Hepatosis is a hepatic disease characterized by impaired metabolism in hepatocytes.
As a result, dystrophic changes in the liver cells begin to develop, which then leads to their replacement by adipose tissues. Fatty hepatosis is a reversible process that can not only be cured, but also prevented.
Otherwise, the disease will lead to irreversible processes, which, in turn, will cause the development of complications that are dangerous to the patient’s health.
Causes of development
Fatty hepatosis is a type of pathological processes, accompanied by impaired metabolic processes in the liver cells. The disease develops gradually under the influence of the accumulation of fat cells in the tissues of the liver. Subsequently, these cells begin to replace hepatocytes, which causes dystrophic processes in the tissues of the diseased organ.
There are a number of reasons for the development of fatty hepatosis. The most common of them include:
- pathologies that disrupt the metabolic process: diabetes mellitus and other endocrine diseases, obesity (especially severe), etc .;
- prolonged exposure to the body of toxic substances, drugs, alcohol;
- lack of protein in the diet;
- adherence to strict diets;
- binge eating;
- dysfunction of the adrenal cortex;
- excessive content of lipids and lipoproteins in the body;
- chronic diseases of the gastrointestinal tract;
- viral liver diseases (especially hepatitis);
- an excess of liver enzymes;
Often, liver obesity develops against the background of excessive flow of lipids (fats) into the blood. But sometimes it happens when the body is unable to remove excess fat from the body. Violation of this function is often due to a deficiency of biologically active substances involved in lipid metabolism (for example, proteins).
Etiological types of hepatosis
In most cases, the accumulation of excess fat in the liver cells occurs under toxic effects due to pathological conditions of the body. The most common cause of this effect is alcohol. If the etiology of the disease is not associated with toxic effects, it is classified as a primary non-alcoholic steatosis.
Women, persons over 45 years old, patients with abdominal obesity, a tendency to hypertension are those factors that also predispose to the development of fatty hepatosis.
According to the generally accepted classification, the disease is divided into 4 stages of development. In their determination, the number of affected hepatocytes is taken into account, and the further prognosis for the patient is also determined.
- The zero stage is characterized by the replacement of single liver cells with fatty tissues.
- The first stage is accompanied by lesion of 10-335 liver cells. The size of the fat drops increases, which leads to the formation of separate lesions.
- At the second stage, from 33 to 66% of hepatocytes are involved in the pathological process. The foci of cell obesity form various compounds.
- When the disease passes to the third stage of development, fatty compounds spread not only to the liver cells, but also to other tissues. Under the influence of this process, fatty cystic formations are formed. The degree of damage to hepatocytes reaches 66%.
If treatment was started in a timely manner, the disease can be quite successfully eliminated. However, the patient should remember that this process is not fulminant, and in order for it to fully cure, it is likely that he will have to undergo a course of therapy for several years. In addition, many of the recommendations of the hepatologist will need to perform for life.
It is impossible to speak unequivocally about the specific clinical picture of hepatosis of the liver. Symptoms of the disease depend on the severity of the pathology.
So, the most common symptom of hepatosis at an early stage is a feeling of discomfort on the part of the digestive tract. There may also be negative changes in the patient's appearance.
As the pathological process progresses, obesity begins to develop. Fat deposits appear on various parts of the body - the sides, thighs, buttocks, abdomen, hands, and even the face. And if at the initial stages of hepatosis this process can still be stopped, then when the disease moves to stage 3 of development, doctors' forecasts become very unfavorable.
When the pathology goes to the 3rd stage of development, the process of active fibrosis of the liver tissues occurs. In addition, they gradually begin to be replaced by connective tissue structures. Such a deviation leads to the development of severe complications of hepatosis - cirrhosis of the liver.
In hepatosis, the most common complaints of patients are the following symptoms:
- heaviness in the right hypochondrium (in the area of the liver);
- dull pains in the area of the diseased location of the organ (in case of its primary lesion);
- acute pain in the right hypochondrium due to tissue fibrosis, or in the development of liver cirrhosis;
- reduced visual acuity;
- deterioration of general well-being;
- apathy, depression;
- sleepiness during the day and sleeplessness at night;
- recurrent nausea;
- the urge to vomit, accompanied by the release of vomit with a bitter (bile) taste;
- the development of dysbiosis;
- frequent bouts of diarrhea;
- skin rash, resembling hives;
- blanching of the skin.
