Toxic liver: symptoms and treatment
Toxic liver means not only contamination from hazardous poisons and chemicals. Detrimental factor for the liver can be the use of the usual patient food, beverages, medicines. To prevent dangerous for the liver structures of the States it is important to control the functional state of the liver, especially in patients with a complicated clinical history.
The features of pathology
The liver is the filter of the human body, which ignores all harmful compounds and toxins through your cells. Toxic liver combines the whole group of diseases characterized hepatotoxic effects on the cells of the body. The negative impact of internal and external factors destroys the cells of the liver and structures, leading to irreversible functional disorders of the body. The modern era dictates its own rules, and the person becomes the hostage of any changes. Poor quality of food, radiation, bad ecology, mushrooms, cosmetics, and household chemicals – all of which can to varying degrees affect liver function. Some toxins can destroy the liver and quickly bring the patient to death:
- toxic hepatotropic substances (benzene, hydrocarbons, aldehydes, alcohols and all their derivatives, amines);
- hemolytic toxins (derivative of chromium and its compounds, sulfate, Myslakowice drugs);
- the organic polyhydric alcohols (glycols, ether glycols connection);
- the insecticides (all funds against rodents, insects, midges, used in horticulture and the chemical industry);
- compounds of heavy metals.
These toxic ingredients are absorbed into the body through:
- the digestive organs;
- respiratory system;
Long-term use of certain medications can cause the destruction of healthy liver cells. Unfortunately, some drugs are essential and require lifelong treatment (cytostatics). Adversely affect the liver cells from the toxins contained in mushrooms.
Causes a strong toxic damage of liver structures and parenchymal layers of the organ can cause the following external factors:
- medications (antibacterial, cytotoxic, psychotropic medications);
- prolonged exposure to household chemicals or finishing construction chemistry;
- poisonous plants and mushrooms;
- elevated levels of radiation in the region;
- unsatisfactory ecological environment;
- professional activities (mines, nuclear industry);
- alcoholism, drug addiction, tobacco Smoking;
- severe injuries.
The duration of the destruction of the liver tissue is determined by the immunity of the patient, his General health, presence of concomitant liver diseases (e.g. viral hepatitis), type potential or a direct aggressor.
Groups of toxic substances
All the poisons and toxins in the liver have an impact on different parts of body is affected with varying degrees of intensity, so they are divided into two large groups:
- Compounds and substances that cause specific damage to the liver.
- Compounds and substances causing nonspecific damage to the liver.
In the first case, the aggressive components affect liver cells cause the mutation of healthy cells into abnormal, harmful for the regenerative processes in the tissues of the body and destroys the cells (hepatocytes) cells in third quarter of body. The depth and extent of the damage is measured by the dose or amount of damaging substances, and hereditary sensitivity to toxic compounds. Toxic liver injury is characterized by the spread of the pathological process to other bodies, until the development of multiorgan failure.
In the second case violated hematological processes. Blood circulation in the small blood vessels (capillaries, veins), begin necrotic processes at the level of cellular structures due to lack of oxygen and other nutrients. The kidneys thus affecting rarely. The clinical picture is characterized by signs of violations by the organs of the epigastrium. Patients complain of dyspepsia, a feeling of inflammation and pain in the stomach.
In all cases, is a specific liver and adjacent organs or systems in varying degrees. Specific toxic liver injury develops rapidly, accompanied by rapid increase renal and heart failure, and more than 75% are fatal. Nonspecific changes in the body contribute to the slow increase of symptoms, often lead to patient disability.
Classification and types
The clinical picture in the liver looks like a multi-faceted, is often the greatest difficulty for specialists, if the patient can not clearly explain his own condition, possible predisposing factors with aggravated clinical disease (gastroenterology or Hepatology).
To help diagnose the pathology of isolated classificationlesions according to different criteria.
According to the severity of
There are the following degrees to determine the severity of the toxic damage of liver structures:
- Stage I (level of enzymes in liver cells is 1.5-5 times);
- Stage II (increase in enzymes 4.5-10);
- Stage III (increase in enzymes is almost 10 times more).
Determining the severity of intoxication allows you to start timely resuscitation or replacement therapy.
The shape of the flow
The rate of rise of the symptoms of intoxication and destruction of the hepatic structures due to the shape of the pathological state:
- The acute form. Acute attacks can last from several days to six months. Pathology develops immediately after getting a huge dose of damaging substances in the body. The first symptoms appear after only a daybecause the first day the body is able to compensate for their own lack of authority.
- A chronic form. The duration of destruction lasts for more than six months, is characterized by a relatively slow increase of liver failure with regular ingestion of small doses of toxic substances. The first symptoms can occur after a year or more complications of cirrhosis, necrotic tissue changes, until the development of acute liver failure.
Both forms have a fundamental difference in the therapeutic treatment, so it is important to determine the intensity of the onset of symptoms.
The type of flow
Toxic liver injury can be symptoms, reminiscent of some diseases of the digestive tract, kidneys and pelvic organs. There are the following types of flow:
- the stagnation of bile (cholestasis with severe);
- hepatic necrosis and development of acute or chronic liver failure);
- acute hepatitis (acute focal inflammatory process);
- persistent hepatitis (low-level phase of inflammation);
- chronic lobular hepatitis (inflammation in the lobed structures of the body);
- autoimmune hepatitis.
