Advices for Life


September 27, 2016 23:01

Steatohepatitis : causes, symptoms , diagnosis, treatment

steatohepatitis - a transitional phase of the disease from steatosis to cirrhosis.This pathology affects the liver tissue cells, to use the inflammatory process, developing on the basis of fatty degeneration.The good news is that this process is still reversible (as opposed to cirrhosis of the liver).

In this article:

  • reasons
  • Symptoms
  • Diagnostics
  • Treatment
  • Prevention
  • forecast

code in ICD-10

Since the code in ICD-10 (International Classification of Diseases)It does not refer to a single, today the most common encoding K76.0 - fatty degeneration of the liver, not elsewhere classified.

reasons steatohepatitis

To effectively arrest the problem, you must have an idea, how about the disease and about its generating sources.

This pathology is an inflammation in the liver tissue that occurs on a background of the degeneration of the liver of fat cells.Physicians separation is carried out on several types which result in different pathologies.Reasons steatohepatitis.

  1. Alcoholic genesis.Almost every third person abusing alcohol, it is possible to observe the development of this deviation.
  2. Metabolic genesis - on the basis of violations of metabolic processes in the pathology.
    1. Too much weight.
    2. protein deficiency.
    3. deficiency of insulin in the body, causing diabetes.
    4. Rapid weight loss.
    5. hunger strike.
    6. failure in the lipid (fat) metabolism - dyslipidemia.
    7. Complete replacement of the patient's natural nutrition parenteral nutrition (bypassing the digestive organs).Mostly it is the intravenous route.
    8. Prolonged and repeated administration of glucose intravenously.
  3. Drug trace of the disease.A number of drugs are poisonous chemical compounds (toxicity), as well as fatty infiltration, due to increased accumulation of lipid components in the cells of the liver.These effects may be observed after administration of certain drugs:
    1. cytostatic drugs that block the ability to cells to divide.
    2. Glucocorticoids directly affect human hormones.
    3. Series antibiotic drugs.
    4. nonsteroidal anti-inflammatory drugs (NSAIDs), used as analgesic, anti-inflammatory and antipyretic agents.
  4. provoke this deviation is capable of and surgery produced on the gastrointestinal tract organs, especially in the case of partial removal of the small intestine.
  5. The cause of degeneration is capable of becoming and diverticulosis - a deviation obtained by the formation of the bag presentations of the small intestine wall.Thus there is enhanced increase in colony gut pathogens.
  6. Pathology Wilson, associated with a change in the normal metabolism of copper.
  7. And a number of other factors.All sources of modern medicine is still not known for certain.

Symptoms steatohepatitis

Symptoms of alcoholic or non-alcoholic steatohepatitis is almost identical.Developing on the background of the prolonged use of alcohol, which leads to malfunction of metabolism (including lipid) considered changes primarily affect the liver.After all it is - a "custom" of the body and entering into ethyl alcohol passes disposal here.With regular alcohol attack the body ceases to cope with the cleaning of the body begin to get damaged and its cells.They do not work, but on the surface gradually begins to accumulate fat.Gradually kummulyatsii process leads to inflammation and if not treated, further progression can lead to more serious illness - cirrhosis.It is already irreversible process in which the regeneration of parenchymal hepatic fibrous tissue connecting structures or stroma.

Similarly, there is a development and non-alcoholic form, with the only change is the catalyst of the problem.

main symptoms of steatohepatitis:

  • In the liver, location area (under the right upper quadrant) begins to be felt aching pain.
  • appears general weakness.
  • nausea.
  • observed body weight loss.
  • There may be signs of diarrhea.
  • Skin takes on a yellowish tint.
  • But one of the main indicators of pathology as in alcoholic and nonalcoholic following diseases is to increase the size of the liver, which can be easily determined even by palpation.When pressed on the diseased organ, the patient feels pain symptoms strengthening.

Nonalcoholic steatohepatitis

speaks for itself the name of the type of disease - nonalcoholic steatohepatitis, ie the catalyst abnormality has become a source not associated with alcoholic beverages.He has another term - metabolic.

