How long do you need to drink to have cirrhosis? How much do you need to drink to develop cirrhosis of the liver, how anesthesia works and why ammonia smells so strong. Removing excess fluid from the body

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

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

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 connective tissue.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Lev Belonovsky 05/14/2017

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

Why does ammonia have such a pungent smell?

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

Firstly, substances are non-volatile and highly 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), non-volatile, but light substances with low molecular weight are, on the contrary, volatile, that is, individual molecules of a substance are easily split off from its liquid and even solid aggregate state.

What is the reason for smell? - namely, the volatility of the substance. The evaporated molecule of the substance binds to the olfactory receptors in the nose, which are protein molecules with such a structure that each of them is suitable only for 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 can be non-toxic and highly toxic. Non-toxic substances may have no effect on the body at all or may affect it, but to a small extent, and only in large concentrations, while toxic substances disrupt physiological processes even in small quantities.

Ammonia- This is an aqueous solution of ammonia. Ammonia is a highly volatile toxic substance. It is so volatile that a small concentration of ammonia in the air already creates a suffocating odor. Inhalation of a slightly higher concentration or a long stay in the atmosphere of that small concentration will certainly 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, it, on the contrary, activates the respiratory center, due to which it is used for fainting. In fact, when the concentration increases, it still activates it, but so much so that the center cannot withstand the overexcitation and turns off.

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

From this moment the answer to the question begins. Over the course of epochs, various receptors for odorous substances, ways of delivering nerve impulses in the form of olfactory nerves of various structures and all sorts of effects of the body’s perception of certain odors, different complexes of olfactory sensations were formed in living organisms - and evolution fixed those of them that led to the survival of the organism or at least they did not harm him, and those of them who could kill him and did kill him were eliminated. 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 a tool for protecting against them.

Ammonia (and other nitrogen and sulfur compounds) accompanies us throughout our evolutionary journey, being present in harmful metabolic products excreted from the body (urine, feces), and in decomposing bodies, the consumption of which is dangerous and harmful for obvious reasons. That's why he smells So.

How does anesthesia work?

Answer: If you want for a superficial overview and briefly: during anesthesia, nerve transmission is disrupted through different mechanisms and at different points of application. If you want to really understand the essence of anesthesia, then get ready for a long and complex read.

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) is a decrease in the sensitivity of the body up to the complete cessation of its perception of information both about environmental impulses 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 the footnote at the end of the answer):

Neuron- is a nerve cell, which is a structural and functional unit 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, mainly consisting of nerve cells. The car has a gearbox, the transmission of 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, not the Schwann cells spanning the processes of the neuron, and not the glia between 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 electrical charge, with the same change in the balance of ions in itself, that is, transfer the electrochemical charge further.

It is clear that anesthetic substances that disrupt sensitivity, which is caused by nerve transmission from the peripheral receptors of the body to the central nervous system, will affect the nerve cells that carry out this transmission. That's why we're 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 more dendrites and transmits it along only one axon. Between the axon of one neuron and the dendrite of another or another cell receiving an electrochemical impulse (for example, muscle), are located synapses.

Synapse consists of the synaptic space between the presynaptic and postsynaptic membranes. Membrane- this is the cell membrane, consisting primarily of phospholipids, capable of passively allowing only fat-soluble molecules to pass through, due to which water-soluble substances do not enter the cell uncontrollably. Pre- and post- means before and after. Presynaptic membrane located on the axon and indicated in yellow in the figure; postsynaptic- on a sensitive cell, green. Transfer between these membranes is carried out by chemicals - neurotransmitters, or neurotransmitters, or both without the prefix “neuro-” in the appropriate context.

There are receptors and transporters on both membranes. Receptors- these are high-molecular compounds of a protein nature that, when interacting with a substance specific to them (mediator), 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 are channels that pass substances along a concentration gradient (a substance from a concentrated mixture will tend to a diluted one, that is, along a gradient, like a person from a crowd into fresh air), or pass these substances in response to others or with the expenditure of ATP energy ( in the last two cases, a move against the concentration gradient is possible, like on a tank with fuel consumption in a crowd of zombies).

WITH nerve cell and synaptic transmission figured out. Let's move on to the mechanism of action of narcotic substances.

The mechanism of action of each specific anesthetic drug is different depending on its chemical structure and physical properties. Depending on the same parameters, anesthetics can be used inhalation and non-inhalation, but general mechanisms the method of administration depends only in the last place. So, according to modern ideas, anesthetics can have various points neural network applications:

Change the physicochemical properties of proteins and lipids* of neuron membranes;
Disturb the function of receptors, including both reactivating them and blocking them;
Impair the function of ion channels;
Disturb the function of other enzymes on the membrane;

This includes displacing cofactors from their connection with proteins (which are receptors, channels, and other membrane enzymes), without which the protein cannot function, or penetrating into the cavities of the protein molecule, thereby disrupting its internal and intermolecular connections.

