use: allergic reactions, severe diseases of the kidneys, liver, pancreas, acute inflammatory diseases of the gallbladder and bile ducts, complete obstruction of the bile ducts, calcified gallstones.

1. To prevent constipation in liver cirrhosis lactulose is used. A dose of this drug is prescribed such that the stool will be of soft consistency 2 times a day. Side effects of the drug: nausea, increased gas formation, abdominal pain, vomiting, diarrhea. Contraindications: allergy to this drug, intolerance to fructose, galactose, lactase deficiency, acute inflammatory diseases Gastrointestinal tract, bleeding from the rectum (except hemorrhoids), intestinal obstruction.
2. For insomnia diphenhydramine is prescribed. Side effects of the drug: allergic reactions, drowsiness, general weakness, dizziness, numbness of the oral mucosa, dry nose and mouth, decreased blood pressure and increased heart rate. Contraindications: allergy to this medicine, breastfeeding, children.

Amitriptyline is also used with good results to improve sleep and the general condition of patients.

Side effects of this drug include: allergic reactions, blurred vision, drowsiness, weakness, dizziness, dry mouth, intestinal obstruction, increased sweating, hair loss, changes in libido, increased heart rate and decreased blood pressure.

Contraindications for use: myocardial infarction in acute and early recovery period, allergic reactions, paralytic intestinal obstruction, prostatic hyperplasia, bladder atony, severe liver and kidney diseases, intracardiac conduction disorders, high blood pressure, childhood.

1. For liver cirrhosis of viral etiology(hepatitis D, C, B virus) must be prescribed antiviral drugs: interferon alfa, peginterferon alfa 2a, lamivudine, telbivudine, ribavirin, entecavir.

The listed antiviral drugs cannot be used independently; they must be prescribed and strictly monitored by a doctor. The doctor also individually selects combinations and doses of these medications.

Common side effects of antiviral drugs are: weakness, dizziness, flu-like syndrome, muscle pain, joint pain, anemia, sleep disturbance, pancreatitis, diarrhea, vomiting, decreased number of white blood cells and red blood cells, hair loss, allergic reactions, sweating.

Contraindications: allergic reactions, autoimmune diseases, severe liver and kidney dysfunction, pancreatitis. It should be used with caution in pregnant women, children, and during lactation.

Antiviral therapy allows you to stop the process of destruction of liver tissue by viruses and preserve part of the organ. The earlier such treatment is started, the greater the effectiveness.

Is it possible to cure cirrhosis using the above methods? Unfortunately no. But these medicinal and non-medicinal methods can significantly improve the patient’s condition, feel a surge of strength and vigor, reduce the load on the organ, stop the process of death of liver tissue and preserve part of the intact liver.

If it was not possible to cure using the above methods and the course of the disease worsened by the occurrence of pain, then you must immediately contact a medical institution to receive full treatment.

Treatment of complications of cirrhosis should be carried out under the strict supervision of a doctor.

Complications of liver cirrhosis are dangerous with a high incidence of death Without medical care:

1. For hepatic encephalopathy, treatment is to limit protein to 50 g per day and prescription of medications:

• To reduce the formation of toxins and ammonia in the intestines, non-absorbable antibiotics are used: vancomycin, ciprofloxacin, metronidazole. Side effects of this group of drugs: hearing impairment, allergic reactions, renal dysfunction, decreased number of platelets, leukocytes, red blood cells, nausea, diarrhea, vomiting. Contraindications: allergic reactions to these drugs, pregnancy, breastfeeding, auditory neuritis;
• Ornithine aspartate neutralizes toxic ammonia, used intravenously or orally. Side effects: nausea, skin rashes, vomiting. Contraindications: allergic reactions, renal dysfunction;
• The benzadiazepine receptor antagonist flumazenil is used to reduce inhibitory processes in the nervous system. Side effects: shortness of breath, dizziness, depression, headache, dry mouth, palpitations. Contraindications for use: allergic reactions to this medicine, poisoning with cyclic antidepressants, taking benzodiazepines for the treatment of serious diseases (epilepsy or intracranial hypertension).

1. When infectious complications develop, strong broad-spectrum antibiotics are used.
2. Ascites is treated with diuretics. The effect of these drugs is assessed by measuring body weight: a decrease in the patient’s weight in the absence of edema by 500 g and by 900 g in the presence of edema indicates a correctly selected dose of diuretics and effective treatment.

