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What is portal cirrhosis of the liver?
portal cirrhosis – the most common form of this disease, characterized by damage to the liver tissue with its replacement with fibrous fibers and the death of hepatocytes. These changes occur as a result of a number of morphological factors, the leading positions among which are occupied by alcohol abuse and malnutrition. Although Botkin’s disease can also cause liver dysfunction, according to statistics, hepatitis A causes cirrhosis in only 20% of cases.
Most often, portal cirrhosis affects older people: from 40 to 60 years. At the same time, the male sex is twice as susceptible to this pathology as the female. In medicine, you can also find other names for the portal variety of cirrhosis, for example, alcoholic, septal, fatty, Linek’s cirrhosis.
Symptoms of portal cirrhosis of the liver
The disease is hidden, the symptoms are blurred, as in the initial stages of other cirrhosis.
The clinical picture is similar to the manifestations of chronic hepatitis:
The patient complains of digestive disorders: he suffers from heaviness and bloating, cannot tolerate fats and spicy foods, and his appetite disappears. Frequent diarrhea can be replaced by constipation, flatulence increases;
The pains are localized in the right hypochondrium, tend to intensify after eating, as well as after physical exertion. The nature of the pain is aching, not sharp;
There is a general disturbance of well-being, weakness, fatigue;
The liver is compacted and painful, its sharp edge is palpable, the spleen is enlarged;
Spider veins form throughout the body and on the face, erythema of the palms is characteristic. These signs appear in the early stages of the disease;
Unexpressed yellowing of the skin is rare, not more than 12% of patients;
As the disease progresses, the patient begins to lose body weight, signs of hypovitaminosis appear;
The skin begins to itch, scratching appears;
Hemorrhoidal and nosebleeds may occur;
Collaterals – dilated veins that shine through from under the skin of the abdomen, often located in the navel and diverge from it in different directions.
The final stage is characterized by the appearance of severe complications, ascites, and gastric and intestinal bleeding may occur. It is at this stage that jaundice develops, the risk of death increases if an organ transplant is not performed. It should be noted that portal cirrhosis can develop over a long period of time and begin to disturb the patient only after 20 years. In this form of the disease, it is advisable to distinguish three stages: preascitic, ascetic and cachectic. As they pass, the patient’s condition worsens more and more.
Causes of portal cirrhosis
The reasons for the development of this form of cirrhosis may be as follows:
The root cause of the development of portal cirrhosis is alcohol abuse. Frequent drinking of alcoholic beverages, regardless of their type, leads to the fact that liver cells gradually die, and its tissue is replaced by connective tissue, and the organ becomes no longer able to perform its functions in the required volume;
Portal hypertension or increased pressure in the portal vein and the inability to move blood normally. It can be caused by the growth of tumors, the formation of adhesions after surgery, the development of extrahepatic blockade, thrombosis of the hepatic veins;
Vitamin-protein deficiency due to congenital malformations, inattentive attitude to nutrition, frequent bleeding or infectious diseases;
Toxic-allergic effects on the body;
Hepatitis.
Treatment of portal cirrhosis
Treatment of the disease should be based on its etiology. In addition, the stage of development of the pathology, the degree of necrotic activity of cirrhosis and the presence of concomitant diseases will have a significant impact on the course of the therapeutic effect.
It is necessary to control the amount of salt that the patient consumes, since sodium chloride contributes to fluid retention in the body. Periodically, the patient will need to take diuretics. In this regard, a diet with restriction of liquid and salt is no less important. At the same time, the diet should provide the patient with the necessary amount of kilocalories and replenish fats, proteins and carbohydrates.
Since the synthesis of vitamins in portal cirrhosis is reduced, the patient is recommended to take vitamin-mineral complexes.
With patients, it is necessary to carry out preventive measures aimed at eliminating the complications of the disease, which is especially important in the early stages of cirrhosis:
Firstly, it is psychotherapy, the purpose of which is the removal of dependence and the complete exclusion of alcoholic beverages from the patient’s life;
Secondly, this is the avoidance of the possibility of poisoning with other toxic substances, for example, at work;
Thirdly, it is the observance of the diet and a healthy lifestyle in general.
It is important that the patient is not subjected to significant physical exertion, as medical practice indicates that overexertion greatly aggravates the course of cirrhosis. In addition, it has been scientifically proven that bed rest enhances the blood supply to the liver, increases enteroportal blood flow and triggers regeneration processes.
Treatment of cirrhosis with drugs is divided into two large groups:
Symptomatic therapy: taking hepatoprotective membrane stabilizing agents (Essentiale Forte, LIV-52, etc.), vitamin therapy (vitamins B12, B6, ascorbic acid, rutin, etc.), diuretics (Furosemide, Lasix, Veroshpiron), hemostatic agents (Vikasol, Vitamin K, calcium chloride), iron supplements (Sorbifer Durules). The choice of a particular drug will depend on the nature of the disease and its clinical manifestations;
Pathogenetic and etiotropic therapy comes down to taking antiviral drugs (interferon), drugs aimed at preventing the formation of scar tissue (colchicine), immunosuppressant drugs and anti-inflammatory drugs (glucocorticosteroids and azathioprine).
The most important thing in the treatment of portal cirrhosis is to prevent a return to alcoholism and maintain a healthy lifestyle.