Depending on the totality of which groups of application points and which particular application points (for example, on all or many ion channels or, on the contrary, only on muscarinic-sensitive cholinergic receptors of the first type, or on several enzymes, or in general on all proteins in the synapse or even not only in it), various therapeutic and side effects occur, the intricacies 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 central nervous system: bark cerebral hemispheres(in which tens of trillions (!) of synapses), hippocampus, thalamus, reticular formation, spinal cord, the action on which determines the hypnotic effect of anesthesia; - except for the respiratory (responsible for what it is clear) and vasomotor (affecting vascular tone and the frequency and strength of heart contractions) centers, which are suppressed only when large quantities of anesthesia are administered, and are switched off when excessive, which causes toxic effect anesthesia in case of an error in selecting the concentration;
Afferent¹ synapses from the peripheral receptor to the peripheral nervous system and from it to the central nervous system, that is, bringing a signal, which causes 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 different mechanisms and at different points of application. But now you also understand what this means and what diversity is hidden under the “different” mechanisms and points.

Notes:

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

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

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

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

Many anesthetics activate glycine receptors and gamma-aminobutyric acid- the main inhibitory mediators of the nervous system, - opening channels for chlorine ions, and blocking nicotine-sensitive cholinergic receptors and N-methyl-D-aspartate receptors associated with channels for sodium, potassium and calcium ions.

Chlorine has an inhibitory effect already inside the cell, just as inside the cell sodium, potassium and calcium ions have an exciting effect. The fact is that the transition of a cell from a resting state to an action state requires a transition on its membrane from the resting potential to the action potential, and the resting potential is caused by negative charges, and actions by positive ones, respectively, the more negatively charged ions in the cell, the more it is at rest , and the more positive ones, the closer to action. In this case, there is more sodium outside, and more potassium inside, so 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 of positive charge by the cell and the spread of action throughout it.

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

This will cause depression of consciousness and conductivity in both directions, including depression of sensitivity.

How long do you need 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 long-term 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 increased sensitivity to endogenous toxins due to different hormonal levels compared to men. At the same time, at some conferences of gastroenterologists and hepatologists you 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, it is never possible to give a definite answer to such a question, because there are too many factors that influence the final result one way or another. Genetic predisposition, the condition of the liver before the person began to abuse alcohol, his lifestyle, diet and bad habits (in addition to alcohol dependence), age, life history and presence chronic diseases, especially those that force you to take any medications, for example, if you drink and use paracetamol in large dosages, then cirrhosis will come much faster, and it will even play a role here psychological condition a person, being under constant stress and so on, all this also affects the hepatobiliary system, plus the same constitutional anomalies and the nature of the blood supply to the liver in an individual individual.
So, based on all the information, we can say that some people will develop cirrhosis within a couple of years, while others may not develop it at all. Many have heard stories about alcoholics, whose autopsies reveal that the liver is in very good condition. But these are rather unique cases, and most likely this person simply died from something else and cirrhosis did not have time to develop, but he definitely had fatty liver degeneration, plus, as a rule, all these stories, like: “My 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 will happen if you let little brother-gulls flow through your veins?

Answer: You won't die. Surprised? If not the whole cup and slowly, say, through a dropper, then 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 turns black after exposure to bacteria; it may contain their remains. Your pulse may increase because 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 shouldn’t repeat the procedure, because your immune system has already targeted this tea and upon repeated contact there will be anaphylactic shock - a systemic destructive reaction, a terrible battle between the body and tea, which can result in the death of both (mortality rate up to 20%). Don't try again. And I don’t recommend it for the first time either - you never know.

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

Answer: Who told you that the rifle caliber is 5.56? With Russian (Soviet) weapons, everything is not so simple. For example, the Tokarev Pistol (TT) was sharpened for 9 mm caliber - a kind of microhowitzer. Exactly the same caliber was originally intended 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 consisted of 7.62 mm cartridges, which were simultaneously suitable

a) to Mosin rifles (“three-line”)

b) machine guns of the Maxim system;

c) revolvers of the Nagan system.

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

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

Now for the question itself. When a 9 mm caliber bullet hits 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 bullet has the highest (by our standards) kinetic energy. In addition, the standard Soviet-made 7.62 bullet has a specific geometry.

Its penetrating power is extremely high; the sighting range of a Nagan revolver or a Mauser pistol is about one and a half (!) kilometers. For comparison, the sighting range of a Makarov pistol is 25-75 meters.

A 5.6 mm bullet has an extremely low initial velocity - the result of shooting: it is useless in long-range combat, in close combat it is the enemy’s torn belly with a huge hole. As a rule, there are no casualty injuries. Due to its qualities, the issue of final removal of the caliber from service is being considered.

In contact with

Did you know that your liver is the largest internal organ(about the size of a soccer ball!)? Your hard-working liver weighs approximately three to four kilograms and is located under the rib cage on the right side of the abdomen. She is responsible for essential functions body functions such as digesting food, storing energy and removing toxins from your body.