This type of disease is most common in the ladies endowed curvaceous.That excess kilograms (obesity) and provoke its initiation and progression.And as the disease is able to trigger a genetic predisposition.

reason may be, and the organic nature: the presence of the patient in the history of hypothyroidism, disorders of protein metabolism (it may be the result of an incorrect "sitting" on a variety of diets or frank fasting) and diabetes.The source can be patient and love for fatty foods.

essence of the pathological mechanism - a violation of the metabolic response to endogenous or exogenous insulin (insulin resistance).The disease poses a danger not only at high risk of developing cirrhosis, but also increase the likelihood of violations in the work of the cardio - vascular system, since the failure of the lipid metabolism provokes accelerated progression of atherosclerosis.

Mostly person with non-alcoholic fatty liver disease genesis, chronic course of her can not even guess about the problem.In this case, the clinical picture is little expressed and does not give a person much discomfort.In this situation, it can be recognized only when the routine inspection.

much more complicated is the case in the diagnosis of hepatic inflammation vesicular structures with a small lipid inclusions.This pathology can cause low blood pressure, or fainting, the emergence of internal bleeding or the development of cholelithiasis.

alcoholic steatohepatitis

pathology of this type is usually diagnosed every third person has a particular fondness for the "green snake".This does not matter, he is drinking hard liquor or beer maloalkogolnoe.

Ethyl alcohol is split almost completely in the liver.But if alcohol in excess, the liver cells are not able to process it qualitatively.A problem occurs, starts to break down their cell structure, there is a painful symptoms.Man feels the weight loss, appears jaundiced skin, rarely seen belching, stool thinning, heartburn.

In laboratory studies, alcoholic steatohepatitis shown increasing number of liver function tests, a decrease in hemoglobin and development of leukocytosis.

primary treatment of diseases of this type involves the rejection of alcohol, and then the patient is offered as a medication, and diet food.

steatohepatitis Adipose

this pathology, except for the above, has a number of names: fatty liver or fatty liver, caused by degeneration or dystrophy cellular structures.After appearing in the sixties of the last century, a biopsy, the pathology has been allocated in a separate disease.

The main characteristic of this pathology is the occurrence of lipid deposits in the cell or cell-cell area.Parameter morphological character is the presence of triglycerides in this body for more than one-tenth of the dry weight.Medics this pathology is divided into certain stages of progression: 1.

Increased lipid in liver cells.This hepatocyte structure and their work were not impaired, mesenchymal (stromal - vascular) cells of the reaction is observed.2.

There is increased lipid hepatocytes, the first signs of cell necrosis, is there a mesenchymal (stromal - vascular) cells reaction.3.

Predtsirroticheskaya stage of development.There is an irreversible rearrangement of lobular structure of authority.

Chronic steatohepatitis

persistence of steatohepatitis develops on the basis of constant alcohol intoxication and affects 20 to 30% of people suffering from alcohol addiction.

almost completely by oxidation with special enzymes, ethyl alcohol is metabolized in the liver tissues.Excessive alcohol load on the body causes a malfunction of the body, thereby starting the sluggish inflammatory process that leads to a deviation from the normal operation of several functions of the liver.

Such a patient begins to complain of pain in the right upper quadrant, yellowing of the skin and dyspeptic disorders.

If you do not conduct timely treatment of the chronic stage of the disease sooner or later, it is able to develop progression in cirrhotic manifestations that do not allow you to restore the original integrity and functionality of the liver.

steatohepatitis minimal activity

Against the background of general automation, modern people are increasingly beginning to suffer on the physical inactivity that develops against the backdrop of sedentary lifestyles: from floor to floor in the elevator, ride to work in transport.Many of our compatriots are your vacation just as the time lying on the couch watching TV.This approach to life can not affect the state of the whole body and the internal organs, in particular.

fatty and high-calorie foods and a sedentary existence, all this develops in the appearance of additional kilograms.But fat cells begin to "settle" not only in the subcutaneous area, but also on the bodies themselves.This lipid deposition in the cellular and intercellular area of ​​the renal tissues and gives rise to the progression of this pathology.