If the albumin level is low, then intravenous infusions of the solution are performed.

If it is not possible to cure ascites, then they resort to a surgical method - laparocentesis. Laparocentesis is a puncture of the anterior abdominal wall to remove accumulated fluid from the abdominal cavity. When removing a large amount of fluid, it is necessary to replenish the loss of albumin: inject an albumin solution intravenously at the rate of 8 g per 1 liter of removed fluid.

1. Bleeding from varicose veins of the stomach and esophagus is treated in the intensive care unit and surgery. The volume of blood loss is replenished, fibrogastroduodenoscopy is performed, a Blackmoor probe is installed (the tip of the probe presses the bleeding vessels to the wall of the gastrointestinal tract); suturing of bleeding vessels is carried out if the patient’s condition allows.

Surgical methods: laparocentesis, suturing of dilated veins of the esophagus and stomach, intrahepatic portosystemic transjugular anastomosis, liver transplantation.

Of all the listed methods, only liver transplantation can completely cure liver cirrhosis. Liver transplantation is performed in patients with end-stage cirrhosis, intractable ascites, frequent bleeding from varicose veins of the esophagus and stomach, hepatic encephalopathy, and intractable skin itching.

The one-year survival rate after transplantation is 93%, and the five-year survival rate is 76%. 20% of patients experience a relapse of the disease within three years.

Currently, a complete cure for liver cirrhosis is possible only through liver transplantation. Unfortunately, following a diet, daily routine and taking medications does not guarantee a cure for this disease, but with proper treatment and a competent approach, it can stop the process of destruction of liver tissue and stabilize the patient’s condition, increase the duration and quality of life.

Many, having heard the diagnosis “,” wonder whether the disease can be treated at an early stage, and if so, how.

In fact, the method and method of treatment depend on the degree of neglect of the disease, its course and individual characteristics and, of course, predispositions. In general terms, we can say that grade 1 and 2 liver cirrhosis is completely curable with the help of a surgical method - liver transplantation. In other advanced cases (grades 3 and 4 of the disease), medicine can only slow down the development of complications and relieve pain.

If you want to be completely healthy, then you should make every attempt to recover at the initial stage of the disease or any other type of hepatitis and not lead to cirrhosis of the liver.

Hepatologists advise their patients to treat the disease comprehensively, using all possible means(, medications (tablets, antibiotics, injections, IVs, other necessary therapy), follow a diet, lead a healthy lifestyle). Each patient is recommended:

• get plenty of rest, especially if you experience severe fatigue;
• do not lift heavy objects, otherwise this may lead to bleeding;
• monitor the frequency of bowel movements (the norm is 1-2 times a day); if problems arise, take Duphalac, which does not cause side effects and is allowed even for pregnant women;
• to improve the functioning of the gastrointestinal tract, take multienzyme drugs;
• drink 1-1.5 liters of water per day, and limit salt intake to 0.5 g per day;
• exclude mineral water containing sodium from the daily diet;
• measure the weight and volume of the abdomen daily, and also keep records of the volumes of fluid consumed and exited;
• monitor the emotional state, which should be calm, by writing down the same sentence on a piece of paper, which must be shown to others. If the handwriting changes, then this indicates a psychological change. Therefore, you should consult a doctor to prevent encephalopathy syndrome from occurring.

With cirrhosis of 1 or 2 degrees, doctors allow patients to stay at home, since close medical supervision is not required. If the disease enters an acute, chronic stage or develops into other diseases such as ascites or cancer, then the patient should immediately come to the hospital to provide qualified medical care. And the question of being discharged in the near future is postponed indefinitely. Under such circumstances, cirrhosis of the liver is difficult to cure; the most that can be done is to create a period of remission.

Treatment at different stages of cirrhosis

This disease has several phases (stages):

1. compensation - absence of any symptoms;
2. subcompensation - lack of appetite, feeling of discomfort on the right side of the peritoneum, general weakness, liver function is not at full capacity;
3. decompensation - liver failure and coma, coloring the human body yellow. At this stage, urgent hospitalization and surgical intervention are necessary.