The first stages of the disease proceed without any visible symptoms. And only at its transition to the third stage of development, the first clinical manifestations begin to arise. If untreated, they will be greatly aggravated, manifesting with increasing intensity. This situation is dangerous for the health of the patient, so if the symptoms described above, it is important to respond to them and start therapy in a timely manner.
Pregnancy and hepatosis of the liver
Fatty hepatosis of the liver can also occur in women during pregnancy. Often, its development is due to changes in the hormonal profile of patients, but sometimes this process can trigger excessive consumption of high-calorie foods. Such a deviation is called acute fatty hepatosis of pregnant women, or abbreviated as OZHGB.
The disease faces serious complications, both during pregnancy and during labor. Such a deviation in severe cases can be fatal to the mother.
The most dangerous period when there is a high risk of developing the disease is considered the interval between 29 and 38 weeks of pregnancy. However, this is only a conditional deadline, in fact, the disease may occur earlier.
Fatty hepatosis during pregnancy is characterized by the appearance of the following symptoms:
- yellowing of the skin, as well as sclera and eye proteins;
- the acquisition of feces light shades;
- darkening of urine (it acquires the color of dark beer or strong black tea);
- general weakness and indisposition;
- bitterness in the mouth;
- persistent heartburn attacks;
- vomiting with or without bile;
- heaviness, pain, or discomfort in the right hypochondrium;
- loss or loss of appetite.
If any of the above symptoms of jaundice occur, a pregnant woman should definitely contact a general practitioner who observes her.
Untreated fatty hepatosis of the liver is fraught with consequences for the patient’s health and life. If you do not respond to alarming symptoms in a timely manner, this can lead to:
- disruption of the liver (cirrhosis), kidneys, heart, lungs (in some cases even irreversible pathological changes occur in these organs);
- intestinal dysbiosis.
Impaired hepatic function leads to a deficiency of important for the human microelements. As a result, malfunction of the heart occurs, which provokes the development of hypertension, varicose veins, vision problems. In parallel, hepatic hepatosis leads to a weakening of the immune system, which causes frequent colds, infectious diseases of bacterial or fungal etiology.
The scheme of complex diagnostics for suspected fatty hepatosis of the liver includes:
- ultrasound diagnostics, which makes it possible to catch echo-signs of the pathological process and fix the increase in the liver in size;
- computed tomography, which helps to identify liver tissue lesions;
- magnetic resonance imaging;
- liver biopsy - taking a sample of liver tissue for further research in the laboratory. The procedure is painful, so it is carried out only after the preliminary injection of the anesthetic drug. Detection of fat cells in the biopsy is an absolute confirmation of the preliminary diagnosis.
Despite the highly informative biopsy, it cannot be performed in some situations. This concerns, first of all, patients with poor blood clotting, therefore, before the appointment of a diagnostic procedure, a blood clotting test must be performed.
Fatty hepatosis treatment
Treatment of fatty hepatosis of the liver can be carried out both on an outpatient basis and in a hospital setting, in the gastroenterology department. Obligatory action is the assessment of nutritional status and the appointment of diet therapy. In some situations, it is dieting that allows you to get rid of a dangerous disease.
The essence of the diet is primarily to limit the consumption of animal fats to 100-100 g per day. Of great importance is the inclusion in the diet of foods enriched with the necessary body of the patient with vitamins and trace elements.
In case of fatty hepatosis, predominantly conservative therapy is performed. It involves the use of lipotropic drugs aimed at eliminating fatty infiltration of the liver. In this case, use vitamin B9, B6, B12, lipoic acid and essential phospholipids.
To reduce the effects of insulin resistance, it is necessary to adjust and carefully monitor the patient's body weight. Even a slight weight loss (5-10%) significantly improves his health, and has a beneficial effect on the process of carbohydrate and fat metabolism.
The minimum weekly weight loss is 400 g, the maximum is 700 g. If you allow a more rapid weight loss, it may not be beneficial, but only harm, causing rapid progression of fatty hepatosis, the development of renal failure or the formation of gallstones or ducts . To prevent the appearance of stones, prescribed drugs based on ursodeoxycholic acid.
To stimulate the process of active phosphorylation in the muscles, which contribute to the utilization of fatty acids, the patient is prescribed a course of physical therapy. Exercise also helps to increase the sensitivity of the receptors to the effects of insulin. To eliminate insulin resistance, treatment is carried out with medical preparations - thiazolidinindione and biguanides.