Moderate steatohepatitis

Light to moderate development of the disease observed in 10.6% of cases, especially manifests itself considered against the background of progressive pathology steatosis affecting hepatocytes perivenulyarnoy zone and undergo apoptotic changes.

Ongoing research and monitoring numerous cases confirms recent medical assumptions about steatohepatitis as a transitional bridge from steatosis to cirrhotic changes.

With this degree of disease which - or pathological symptoms is practically not observed, which prevents early diagnosis.At this stage the disease can only be detected by chance during routine inspection, so it should not be ignored.

steatohepatitis during pregnancy

This pathology is the woman who bears his child, may be genetic in nature (ie, a genetic predisposition to the disease) or develop on the background of another liver disease, which may have been the girl before the moment of conception.

can provoke the problem and receive a number of drugs (vitamin - mineral complexes).Some multivitamins for pregnant women are composed of such chemical compounds that the female body in a high load condition (which is a pregnancy) is not able to process.

many cases where due to their incompetence, higher doses of drugs pregnant appoints doctor himself.

should not forget that due to many wrong beliefs prevailing, some women and their relatives still consider that to be pregnant at this time to eat for two, which may not affect the overall weight of the expectant mother.Hence, the abnormal deposition in the liver tissues and as a result - the development of a pregnant woman covered in this article the disease.

Diagnostics steatohepatitis

complexity of diagnosing the disease in question is that it is, in most cases, has a rather low rate of development, and for the time being has no clear clinical picture does not prove itself.

Mostly, the only symptom may be pain on palpation, and for a specialist - it is also increasing the size of the liver, seal its structure.Therefore, to detect the disease in the early stages is only possible during a visit to a doctor at the next routine inspection, or in the case of treatment a person with a different problem.

If a patient already has reason to worry, you put off a campaign to see a specialist is not necessary.

Diagnosing a comprehensive approach to the problem, since such symptoms characteristic of not one but several diseases:

  1. Figuring expert patient complaints:
    • What symptoms manifested discomfort.
    • How long bouts began.
    • What events preceded the next attack.
  2. study of history.
  3. What sick infectious diseases.
  4. What drugs were used.
  5. Is there a genetic predisposition.
  6. and others.
  7. Outdoor (Physical) inspection.
    • Have yellowed cornea and skin.The intensity of the hue.
    • assess the state of the epidermis for scratching.
    • getting hurt weight index, which measures the presence of obesity.
  8. probing abnormal area for liver enlargement and manifestations of pain symptoms.
    • tapping and feeling the abdomen to determine the size of the spleen and liver.
    • degree of tenderness touch.
  9. Due to the fact that the cause of hepatic changes can become alcohol, the doctor may prescribe a special study, the result of which should be the answer to the question of the presence or absence of human addiction to alcohol.
  10. Ultrasound examination of the liver.There are estimated dimensional parameters organ, morphological and organic developments affecting its fabric.
  11. conducted laboratory tests to assess the quantitative components of immunoglobulin A, cholesterol, triglycerides, alkaline phosphatase, bilirubin, and other indicators.Based on the degree of deviation from the norm, you can talk about the presence of inflammation of the area.
    • Complete blood count.
    • Biochemical analysis of blood.
    • Urine.
  12. tissue biopsy is performed, if necessary, to assess the level of pathological changes, and therefore the prescription of the inflammatory process.
  13. computed tomography may be imposed under certain circumstances.
  14. may need more advice more narrowly focused specialists.For example, a hepatologist, internist, a surgeon, and so on.

Treatment steatohepatitis

Primary should determine the source of the changes.If the catalyst for the problem is alcohol, the first thing to do - is to abandon the "bad" drinks.

parallel is to eliminate the toxic effects on the body, raise insulin sensitivity, strengthen the immune forces to stabilize and lead to normal lipid metabolism and other types, hepatoprotective restore the capacity of the