At any stage (initial or last), the disease is treated with medication, most often with antibiotics. For grade 1 or 2 cirrhosis, doctors prescribe taking pills and medications such as:

• diuretics, for example, Albumin, which improves microcirculation and kidney function;
• follow a strict diet;
• vitamins B6 and B12, which improve liver cell metabolism;
• glucocorticoid hormones;
• painkillers - for example, Tramadol, which is difficult to buy in pharmacies, only with a doctor’s prescription in a certain dose established by WHO;
• antiviral drugs (if the patient has viral hepatitis);
• hepatoprotectors that protect liver cells, for example, “Silymarin” or “Ademethionine”;
• medications that lower pressure in the portal area, for example, Anaprilin or Nitrosorbitol. These drugs are good for treating portal hypertension.

If a vital organ stops clearing the blood of toxins on its own, then it is necessary to resort to plasmapheresis (a procedure performed outside the body to collect, clean and return blood).

If the patient has an acute, pathological, or chronic form of the disease, then surgical intervention may be performed:

• bypass - creating a new path for blood flow that does not involve the liver. This method does not help to cure the disease, but only helps to reduce pain - a state of remission;
• Liver transplantation is a radical and expensive method of treatment, which makes it difficult to carry out long-term rehabilitation and take immunosuppressive drugs. This method can get rid of this disease for life, but it has contraindications;
• paracentesis is a puncture of the abdominal cavity in a hospital to remove fluid; this is not a method of treatment, but a manipulation that helps keep the disease in remission.

On the Internet you can find a huge amount of information that cirrhosis of the liver is curable in men and women, and there are even reviews “after treating cirrhosis, I am healthy...” and so on. But all this is a lie, the disease is not divided by age or gender. According to WHO statistics, several hundred operations are performed per year on patients with liver cirrhosis, of which 10 are transplantations. It is impossible to completely recover from such a disease unless you resort to a liver transplant, which not everyone can afford. The state of remission of the disease (cirrhosis of the 1st and 2nd degrees) is also good, with it you can live peacefully for more than 10 years, while doing your favorite thing.

Often in women aged 40 to 50 years, a disease such as primary biliary cirrhosis occurs (destruction of the intrahepatic ducts, leading to liver failure or coma). With it, the patient may experience severe itching, which is treated with Cholestyramine (an hour before taking other drugs) or Phenobarbital (120/160 mg per day).

Some doctors treat their patients the old fashioned way.” SDA faction” is an antiseptic created to protect a person from chemical and radioactive influences (for example, during the outbreak of war). In the USSR it was widely used for liver cirrhosis. But currently this medicine is not recognized by WHO, therefore it is not used in medical practice.

If the disease has developed into cancer, then doctors prescribe chemotherapy to the patient, and if cirrhosis occurs due to hepatitis C, then they prescribe Sofosbuvir.

Many patients, in particular women, in the initial stages of cirrhosis ask the question “is it possible to sunbathe with this disease.” The answer is no. Ultra-violet rays affect the body's defenses, and people with impaired general liver health develop increased sensitivity to the sun. Therefore, sunbathing with cirrhosis is contraindicated.

In order to keep your health safe and sound, as well as to help the body cope with the disease, you must comply with all the requirements of the attending physician. Do not experiment on yourself, do not provoke illness. Avoid any harmful contact with the external environment. And then you will be able to live this life in a stable state and in pleasure.

Liver cirrhosis is a serious chronic disease. According to statistics, in developed countries it is one of the six leading causes of death people aged 35 to 60 years. It kills about 50,000 people every year in the United States. In Russia, where the population is half as large, mortality from cirrhosis is comparable to American rates.*

This disease is an extensive lesion of the liver, in which the tissues of the organ die and are gradually replaced by fibrous (connective) fibers. During the replacement process, the structure of the organ changes radically. Violation of the normal structure of the liver leads to the fact that it can no longer perform its functions. This is called liver failure.

Classification

Experts distinguish several types of liver cirrhosis. For the reasons that led to the development of the disease, the following variants can be determined:

• Viral– it is caused, for example, by hepatitis C and various biliary tract infections
• Toxic– caused by the use of alcohol, certain medications, food poisons and other substances that have a toxic effect on the body
• Congenital– represents the consequences of certain diseases that the patient’s parents suffered from, for example, hemochromatosis or tyrosinosis
• Stagnant– its origin is associated with circulatory failure
• Metabolic and nutritional– develops due to obesity, as well as in severe forms of diabetes mellitus

Separately, a group of liver cirrhosis of unknown etiology should be mentioned. We are talking about those cases when it is not possible to clearly determine the cause of the disease.