Few of us live in a clean environment and eat completely “clean” foods. As a result, many people experience a constant influx of toxins from the air, soil, water and food. These toxins, in most cases, cause the liver to become overloaded and large doses of hepatoprotectors are required to protect the liver from these toxins. Poor liver function results in a range of symptoms, and disorders in the liver can affect almost all systems of the body. Among these symptoms there are a large number of them that people do not usually associate with a diseased liver.

Some minor to moderate problems with this organ can be effectively stabilized or treated with lifestyle changes alone. Losing excess weight, improving the quality of food and stopping alcohol consumption can help quickly. But this does not always work for cirrhosis of the liver. In fact, cirrhosis is a much more serious and advanced form of liver damage. Unfortunately, modern medicine cannot offer any treatment against liver cirrhosis And. However, there are procedures that can reduce the risk of liver failure and other complications.

How can you prevent cirrhosis and other developing liver diseases? When it comes to the liver, it is the key to solving problems. Regular exercise, reducing exposure to toxins, limiting alcohol, medications, pesticides, herbicides and hormones... can all complement and support healthy eating.

What is cirrhosis of the liver?

Liver cirrhosis is a serious, progressive disease in which scar tissue develops in the liver. As a consequence, such changes cause dysfunction of the organ, which affects a number of important processes, such as: blood circulation, removal of toxins from the body, hormone levels and proper digestion of certain essential nutrients.

According to the National Institute of Diabetes (USA), gastrointestinal diseases, kidney disease, alcohol abuse, advanced fatty liver disease, and various viruses (hepatitis) are the most common reasons why dangerous scar tissue replaces healthy liver tissue.

Other factors, such as poor diet, inherited genetics, or genetics, may also contribute to liver dysfunction and an increased risk of cirrhosis.

Unfortunately, if liver disease seriously worsens to “advanced cirrhosis,” liver failure and liver cancer may develop. With modern medicine, this condition can become fatal, and liver transplantation may be the only way out. But fortunately, lifestyle changes and the use of certain pharmacological medications can help stop the progression, and even reverse cirrhosis to some extent.

General symptoms of cirrhosis

Many people do not notice any symptoms of liver damage or cirrhosis. Some general signs and symptoms of cirrhosis and other forms of liver disease include the following list of conditions:

Lack of energy or fatigue.
Loss of appetite.
Symptoms of jaundice, including yellowing of the skin and eyes
Digestive problems such as nausea, vomiting, abdominal pain and cramps.
Brain problems such as confusion, disorientation, and mood changes.
Swelling in the legs and ankles.
Skin problems such as itching sensation.
Dark colored urine (brown or dark yellow)
Pale or very dark-colored stool
Chronic fatigue syndrome
Change in weight, usually loss due to less apatite
Tendency to bruise easily

Stages of liver cirrhosis

Liver disease is a serious problem that affects millions of people every year. Liver disease is one of the 10 leading causes of death every year. There are more than 100 different types of liver diseases, including: fatty liver syndrome, jaundice, cirrhosis, genetic diseases and various viruses such as hepatitis A, B and C.

Liver cirrhosis leads to a severe reduction in life expectancy. Unfortunately, the median survival time for patients with end-stage liver cirrhosis is 1-2 years. And in the early stages of liver disease and even cirrhosis, there may be no symptoms at all. Because of this, the causes or risk factors that make the condition worse cannot be identified and addressed in a timely manner.

At the onset of the disease, symptoms such as low energy (frequent or constant fatigue), skin changes, swelling of the extremities and nutritional deficiencies appear. Over time, if liver damage deepens, scarring begins to develop, indicating cirrhosis. This can eventually lead to liver failure, which can be fatal to a person.

Complications of cirrhosis with developing scarring can cause the following symptoms:

Portal hypertension: Fluid accumulation leads to swelling, increased risk of infection, enlarged blood vessels and spleen, and confusion.
Edema and ascites, which can lead to bacterial peritonitis.
Varicose veins: Enlarged blood vessels in the esophagus, stomach, or both, which can rupture and lead to fatal bleeding.
Problems with the spleen causing changes in the blood.
Hepatic encephalopathy: Due to poor liver function, toxins accumulate in the brain, causing impaired thinking.
Metabolic bone diseases: leading to changes in mineralization levels and bone loss.
Stones in the gall bladder and bile ducts.
Hypersensitivity to drugs.
Weakened the immune system and increased risk of infection.
Higher risk of kidney and lung failure.
Development of liver cancer.

NON-ALCOHOLIC FATTY LIVER DISEASE AS A CAUSE AND EFFECT OF METABOLIC SYNDROME

Causes of cirrhosis and risk factors

Most people associate liver disease with. However, everything that your body cannot break down and use for energy goes straight to the liver for detoxification. Thanks to this, your liver is constantly in need of any help. When you overindulge in alcohol, chemicals, medications, fried foods, and processed or refined foods (such as white flour, regular store-bought dairy, sugar, and low-quality meats), your liver is stressed and unable to function properly.