Another highly effective treatment for fatty liver hepatosis is lipid-lowering therapy. But it is impossible to speak about the complete safety of statins in this disease, since such drugs themselves are capable of destroying liver cells.
To normalize the functions of the diseased organ, hepatoprotectors are prescribed. Appropriate is the use of vitamin E, ursodeoxycholic acid, betaine, taurine.
To date, there are numerous studies of the efficacy of pentoxifylline and angiotensin receptor blockers for the treatment of hepatosis.
The use of folk remedies for the treatment of hepatosis should be discussed with a gastroenterologist. With this disease will be effective such recipes:
- With severe nausea and heaviness in the right hypochondrium, it is helpful to drink tea with mint or melissa.
- To stimulate the outflow of bile and the normalization of the liver and gallbladder is used decoction or infusion of milk Thistle (milk thistle). The tool also helps to restore hepatocytes, and speeds up the process of protein synthesis.
- Infusion of peppermint. 1 tbsp. l chopped dry peppermint leaves pour 100 g of boiling water and leave to infuse under the lid overnight. In the morning, a means of filtering, and divided into 3 equal parts. Each serving should be drunk a quarter of an hour before meals.
- Infusion of rosehips. 50 g of berries pour 0.5 liters of boiling water, cover with a lid and leave to infuse for ½ days. Filter the finished medicine and drink one-third of a glass 3 times a day.
You can prepare a special collection of the liver, which must be mixed in a cat:
- herb of St. John's wort, plantain, burdock and caterpillar in equal proportions (3 parts);
- immortelle and eleutherococcus leaves - in 2 parts;
- camomile flowers - 1 part.
All components are thoroughly mixed, after which 1 spoonful of the collection pour 200-250 ml of boiling water and leave for half an hour. Then strain, and take 3 times daily before meals.
Nutrition and Diet
A diet that would be optimal for all patients, without exception, does not exist. Patients with hepatosis, first of all, should reduce the amount of calories consumed per day. It is necessary to limit (and it’s better to refuse) the use of products enriched in saturated fatty acids. They should be replaced with foods that contain monounsaturated or polyunsaturated lipids (milk, fish oil, olive oil, etc.).
It is important to observe a strict ratio of protein, fat and carbohydrates consumed. It should be 1: 1: 4, respectively.
60% of all protein consumed should be animal protein. 20-25% of all fats should make up various vegetable oils - sources of large amounts of polyunsaturated fatty acids.
To balance carbohydrates, it is necessary to calculate the ratio of starch, fiber, pectins and sugars. The latter can be obtained from vegetables, fruits, berries, dairy products, honey.
It is important to remember about the need for daily consumption of foods rich in vitamins and minerals.
Diet refers to the number and frequency of meals. Healthy people are recommended to eat 3-4 times a day every 4-5 hours. Patients with diseases of the gastrointestinal tract - 5-6 times a day.
Nutrition for liver disease
When hepatosis is necessary to abandon the fat and high-calorie foods. In the patient's menu should be dominated by protein foods, as well as a sufficient amount of fluid. Eating should be fractional, in small portions - this will ensure the normal functioning of the organs of the digestive tract (including the liver).
The menu should include:
- vegetables in any form - boiled, fresh, steamed;
- milk soups;
- meatless soups;
- unsalted and mild cheeses;
- boiled eggs (no more than once a day);
- milk and dairy products;
- steam omelette;
- cottage cheese (fat-free);
- oatmeal, rice, buckwheat, or oatmeal cereals;
- low fat yogurt and yogurt;
- unsweetened tea
In parallel, it is necessary to completely abandon:
- meat dishes;
- fatty meats and fish;
- fresh garlic and onions;
- canned food;
- salty foods;
- smoked meat;
- fat cottage cheese and sour cream.
The diet is developed by the doctor individually for each patient.
In spite of the fact that fatty hepatosis of the liver is easily treatable, it is better to make every effort to prevent its development. To do this, you should not only give up heavy food and bad habits, you need to monitor body weight, nutrition and the state of health of the body. And this can be achieved only with regular medical examinations.
Exactly determined cause and timely treatment of hepatosis make predictions of recovery most favorable for the patient.
However, if the first type of hereditary Criggler – Nayar syndrome occurs, in this case, the patient may develop severe complications, even death. The remaining types of hereditary hepatic hepatosis have a favorable prognosis.