Ascites in liver cirrhosis: symptoms and treatment

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Ascites in liver cirrhosis: symptoms and treatment
Ascites in liver cirrhosis: symptoms and treatment
Anonim

Various kinds of aggressive factors (alcoholic beverages, hepatitis virus, toxins) gradually destroy the human liver. When this process begins, the cells of the organ consistently die, and they are replaced by connective tissue. However, it is not able to fully reproduce all the basic functions of liver cells. As a rule, it is at this stage that cirrhosis of the liver occurs. This is a rather serious disease, often accompanied by complications, among which ascites is recognized as the most dangerous. If it is present, the prognosis for a speedy recovery worsens.

General information

Ascites in liver cirrhosis is a very common complication. This is a special condition in which fluid gradually accumulates in the abdominal cavity. According to the available data, this kind of complication accompanies cirrhosis in 75% of cases. Due to the fact that the direct outflow of venous blood to the liver is disturbed, the pressure rises. The affected organs are no longer able to perform their primary functions, that is, to remove excess fluid from the body. The fluid gradually builds up, despite being originally intended to facilitate movement in the cavity of the bowel loops.

ascites in cirrhosis of the liver
ascites in cirrhosis of the liver

Types of ascites

  • Small - symptoms are practically absent, fluid volume is not more than 3 liters.
  • Medium - an increasing amount of fluid changes the shape of the abdomen, there is no difficulty in moving the diaphragm.
  • Large - accumulation of more than 20 liters of fluid in the cavity, the stomach interferes with habitual movements, difficulty breathing.

Transient ascites in cirrhosis, characteristic of small forms, disappears during therapy. With stationary ascites, despite all the therapeutic measures, the fluid always remains in the abdominal cavity, and with a tense form, its amount only increases with time.

Main reasons

liver cirrhosis ascites how long do they live
liver cirrhosis ascites how long do they live

Ascites in liver cirrhosis, as a rule, is the result of the development of insufficiencyfunction of protein synthesis. Albumin deficiency gradually reduces the ability of blood to remain in the vascular bed, thus, the fluid again penetrates into the abdominal cavity through the walls of the veins. The increased content of sodium, which is a consequence of the inability of the liver to neutralize a number of substances, contributes to further fluid retention in the body.

Another reason for this kind of complications is the insufficiency of the lymphatic system. The thing is that 2/3 of the lymph is produced in the liver. However, developing cirrhosis additionally loads the lymphatic drainage system. It is quite difficult to cope with such increased pressure, which provokes an increase in lymph pressure and its penetration into the abdominal cavity. Moreover, if the process of weakening the liver does not stop, the fluid begins to accumulate. In some cases, the size of the abdomen increases so much that a person is simply not able to lead a normal life. As a rule, it is at this stage that patients are wondering how to treat ascites in cirrhosis and quickly normalize their condition.

How does pathology manifest itself?

ascites in liver cirrhosis photo
ascites in liver cirrhosis photo

Primary clinical signs begin to appear at the moment when the amount of fluid in the abdominal cavity exceeds the 1 liter mark. In this case, in an upright position, the stomach looks somewhat sagging. Under constant fluid pressure, the navel begins to bulge. In a horizontal position, the side areas look swollen, and the central part - flattened. On the stretched skin of the abdomen, the pattern of venous vessels becomes clearly visible. It is these symptoms that ascites manifests itself in cirrhosis of the liver. Photos of patients can be viewed in this article.

The boundaries of this pathological process are very easy to determine by percussion. Tapping is carried out in different positions (on the side, back, standing). A characteristic sign of ascites in this case is considered a symptom of fluctuation.

Mechanism of development of ascites

The development of this pathological condition depends on many processes occurring in the so-called parenchymal tissue of the liver, which consists mainly of hepatocytes. Constant intoxication of the body entails cell death, necrosis develops. The liver, in turn, reacts to the appearance of such necrotic foci with an inflammatory process, one of the outcomes of which is scarring of the damaged areas. For example, in chronic alcoholism, and this is the most common cause of cirrhosis, this process is constantly observed. As a result, parenchymal tissue is replaced by connective tissue.

cirrhosis with ascites
cirrhosis with ascites

Such a pathological process changes the size of the liver, its appearance. Gradually, induration sets in, the organ becomes bumpy, rough. All these factors completely change the normal structure of the liver, which prevents it from performing normal physiological functions.