Risk factors for developing liver cirrhosis:

History of fatty liver disease.
Drinking too much alcohol
Drug use and smoking
Poor diet (low in vegetables, leafy greens and fruits, high in processed foods) food products, sugar, salt and saturated fat)
Advanced diabetes or metabolic syndrome
High cholesterol and triglycerides
Chronic viruses and various infections
High exposure to toxins and pollutants from the environment
Genetic factors
Various diseases that damage, destroy and block the bile ducts and interfere with digestion processes

You have two risk factors that you can change quite simply and effectively: eating processed foods (fast food) and drinking alcohol. Very good for your liver various vegetables, including vegetable juices, because they contain important electrolytes, phytonutrients, enzymes and antioxidants. Vegetables and some fruits (especially citrus fruits such as lemons and limes) also help reduce acid levels in the body, which creates a friendlier balance and can prevent decreased potassium levels, which is associated with liver damage.

In addition, all of these plant foods contain much-needed dietary fiber, which helps maintain intestinal microflora. Regulation of work digestive system is critical to liver health, so it is necessary to achieve daily bowel movements to eliminate toxins from your body in time after the liver has eliminated them.

Traditional treatment of cirrhosis

Treatment for cirrhosis will depend on what caused it in the first place and how severe the current condition is. Doctors often use combination treatments, including medications and lifestyle changes. There is no guaranteed “cure” for cirrhosis, so there are a wide variety of condition management methods used to manage the symptoms of cirrhosis:

Stopping drinking alcohol and taking medications
Using diuretics to control edema (fluid retention) and ascites (fluid in the abdomen)
Eating less processed foods, increasing nutrient intake, and decreasing salt intake
Weight loss, and management
Therapies to improve brain function and sometimes medications to improve mood or mental illness
Taking laxatives to improve the elimination of toxins
For advanced hepatitis, various medications (antivirals and steroids) are used.
Liver transplant for liver failure

Eight Additional Treatments for Liver Cirrhosis

Do liver cleanses regularly

Many ancient peoples, including the Chinese, considered the liver to be the most important body, therefore they often included the word “live” in the name of this organ. If you have not yet switched to a healthy diet with a predominance of vegetables, do not exercise regularly, and do not limit alcohol, then, like most people, you need a liver cleanse.

dark green leafy vegetables
stewed and raw vegetables, fresh squeezed vegetable juices
citrus
sweet potatoes, bananas, avocados (source of potassium)
milk thistle seeds or meal
turmeric
ginger
spirulina, chlorella, wheatgrass
probiotics
dandelion root
black cumin oil
fresh lemon juice
olive oil first cold pressed
coconut oil (with caution)
Apple vinegar
beef liver

List of foods or activities to avoid:

binge eating
very spicy food
fried food
refined carbohydrates (sugar)
gluten in food
too much caffeine (tea, coffee)
complex dishes (too many different types of food)

Adopt an anti-inflammatory diet, focusing on foods free of contaminants

Essentially, a diet high in low-quality saturated fats, fried foods, chemicals, and processed foods (fast food) can increase the risk of liver disease. As a result, high levels of triglycerides and cholesterol in the blood are two serious risk factors for liver damage and the development of cirrhosis.

Regular consumption of vegetables and other natural plant foods is key to maintaining a healthy liver. It is important to eat a variety of raw vegetables, ideally around 4-5 servings of fresh, organic vegetables every day. A serving is considered to be no more than one glass of 200 ml. If this amount of vegetables in your diet seems excessive to you, then you should try at least taking a squeezed vegetable juice(watch the sugar content!). Such juices promote rapid digestion and do not require a lot of bile, which gives the liver some rest.

OBESITY CAUSES CHRONIC INFLAMMATION AND THE DEVELOPMENT OF MANY DISEASES. THE BLUE BACKGROUND INDICATES NATURAL SUBSTANCES THAT HELP REDUCE INFLAMMATION AND REDUCE THE RISK OF DISEASE.

To reduce the load on the liver, you can limit your diet so that you receive less of them, but they are only of high quality, for example, from animals raised on open pastures, and not on livestock farms. It is known that animals raised on modern agricultural farms usually have very there are a lot of toxins in fat. In addition, you can add coconut oil, nuts, seeds (not fried) and seafood to your diet.

In short, the less you eat food that is packaged in colorful boxes in the store, the better your body will be. The thing is that products from such boxes contain a significant amount of chemical preservatives, fillers and synthetic flavors. For example, a significant amount of nitrates is always present in canned vegetables, and hydrogenated oils (trans fats) are often found in canned meats.

Try to include these vegetables in your diet as often as possible.:

cauliflower
broccoli
greens, spinach, dandelion, watercress
Brussels sprouts
regular cabbage
celery
asparagus
carrot
cucumber
herbs, including parsley, mint, cilantro, basil

FOOD THAT HELP REMOVE EXCESS FAT STORAGE FROM THE LIVER

Reduce your alcohol intake, stop smoking and taking unnecessary medications

Heavy alcohol consumption is most closely linked to fatty liver disease, which is a buildup of fat in liver cells that can cause swelling and cirrhosis. Drinking a large number of alcohol, you use one of the most quick ways to damage or destroy liver cells. And the combination of alcohol with various prescription drugs, cigarettes and a poor diet is destructively harmful.