Causes

From the above it is clear that the occurrence and development of liver cirrhosis is due to many reasons. Most often, people get sick due to alcohol abuse. According to various estimates, this reason accounts for from 40-50 to 70-80% of cases.*

The next most common factor influencing the occurrence and development of cirrhosis is exposure to viruses. Most cases are hepatitis C, but also hepatitis B.

In addition, cirrhosis is caused by:

• Biliary tract diseases
• Various intoxications - for example, chemical or medicinal
• Poor nutrition – first of all, chronic deficiency of vitamins and proteins in the diet

Cirrhosis caused by hereditary diseases is relatively rare. The same can be said about the disease of unknown etiology mentioned above, when it is not possible to determine the causes of its occurrence.

In about 50% of patients, liver problems are caused by a combination of different factors. For example, doctors often find cirrhosis caused by both binge drinking and hepatitis B.

The main peak of incidence occurs in age group over 40 years old. Approximately 70-75% of those suffering from cirrhosis of the liver are men.

The first signs and degrees of cirrhosis in adults

First sign the fact that a person’s liver is not all right – asthenovegetative syndrome. At the same time, the patient constantly feels tired, although there is no reason for this. He feels weak, becomes irritable and reacts sharply to completely innocent words or actions. He often has headaches.

• Nausea, which sometimes develops into vomiting
• Belching
• Alternating diarrhea and constipation
• Abdominal pain, aggravated by eating fried, pickled and fatty foods, as well as by drinking alcohol
• Reluctance to eat, up to complete lack of appetite for a long time
• Heaviness in the stomach
• Bloating

All of the above may indicate other diseases. Therefore, at this stage it is not always possible to clearly diagnose liver cirrhosis. Moreover, in about 20% of people who suffer from it, the true cause of the problem can only be determined after death.

There are three stages of the disease based on severity

• Initial– symptoms either do not appear at all or are minimal
• Clinical– the symptoms are pronounced, and the doctor, when examining the patient, observes a typical picture of the disease
• Terminal– irreversible changes are detected, which leads to death

Symptoms of liver cirrhosis

In approximately 60% of patients The symptoms of liver cirrhosis are quite noticeable. The specific picture largely depends on what stage the disease is at. But there are signs that are especially common.

The initial stage in most cases is not accompanied by biochemical disorders. But the disease progresses, and at the second stage the so-called hemorrhagic syndrome.

Main signs of hemorrhagic syndrome- This:

• Bleeding from the gums and nose
• In women - uterine bleeding
• Hematomas (bruises) on the body that appear for unknown reasons
• Stomach and intestinal bleeding
• Ecchymoses are pinpoint subcutaneous hemorrhages that look like a rash.

At the same time, the patient increasingly feels weak. Irritability gradually gives way to apathy and indifference, memory and attention impairments appear. Possible problems with sleep: the patient suffers from insomnia at night, and feels drowsy during the day. Over time, coordination of movements is impaired, the patient experiences problems with writing, and his speech becomes less and less intelligible.

When examining a patient The doctor may visually detect the following symptoms:

• The liver and spleen have increased in size
• On the anterior wall of the abdominal cavity there are dilated veins and spider veins
• The skin, mucous membranes and whites of the eyes have turned yellow

Complications

Liver cirrhosis can lead to various complications. This could be, for example, bleeding from varicose veins of the esophagus or pneumonia, peritonitis and other complications caused by infections. The following negative consequences often occur:

• Hepatic coma- a disorder of the functions of the central nervous system, which manifests itself in a sharp decrease in the size of the liver, increasing drowsiness, disorientation, slowing down of thought processes and, ultimately, in the fact that the patient falls into a stupor, and then into a coma
• Thrombosis in the portal vein system– blood clots (blood clots) prevent free blood flow in the liver, which leads to cell death
• Hepatorenal syndrome– leads to impaired renal function, especially common in those who suffer from acute liver failure or alcoholic cirrhosis of the liver
• Liver cancer or hepatocellular carcinoma– the formation of a rapidly developing malignant tumor, which is often associated with hepatitis C and hepatitis D

Liver cirrhosis is a dangerous disease in itself. But if complications occur, the risk of death increases significantly. So, with hepatorenal syndrome, if you do not start treating it on time, death occurs 10-14 days after the development of this complication.