Some signs of liver disease are vague, and therefore requires careful differential diagnosis to exclude the accession of other pathological conditions of the liver and adjacent organs.
The clinical picture
If in case of acute toxic liver damage the increase of the symptoms manifested rapidly and often require resuscitation, when chronic damage to the liver can wear latent. Clinicians combine symptoms or signs of intoxication syndromes in certain diseases. The syndrome can occur as an independent disease or as a symptom of toxic poisoning. There are the following main syndromes:
- for cytolysis;
- syndrome of cholestasis;
- hepatic encephalopathy;
- gepatocitami failure.
Often, all the syndromes are similar to functional disorders of the digestive tract, so it is very important to separate one from the other for adequate treatment. Common symptoms include:
- lightening of stool;
- nausea, uncontrollable vomiting;
- irritation, apathy, weakness;
- itchy skin, redness or rash;
- darkening of urine;
- an enlarged liver (on ultrasound);
- yellowing of the sclera, saliva, skin;
- poor appetite;
- tenderness in the epigastric region;
- weight loss;
- signs of ascites (filling of peritoneal fluid).
In addition to the main symptoms, doctors distinguish some non-specific, which can give an additional definition related to the condition of the patient:
- the appearance of pronounced telangiectasia;
- redness of the extremities (feet, hands);
- sharp obesity (or, conversely, weight loss);
- redness of the face;
- sweating, increase salivation;
- the curvature of tendon structures in the hand;
- the bruising is;
- the appearance of white spots on the nails;
- mental disorder, emotional instability.
The final stage of growth symptoms in toxic liver injury is hepatalgia – acute severe liver failure with the influence on the brain and Central nervous system. Coma develops, and death of the patient.
Differential diagnosis allows to identify not only the stage of development, the form and type of intoxication, but also to determine the degree of liver damage. Diagnostic events include the following:
- gathering clinical history;
- complaints of the patient;
- visual inspection appearance of the patient (skin, sclera, fever, physique, anatomical changes);
- palpation or percussion of the abdominal organs.
All these measures ensure that preliminary diagnosis on the subject of disorders of the liver. To complete the overall clinical picture for the doctor can the following types of studies.
Laboratory data of the study of biological material of the patient will help to identify or eliminate possible complications from other organs or systems, to determine the stage of disease development. The main tests include:
- total blood analysis (as of esinophilia, shiftleukocyte formula to the left, erythrocyte, protein);
- full blood count (status and balance of electrolytes, bilirubin, hemoglobin, indications of creatinine, urea, characterizing the work of the kidneys, inflammation);
- urinalysis (color, presence of protein, bile pigments).
A blood test is required to define the markers of hepatitis, status of the protein fractions, globulins in the structures of the liver and other indicators, can affect the structure of the liver even more. Mandatory to determine coagulation blood clotting. Laboratory studies may include the study of the liver tissues after the capture material for analysis (biopsy).
Instrumental methods allow you to see the condition of the liver on the screen, in different views on the media, literally around the liver in the hand. The main methods include:
- Ultrasound of the pelvic organs, peritoneum;
- biopsy (biopsy of the liver for analysis);
- elastography (identifying the degree of fibrosis);
- fibroesophagogastroduodenoscopy (to exclude diseases of the esophagus and stomach);
- spiral computed tomography (x-ray different depths for the review of all structures of the body);
- MRI to determine the exact picture of the disease.
If necessary or unclear clinical picture conduct additional diagnostic characteristic methods of research. Before curing the disease, the doctor should be convinced of the truth of the diagnosis.
Treatment of liver toxicity always combined, combines a special diet, traditional, and surgery. Diet toxic liver is an important aspects for the successful treatment of a damaged liver structures involves complete abstinence from alcohol and toxic substances from aggressive products (roasted, salted, marinated, spicy, baked), restriction of protein 30-50 g a day, diet should be smaller meals several times a day in small portions. The main diet consists of fruit (fiber), milk products, legumes.
Treatment toxic damage of liver structures are always long, involves being in the hospital, and following the concept of medical treatment:
- medications (tablets, injections);
- glucose, vitamin complexes;
- fat burning the drugs;
- drugs that bind ammonium compounds;
- inhibitors of proteolytic (prevents protein molecules);
- antibiotics, amino acids;
- sedatives and antihistamines.
At the time of treatment, patients must give up all medication (with the approval of a doctor), alcohol, tobacco or drugs. In cases of poisoning in production, you need to take a vacation or change jobs. Treatment can take several months. Severe forms of pathology may require replacement or resuscitation therapy.
Surgical treatment usually involves liver transplant. Transplantation may be related or cadaveric. Patients with severe hepatic impairment, during the transition to full replacement therapy should prepare for a future transplant.
Drug therapy is a priority in the treatment of patients with toxic damage of the liver. Toxic liver drugs are assigned to remediation intoxication of the whole organism. This includes plazmoferez, hemodialysis in severe disorders of the kidney, intestinal or stomach. To avoid toxic liver damage is possible, if you follow a healthy lifestyle, avoid unnecessary contact with chemical emissions and other poisons.