Limit alcohol consumption to a “healthy” level for most adults, which is no more than 1-2 drinks per day (about 30 grams of alcohol is considered a “safe” amount). If you have any known liver problems, the best thing you can do for your liver is to stop drinking alcohol altogether.

Support your liver with special supplements

Supplements, herbs, and spices—including turmeric, milk thistle, probiotics, and ginger—can help produce the right amount of bile and enzymes, soothe the gastrointestinal tract, reduce intestinal gas, and reduce inflammation.

Milk thistle considered the “king” of herbs for getting rid of toxins. This plant has been used for centuries to help the liver cleanse and remove heavy metals, pollutants and drugs.
Turmeric is a powerful anti-inflammatory that not only aids digestion, but also helps restore healthy blood sugar balance, which supports liver metabolism.
Recent studies also show that probiotics may be beneficial for liver health because microflora plays an important role in detoxification and metabolic processes. Changes in intestinal permeability (also called leaky gut syndrome) can cause an already damaged liver to become worse. It is likely that it may be recommended to patients with liver disease to help reduce harmful effects and restore the body's immune functions.
Many of the foods or dietary supplements listed above are also good sources of essential nutrients such as potassium, vitamin C, vitamin A And vitamin B-6. Potassium-rich foods are especially beneficial because they help lower systolic blood pressure, lower cholesterol, and lower triglyceride levels.

Maintain a healthy body weight

Obesity-related liver diseases are the most common diseases of this organ in developed countries today. Obesity can lead to non-alcoholic fatty liver disease and is associated with an increased risk of developing other liver problems. Metabolic syndrome is a term that refers to a number of conditions that occur simultaneously: overweight, high blood pressure, high sugar in the blood, a significant amount of fat around the waist, low level"good" cholesterol and elevated triglyceride values. All these factors increase the chances of liver problems, not to mention diseases. of cardio-vascular system, and also stroke.

A recent study published in Journal of Endocrinology and Metabolism showed that obesity in adults increases the risk of developing liver disease by 3-15 times than in adults with normal weight. This happens because being overweight changes the levels of fatty acids and enzymes your liver produces. Non-alcoholic fatty liver disease (NAFLD) occurs when the rate of fatty acid absorption and synthesis exceeds the rate of fatty acid oxidation and export. This process is called “fatty liver disease,” and the result is an increased amount of triglycerides produced by the liver.

Fatty liver disease is associated with deleterious changes in glucose levels, fatty acids, and lipoprotein metabolism, which can increase the accumulation of adipose tissue, increase systemic inflammation, develop insulin resistance, and contribute to increased cardiac risks.

Reduce your exposure to toxins

We all come into contact with various forms of toxins every day in the air we breathe, the food we eat and the things we use. You should do everything you can to avoid inhaling or touching toxins, especially limiting the amount of household chemicals, cleaning products and cosmetics you frequently use. Chemical elements, found in aerosol formulations, insecticides, synthetic cosmetics and cigarettes, contribute to liver cell damage.

Check your medications

The liver is responsible for processing chemicals in your blood. The list of such substances includes medications, birth control pills, substitution hormone therapy and many others. Many scientists believe that a significant number of drugs available in pharmacies are misused or incorrectly combined, such as antibiotics and painkillers.

If you take medications regularly, learn about how they may affect your liver. Follow dosage instructions. Ask your doctor to recommend some natural remedies that you can use instead of these drugs.

Protect your liver from infections

Various liver diseases, including hepatitis A, B and C, are caused by viruses that are transmitted from person to person. Such viruses, once in the liver, can lead to disruption of the functioning of this organ, even to the point of failure. In addition, they can lead to liver cancer. Most doctors say that the best protection against hepatitis A and B is vaccination, but there is no vaccine against hepatitis C yet. Therefore, in fact, the only way to prevent hepatitis C infection is to avoid contact with the blood of carriers of this virus: safe sex, not sharing syringes, needles, razors, toothbrushes and personal hygiene items, always wash with soap and warm water immediately after visiting the toilets or touching someone's blood.

Reference

The liver is the largest organ of the human body. Its mass reaches 1500 g - approximately 1/50 of the mass of the entire body. Anatomically, the liver has two lobes - right and left. The right lobe is 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 in a Boat and a Dog" once went to the London public library, took a medical reference book, read it, found all sorts of ailments, and came out a deeply sick man. Among all other diseases, he identified the presence of liver problems by the main symptom - “aversion to work.” On the one hand, this may seem funny, on the other, the compiler of the reference book apparently knew a lot about diagnostics, since, oddly enough, often the only complaint for liver diseases is asthenic syndrome, that is, decreased performance, weakness, excessive drowsiness.