What should be the treatment of ascites in cirrhosis of the liver?

First of all, it should be noted that the main goal of therapy in this case is to eliminate the cause of the pathology. Here we are talking about the treatment of cirrhosis. In the case of small transient ascites, properly selected therapy leads to the fact that the patient's condition stabilizes, and the pathology disappears. Generally, diuretics, special procedures to restore the fluid-s alt balance and reduce portal hypertension, and aldosterone antagonists are recommended.

how to treat ascites with cirrhosis
how to treat ascites with cirrhosis

Treatment of ascites in liver cirrhosis involves taking diuretic drugs, such as Furosemide, Veroshpiron.

Diuretics are the main group of drugs that are used in the treatment of this pathology. The most commonly prescribed remedy is Spironolactone. This drug effectively removes excess sodium from the body. However, it is distinguished by a mass of side effects (hormonal imbalance, a decrease in the amount of androgens), which cause a decrease in libido, impotence. If Spironolactone is ineffective, Furosemide is additionally prescribed.

Unfortunately, ascites in liver cirrhosis is not always possible to overcome exclusively with medication. In case of failure of drug therapy, the patient is usually sent to the hospital for paracentesis (abdominal puncture). This procedure is performed using local anesthesia. The doctor initially makes a puncture with a trocar in the midline of the abdomen. Through it, then, excess liquid is released very slowly (no more than 5 liters) to prevent the development of collapse. Frequent punctures are highly undesirable, as they provoke the formation of adhesions in the omentum and intestines, which makes it difficult to repeat procedures.

treatment of ascites in cirrhosis of the liver
treatment of ascites in cirrhosis of the liver

Features of food

Taking into account the fact that ascites is a complication of cirrhosis, when developing a diet, it is necessary to take into account the causes and the main mechanism for the formation of the underlying disease. Experts recommend systematically introducing the missing substances to the patient's body. What is the difference between the diet for ascites, cirrhosis of the liver?

  • It is better to limit the amount of carbohydrates and choose only complex options (for example, cereals, vegetables and fruits). The fat content should be reduced. It is better to cook food using vegetable oil. Fluid intake is also recommended to be limited to one liter per day.
  • The following products are banned: alcohol, coffee, tea, mayonnaise, pastries and confectionery, smoked meats, ice cream, spices and seasonings.
  • The diet should mainly consist of lean meat / fish, vegetables and fruits, cereals, greens, boiled rice. It is recommended to steam food without s alt.

Diet for ascites, cirrhosis of the liver is primarily aimed at preventing fluid retention in the body, as well as improving the functioning of the systems of internal organs and tissues.

diet for ascites cirrhosis
diet for ascites cirrhosis

Forecast

Unfortunately, the number of deaths in this pathology is only increasing year by year. The lethal outcome most often becomes the result of sequential intoxication of the body with acetones and ketone bodies. Only about 10% of patients after the occurrence of this complication live no more than one month. However, this does not apply to those situations where doctors manage to timely compensate for the condition with diuretics, magnesium and potassium preparations, that is, to prevent the development of such pathologies as cirrhosis of the liver, ascites.

How long do patients with this diagnosis live? In fact, it is not possible to give an unambiguous answer to this question, since each case is individual. However, with well-performed and timely manipulations, the life span of patients even with complicated forms of ascites is about 10 years.

Prevention

It is important to note that cirrhosis with ascites is not diagnosed in all patients. Moreover, timely seeking help from a doctor favorably affects the outcome of treatment. With special attention to their he alth, it is necessary to treat those people who have a weakness for alcoholic beverages and fatty foods. Any symptoms of this pathology should in no case be ignored.

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