Contents
What is biliary cirrhosis of the liver?
Biliary cirrhosis of the liver – This is a chronic disease of the organ, which is formed against the background of damage to the biliary tract. Doctors distinguish between primary and secondary forms of the disease. Primary is the biliary cirrhosis, which is the result of autoimmune processes, first leading to cholestasis and only after a long time – to cirrhosis. The secondary form of the disease develops as a result of a violation of the outflow of bile in the large bile ducts.
The disease most often affects people of working age (from 25 to 55 years), this type of cirrhosis accounts for one case out of 10. In women, the primary form of the disease predominates, while in men the secondary one. The disease is rare in children.
Life expectancy with biliary cirrhosis
The life expectancy of a patient with biliary cirrhosis depends on the stage at which the disease was diagnosed. Often people live with this disease for 20 years or more without even knowing they have biliary cirrhosis. After the onset of the first clinical symptoms, life expectancy is about 8 years. On average, 50% of patients die 8 years after the onset of the disease, although much depends on the level of hyperbilirubinemia.
However, it is impossible to predict the life expectancy of a particular patient in absentia, since a number of factors that are individual for each patient influence the course of the disease.
Symptoms of biliary cirrhosis of the liver
It is advisable to group symptoms according to the primary and secondary forms of the disease.
So, primary biliary cirrhosis is characterized by:
Intermittent skin itching, which often appears during a night’s rest, with additional irritating factors (for example, after contact with woolen products or after taking a bath). Itching can last for many years;
Staining of the skin in dark brown, primarily in the area of the shoulder blades, large joints, and later on the whole body;
The appearance of a flat formation on the eyelids, which looks like a plaque. There are most often several of them, xanthelasmas can also appear on the chest, palms, buttocks, elbows;
Enlargement of the spleen in volume is a common symptom of the disease;
A person may begin to be disturbed by pain in the region of the right hypochondrium, in the muscles, in the mouth, a bitter taste often appears, and the body temperature rises slightly.
With the progression of the disease, all symptoms intensify, there is a loss of appetite, itching becomes unbearable. Areas of pigmentation coarsen, the skin swells, the terminal phalanges of the fingers thicken. Pain intensifies, varicose veins of the esophagus and stomach are observed, internal bleeding may develop. The absorption of vitamins and nutrients is difficult, symptoms of hypovitaminosis join. Lymph nodes increase, disturbances occur in the digestive system.
The secondary form of the disease is characterized by the following features:
Increased skin itching, which even in the initial stages of the development of the disease causes serious discomfort;
Pain in the right hypochondrium, while the liver is compacted and painful on palpation and without;
The skin and mucous membranes of the mouth and eyes turn yellow, the urine darkens, and the feces become discolored;
Body temperature exceeds 38 ° C;
Complications of cirrhosis of the liver occur much earlier, in particular, we are talking about portal hypertension and liver failure.
Causes of biliary cirrhosis
Doctors have established the fact that the primary form of the disease does not have an infectious nature. Therefore, the main reason is considered to be malfunctions of the immune system and the production of specific antibodies that are aggressive towards the intrahepatic biliary tract. Also, the role of genetic predisposition to the occurrence of primary biliary cirrhosis is not denied. It is possible that diseases such as autoimmune thyroiditis, scleroderma, rheumatoid arthritis also affect.
The development of a secondary form of the disease leads to:
Cholelithiasis;
bile duct cyst;
Chronic pancreatitis and the narrowing of the bile duct caused by it;
Sclerosing or purulent cholangitis;
Congenital anomalies of the biliary tract;
Enlargement of lymph nodes and clamping of the bile ducts.
Treatment of biliary cirrhosis
The treatment regimen will depend on which form of the disease is diagnosed in the patient. If he suffers from primary biliary cirrhosis, then therapy should be aimed at reducing the concentration of bilirubin in the blood, at reducing the level of cholesterol and alkaline phosphatase. This is facilitated by the intake of ursodeoxycholic acid. In addition, the patient is prescribed colchicine (to prevent the development of complications of the disease) and methotrexate (to provide an immunomodulatory effect). If the disease has already led to the development of connective tissue in the liver, then antifibrotic drugs are prescribed.
In addition, the patient needs to improve the quality of life and get rid of the accompanying symptoms of the disease. To relieve itching, it is recommended to take Colestipol, Naloxin, antihistamines. To lower cholesterol levels, it is advisable to take statins. If the patient develops ascites, then the use of diuretics is necessary. In the formation of serious complications, a transplantation of a donor organ is necessary.
If a patient is diagnosed with a secondary form of the disease, then first of all he needs to normalize the outflow of bile. This is done either through endoscopy or through surgery. When it is not possible to implement such manipulations, the patient is prescribed antibiotic therapy to stop the progression of the disease.
In addition, patients need to follow a special diet. Doctors recommend adopting diet table number 5. It involves limiting the intake of fats, salt and proteins. The basic principle of nutrition is fractional, food is taken in small portions.