Reluctance to do something may be the only thing, but characteristic feature. 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, these are jaundice, itchy skin, baldness, redness of the palms, and in women - menstrual cycle disorders; heaviness in the abdomen, nausea, belching, unstable stool.

In the later stages, there may be an enlargement of the abdomen due to the accumulation of fluid in it (ascites), darkening of the urine (it becomes the color of beer), discoloration of stool, and subcutaneous bleeding. In order not to lead to such a state, you need to take care of yourself at the first unfavorable symptoms. 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 with cirrhosis? A healthy liver consists of hepatic lobules. With cirrhosis, a change in the structure of the liver occurs, the liver contains a large amount of connective tissue, and instead of lobules, nodules of different sizes appear, overgrown scar tissue compresses the blood vessels, resulting in impaired blood circulation. The loss of normal liver cells leads to the fact that the liver is unable to synthesize proteins and other substances needed by the body, as well as 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 the following diagnostic methods:

a biochemical blood test that will show an increase in liver enzymes and an increase in the amount of bilirubin;
Ultrasound of the liver and other abdominal organs will reveal changes 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 esophageal veins 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, the skin directly above the liver is pierced with a special thin needle, a piece of tissue is removed);
examination of 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 quit drinking

THE MOST common reasons liver cirrhosis - alcohol abuse and viral hepatitis (primarily hepatitis B and C). Less commonly they become poisonings toxic substances(for example, toadstool poison, certain medications), gallbladder diseases and bile ducts accompanied by prolonged jaundice.

Increased environmental pollution, increased consumption of various preservatives, alcohol, and uncontrolled use of medications 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, if we talk about “normal” drinkers and high-quality alcoholic beverages, the time that must pass from the start of consumption until the development of liver disease depends on many factors. Firstly, it depends on how much a person drinks, and secondly, who drinks - a man or a woman. In a woman, other things being equal, the disease will develop faster and at lower doses. It is believed that for men the maximum permissible dose is 60 g of pure alcohol per day: this is 3 bottles of beer, or 3 glasses of dry wine, or 3 glasses of vodka. The liver cannot process anything beyond this without causing damage to itself. In women, liver damage can develop even with constant intake of 20 g of alcohol per day.

On average, at least 8-10 years pass from the beginning of systematic drunkenness to the appearance of classic alcoholic cirrhosis. In women and adolescents, this period may be shorter - about 5 years. Alcoholic liver damage for a long time may be asymptomatic. A person drinks and drinks until the liver is no longer able to pump 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 has begun to enlarge due to the fact that fluid has appeared there. This is a very important symptom and a serious prognostic sign. Often, if ascites appears, the patient’s life expectancy is several years. If a person does not stop drinking, this gap will rapidly shrink. However, if the patient can be convinced 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 or more years without further deterioration. Why? Because he stops drinking, there is no progression of the cirrhotic process, and restoration of liver function under these conditions may well occur. Therefore, it is never too late to quit drinking alcohol.

How to protect your liver?

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

Even if the process in the liver ends with recovery, the damage still does not go away without a trace and can make itself felt by a certain functional inferiority, one or another degree of hepatic dystrophy. To avoid this, your doctor may recommend hepatoprotectors - drugs that help the liver restore its structure and protect it from adverse influences. Now there are about 30 types of hepatoprotectors on our pharmaceutical market: herbal, homeopathic, synthetic. Most of the drugs are of plant origin, 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 affordable price.

As for liver cirrhosis specifically, the results of its treatment are both disappointing and encouraging. The impaired architecture of the liver in cirrhosis is never restored, but the ability of liver cells to recover is so good that even with cirrhosis, liver function can be improved.

Of course, only a doctor can choose the optimal treatment regimen for a particular patient, but a lot depends on the patient himself. It is important how he will behave during treatment, whether he will be able to follow all the recommendations as planned drug treatment, as well as diets, etc. If you are diagnosed with liver cirrhosis, carefully follow your doctor’s advice. In addition, take care of yourself: rest as soon as you feel tired. Avoid heavy lifting: a sudden increase in abdominal pressure can cause gastrointestinal bleeding. Monitor the frequency of your stool (the optimal frequency of stool is 2 times a day).

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

What can a patient with liver cirrhosis complain about?

Increased fatigue.
Losing weight.
Various disturbances of consciousness and behavior (decreased concentration, daytime sleepiness, disrupted night sleep, etc.).
Decreased appetite and abdominal discomfort (bloating, feeling quickly full while eating).
Jaundice (yellow coloration of the skin and sclera).
Lightening or discoloration of stool, darkening of urine.
Stomach ache.
Swelling of the legs and (or) increase in the size of the abdomen due to free liquid in the abdominal cavity (ascites).
Bleeding: nasal, gastrointestinal, gum, hemorrhoidal, and subcutaneous hemorrhage.
Frequent bacterial infections (respiratory tract, etc.).
Decreased sexual desire.
In men, gynecomastia (enlarged mammary glands) is common.

It is advisable to avoid drinking mineral waters containing sodium.