Diagnostics

Experts recommend Contact your general practitioner as soon as you think you have signs of liver cirrhosis. The doctor will refer the patient for laboratory tests. When he has the test results in hand, he will send the patient to a gastroenterologist or directly to a doctor specializing in liver diseases - a hepatologist. In some cases, for example, if signs of hepatic encephalopathy are detected, you will need to visit a neurologist. Also, when making a diagnosis, the following data are taken into account:

• History
• Visual inspection
• Instrumental diagnostics

Basic laboratory tests which are carried out in case of suspected liver cirrhosis are:

• Liver complex biochemical research– it shows how well the liver performs its functions and helps to determine whether its activity is impaired
• General blood analysis– it is done because signs of cirrhosis may be a decrease in the number of leukocytes and red blood cells, as well as a noticeable decrease in hemoglobin levels
• Coagulogram– it needs to be done to find out if there are problems with blood clotting
• Fecal occult blood test helps identify hidden bleeding in the stomach and/or intestines
• Serological markers of viral hepatitis used to clarify factors that could lead to the development of the disease
• Blood alpha-fetoprotein test should be done if there is a suspicion of liver cancer
• Level of creatinine, electrolytes must be established to determine renal failure

Treatment of liver cirrhosis

If the patient is diagnosed with liver cirrhosis, treatment can be carried out using different methods. The choice of a specific tactic is largely determined by the stage at which the disease is located and the reasons for which it arose. Specialists also take into account the individual characteristics of the patient. However, it is impossible to cure already formed cirrhosis. Modern medicine can only cope with the reasons due to which it arose.

Radical method of treating cirrhosis- transplantation of the affected organ. They resort to it if there is an immediate threat to the patient’s life. In all other cases, medicinal methods are used. As a rule, the patient should adhere to a strict diet, and in case of alcoholic cirrhosis, it is necessary to eliminate the intake of alcohol in the body. Choice medicines depends on what type of cirrhosis doctors have to deal with. For example:

• Used for viral hepatitis antivirals, in particular pegylated interferons
• For biliary cirrhosis associated with insufficiency of bile acids in the intestines, medications are used to narrow the bile ducts
• Autoimmune hepatitis can be treated with drugs that suppress the immune system (immunosuppressants)

Nutrition and diet for cirrhosis

Diet for the treatment of cirrhosis is extremely important. Proper nutrition– this and great option prevention of the disease, and a way to eliminate the causes that led to its occurrence. If there are no complications, the patient is prescribed a complete high-calorie diet. It necessarily contains proteins, fats and carbohydrates. However, it is necessary to exclude from the diet everything that irritates the digestive organs. First of all, this is:

• Alcohol
• Chemical additives
• Preservatives

If you have cirrhosis, you should refuse from consuming foods that are:

• Spicy
• Sour
• Spicy
• Too salty

The diet must be prescribed by a specialist which takes into account:

• Patient's eating habits
• Individual tolerance of products
• He already has diseases of the digestive system

The diet is modified if there are any complications of cirrhosis or other diseases.

To normalize metabolic processes in liver cells, the doctor may prescribe a vitamin complex. As for any medications, they must be used carefully. You should take only those pills that are prescribed by specialists and for which there are clear and unambiguous indications.

Advantages of carrying out the procedure at MEDSI

Treatment of liver cirrhosis- an important area of ​​activity of the MEDSI clinic. We use effective modern techniques to eliminate the causes that influenced the occurrence of this disease and make the patient’s daily life more comfortable. Our clinic employs a team of international doctors. She takes a comprehensive approach to solving each specific problem. Any patient is guaranteed an individual approach: the doctor selects an examination plan, which is based on genetic factors, risk factors, concomitant pathologies, and medications taken.

Communication with doctors starts with diagnosis. Experienced specialists who have the necessary laboratory equipment at their disposal will perform tests and study their results. Fast and accurate diagnosis is ensured thanks to the availability of diagnostic equipment latest generation: magnetic resonance imaging scanner, computed tomograph, video colonoscope, etc.