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

If there is fluid retention in the body (edema, ascites), it is necessary to limit intake. table salt up 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, cookies and crispbreads, as well as salt-free butter are consumed.

Seasonings such as lemon juice, orange zest, onion, garlic, salt-free ketchup and mayonnaise, pepper, mustard, sage, cumin, parsley, marjoram, bay leaves, cloves and yeast extract (low salt) help enhance the enjoyment of dishes. to taste.

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

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

Salty canned foods are excluded.

100 g of beef or meat is allowed 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 in fresh or in the form of dishes prepared at home.

Our interlocutor: Pavel Petrovich Ogurtsov, doctor medical sciences, professor, head of the Center for Liver Research, Faculty of Medicine, Peoples' Friendship University of Russia, head of the department of hospital therapy.

1. The liver is the main filter of our body. Maybe that’s why today we are called on from the pages of advertising newspapers, and sometimes from the TV screen, to clean it using “folk” methods. What is your attitude to this kind of “cleansing”?

Behind the methods of cleaning the liver are exclusively methods of cleaning the brain and wallet. The most “popular” method today is when someone who wants to cleanse is offered to drink vegetable oil with lemon juice, and the next day the surprised person sees multi-colored “stones” coming out with waste products. And few people understand that if in a jar with vegetable oil add lemon juice and place it in a warm, dark place (similar to the intestines), in the morning the same crystals will settle at the bottom of the jar. That is, the usual thing will happen chemical reaction oils with citric acid. The level of other liver cleansing methods is similar.

2. That is, there is not a single proven effective method for cleaning the liver?

It's not so bad, at least one exists. But not cleansing, but stimulating the secretion and excretion of bile. It is carried out in specialized gastrointestinal sanatoriums; this physiotherapeutic technique is called tubage. This technique includes taking choleretic drugs, mineral water with simultaneous heating of the liver area, using other physiotherapeutic effects on the right half chest and right hypochondrium.

3. How else can you protect? The same advertisement offers a variety of remedies - from dietary supplements to hepatoprotectors.

Unfortunately, the liver is exposed to so many different factors every day that it is impossible to protect against all of them at once. Therefore, the same dietary supplements often become an extra burden for the liver, from which it is time to protect the liver itself. As for hepatoprotectors, the consumer should know that such drugs are not available as a class in the rest of the world. Well, there are no such things in national pharmacopoeias, that’s all. Why? Because they have not proven any effectiveness in studies. With the exception of two active ingredients: ademetionine (several drugs have been developed on its basis), which is effective for protecting and restoring the liver from chronic drug and other intoxications, and ursodeoxycholic acid (several drugs have also been developed on its basis), effective in primary biliary cirrhosis and less effective for other cirrhosis.

4. That is, if you overdid it with alcohol during the holidays, you should take ademetionine?

This may improve liver health, but it is best not to expose it to toxic doses of alcohol.

5. We come to a question that worries many: liver and alcohol. How much and how to drink so as not to develop cirrhosis?

There is no common denominator in this matter, especially since the liver is a very “patient” organ. Some people “drink” all their lives and have a relatively healthy liver, others “drink like everyone else,” and by the age of 40 they develop cirrhosis. Therefore in last years We came to some interesting conclusions. Firstly, alcohol in almost any dose is poison. Moreover, the poison is both ethanol itself and the formaldehyde formed during its breakdown. We believe that anything more than 20 ml of pure alcohol per day (45 grams of vodka) is already a poison that is harmful. And now everything depends on what kind of genetics a person is given, what kind of enzymatic system of the liver, what kind of metabolism, and how long the liver can withstand the blow depends on these factors. And here we come to the second interesting conclusion: healthy liver can take a hit for a very long time. If alcoholic hepatitis and then cirrhosis develop, it means that besides alcohol there is someone else who enhances its effect.

6. Who is this stranger?

First of all...iron. We used to underestimate how common one thing is in a population genetic disease- hereditary hemochromatosis. This is a disorder of iron metabolism, in which it is intensively deposited in the liver. Not only does iron lead to the development of liver fibrosis when it becomes dense, but it and ethanol also enhance the destructive effect of each other. The worst thing is that most often a person has only one gene for this disease in a pair, and it is erased, without symptoms. As a result, a person “drinks like everyone else,” and by the age of 40 he comes to us with cirrhosis of the liver. This disease can be indicated by a constant blush of the cheeks, a high level of hemoglobin (for example, 170-180 g/l), and an increased level of the iron storage protein - ferritin. The second likely stranger is unrecognized chronic viral hepatitis. The patient suffers from a chronic form of hepatitis B or C, does not know about it and drinks alcohol, meanwhile, the liver is already seriously affected by the virus. The third enhancer of the effects of alcohol is medications. This is especially true in our country, where most of them are sold without a prescription. Many people, and women more often than men, swallow painkillers and non-steroidal anti-inflammatory drugs by the handful, and in the evening they calmly drink a couple of glasses of wine or champagne. For the liver, this is not a double, but a quadruple blow, and cirrhosis can occur very quickly. Therefore, I would suggest that every young person entering adulthood take several tests that will help him build the right relationship with alcohol. This is an analysis for viral hepatitis, a genetic test for hereditary hemochromatosis, “liver” enzymes ALT and AST. If everything is normal, you can be friends with alcohol, of course, within reason. If not, go to an appointment with a hepatologist, who will give further recommendations.

7. Some people don’t drink at all, but still experience liver problems. First of all, with fatty hepatosis. What is this disease and how to avoid it?

Our ancestors' liver was like a camel's hump. The hunter ate “to his fill” and moved on; perhaps in the coming days there would be no prey, and there would be no food. But he walks a lot and gradually burns all the liver fat. Nowadays, the situation has changed: we have not forgotten how to eat to our heart's content, but we are too lazy to walk, and a hearty lunch will be followed by an equally hearty dinner. As a result, fat in the liver is retained and liver cells are gradually replaced by it almost completely. At first, liver function does not suffer, this is the stage of fatty hepatosis, but then excess fat disrupts its function and causes inflammation, and fatty hepatitis develops.

8. Is it possible to remove fat from the liver?

It is possible, and in the most natural way, to reduce the fat content and caloric content of food and increase physical activity. The main thing is to start a war with fat at the stage of fatty hepatosis, before fatty hepatitis has yet begun, in which case some liver cells will already die. Fortunately, there are additional ways to combat fatty liver disease.

Certainly. Personally, I prevent fatty hepatitis with several cups of coffee a day. It has been proven that the substances contained in coffee have a strong anti-inflammatory effect, especially in relation to cytokines - inflammatory factors that play an important role in the development of hepatitis.

10.You have already mentioned viral hepatitis. Which of them are the most dangerous for humans today? Are new viruses emerging like the mutation of the influenza virus?

Hepatitis A virus is considered the mildest because it is acute and never progresses to chronic form. I got sick with jaundice and didn’t remember about it anymore. Although this opinion is quite misleading, any inflammation of the liver can become life-threatening. Do not forget about hepatitis E - a brother of hepatitis A in terms of transmission mechanism and symptoms. But the peculiarity of this infection is that it can become very dangerous for mother and child in the 3rd trimester of pregnancy. Fortunately, a vaccine has recently been developed for it and will soon be introduced into healthcare. Hepatitis B can become chronic, this figure reaches 15%, and even in acute form are much more severe and more dangerous than hepatitis A. It is also very contagious; a literally invisible drop of blood is enough for the virus to enter our body. Hepatitis C has received the nickname “gentle killer”, and all for its ability to settle in the liver for a long time and become chronic. According to statistics, up to 85% of all cases of hepatitis C become chronic. It is this virus that has many genotypes and is prone to constant changes in the genome, like a “Rubik’s cube”, which, each time passing through the liver, comes out a little different, so a vaccine against it has not yet been developed It turns out that immunity is poorly developed; if you become infected with one genotype of the virus, you can easily pick up another. Over time, in almost ¼ of cases, chronic hepatitis C develops into cirrhosis of the liver, so I consider it the most dangerous for humans. Hepatitis D is a superinfection¸ it affects those who are already sick with hepatitis B. In general, more than 70 viral hepatitis are known today, so the letters of the alphabet were no longer enough, viruses began to be called like ttv car numbers, etc. Fortunately, they are mild and the immune system copes with them. Almost every one of us has suffered from one of the viral hepatitis at least once in our lives, sincerely believing that it was the flu or ARVI.

Scientists have proven that coffee has a beneficial effect on the liver and protects it from inflammation.

11. How effective is the hepatitis B vaccine, when to vaccinate against hepatitis A, and can we expect the development of a hepatitis C vaccine in the coming years?

The hepatitis A vaccine should not be neglected; it is usually given to children 3-6 years old or to adults after contact with a sick person. It is imperative to get vaccinated before traveling to an epidemiologically affected region. When planning a pregnancy, it is important to get vaccinated against hepatitis E. The hepatitis B vaccine has already proven its effectiveness. Firstly, you can make sure that the vaccine “works” by taking a blood test for antibodies to hepatitis B before the first vaccination and after completing the entire course. If the concentration is more than 10, this means that the immune system is tense and will immediately destroy the virus upon first contact. The second proof is the almost zero incidence of hepatitis B among vaccinated health workers, before the introduction of vaccination - the most “sick” contingent. The first vaccination is carried out in infancy, usually it is 3 injections over several months, but when to do revaccination can be decided together with your local doctor - you can do 1 injection every 5 years, or after 5 years you can get tested for the same antibodies and decide The time has come or you can wait a couple more years. As for the hepatitis C vaccine, the many genotypes of the virus and the tendency to mutation complicate the work on creating a vaccine; while there are no concrete results yet, the appearance of a vaccine for hepatitis C is expected at about the same time as the HIV vaccine - in about 10 years.

12.Is it possible to become infected with viral hepatitis B and C through household means? Are they sexually transmitted?