Fatty liver hepatosis symptoms and treatment. What symptoms indicate fatty liver disease, what treatment is necessary and how to treat it correctly? Functional syndromes of hyperbilirubinemia

Fatty liver disease, or fatty hepatosis, or as it is also called, liver steatosis, is the most common liver disease in the world today, affecting almost the vast majority of people over 40 years of age, and recently a fairly common disease among young people and not only those with overweight. The essence of the disease is fatty liver, the replacement of a normal healthy liver with fat, which leads to cirrhosis, like any other liver disease, including viral hepatitis.

The diagnosis is made by ultrasound examination of the liver, and most often the patient hears from the doctor that almost everyone has this disease and the only way to treat it is to lose weight. Most often, these recommendations are not taken seriously, and weight loss is not such a simple solution, since the cause of obesity, including internal obesity, is pathological changes in metabolism and hormonal disorders.

Fatty hepatosis or liver steatosis – not the result of bad behavior, unhealthy lifestyle, including nutrition and physical activity. Fatty hepatosis is a dangerous disease that requires treatment.

However, unlike many other liver diseases, fatty hepatosis is a difficult to treat disease, since hepatologists do not have a uniform standard for drug treatment of this pathology.

Since the main cause of the disease is metabolic and hormonal changes in the body, the so-called metabolic syndrome, then an endocrinologist is involved in treatment. However, even in this case, only drug treatment with drugs that restore metabolic and hormonal processes, as well as help remove fat from the liver, does not produce results. Individual recommendations on nutrition and physical activity, without which it is impossible to achieve recovery, are often an insurmountable obstacle, since it is always easier to take pills than to change lifestyle.

In our center 10 years of experience in the treatment of fatty hepatosis showed that this disease is curable at any stage with the exception of cirrhosis, and the success of treatment is the joint work of the doctor and the patient.

Our hepatology center has unique equipment for assessment of the degree of liver steatosis (fatty liver): from S0 to S4, in which S4 is cirrhosis (as with any other liver disease, accompanied by its destruction and replacement with another, non-functioning tissue). The new generation fibroscan allows you to assess what percentage of the liver (in percentage) no longer functions as a liver. This is important for diagnosis and choice of treatment tactics, as well as monitoring the effectiveness of treatment. The result of treatment should be recovery.

It is especially important to determine the degree of fatty hepatosis (liver steatosis) if there are concomitant diseases, for example, most often, viral hepatitis B and hepatitis C. Damage to the liver by viruses is accompanied by the replacement of a healthy liver with connective tissue, which also leads to cirrhosis.

The new generation Fibroscan device allows you to separately assess the degree of each damaging factor: virus and fat. Treatment tactics depend on this. Sometimes the doctor does not have the right to prescribe antiviral therapy if the liver is affected by fat and treatment with antiviral drugs will not stop the process of formation of cirrhosis.

An examination to determine the degree of fibrosis and steatosis using the Fibroscan device is much cheaper than determining the same indicators using FibroMax blood, and much more accurate, since biochemical indicators - markers of liver damage - change much faster than the formation of fibrosis and steatosis.

The Fibroscan device determines, using ultrasound diagnostics, the physical characteristics of the density of the liver tissue and the measurement result is expressed in physical units that correspond, from a medical point of view, to the degrees of liver damage: fibrosis from F0 to F4, steatosis from S0 to S4 (the fourth stage corresponds to cirrhosis). The measurement results are provided by the program, which eliminates subjectivity in the assessment.

Examination is the first step to recovery. We conduct an examination on the day of treatment after a free consultation with a hepatologist to determine the tasks and scope of the examination. Based on the results, you will be prescribed effective treatment, which in the vast majority of cases ends in recovery.

What is fatty liver disease? Fatty liver disease or non-alcoholic fatty liver disease - NAFLD (liver steatosis, fatty infiltration, fatty liver) is a condition in which more than 5% of the liver mass is fat, mainly triglycerides. If the fat content exceeds 10% of the organ's weight, then more than 50% of the liver cells contain fat and fat deposits are distributed throughout the liver tissue.

Causes of fatty hepatosis

The cause of fatty liver disease is metabolic syndrome - metabolic disorders and hormonal changes. In this case, diabetes mellitus and an increase in blood lipid levels develop with the threat of cardiovascular complications.

Fatty liver disease can be caused by:

Fatty hepatosis is based on insulin resistance (cell immunity to insulin) and metabolic disorders, mainly lipid and carbohydrate. Fatty liver disease occurs due to increased intake of fatty acids into the liver either from food or due to increased lipolysis (the breakdown of fat in adipose tissue).

Who is at risk of developing fatty liver disease?

NAFLD is a multifactorial disease resulting from exposure to a number of risk factors:

• abdominal obesity (waist circumference more than 94 cm in men and 80 cm in women);
• an increase in the level of triglycerides in the blood more than 1.7 mmol/l, cholesterol and a decrease in high-density lipoproteins;
• increased blood pressure more than 130/85 mm Hg;
• impaired glucose tolerance, prolonged hyperglycemia (type 2 diabetes mellitus);
• insulin resistance.

Why is fatty liver disease dangerous?

Non-alcoholic fatty liver disease (NAFLD) progresses gradually and is dangerous due to the possibility of developing into cirrhosis. Fatty liver disease will become the most common cause of liver cirrhosis requiring liver transplantation in the next 20-30 years. NAFLD includes the following stages of the disease: hepatic steatosis, non-alcoholic steatohepatitis and fibrosis with a possible outcome in cirrhosis with an increased risk of developing hepatocellular carcinoma.

For many years, steatosis was considered a benign disease, but experience has shown that this disease increases the risk of cardiovascular complications and diabetes.
The prevalence of NAFLD is 20-25%, and among obese patients it is 90%.
Fatty disease usually develops at the age of 40-60 years, women get sick more often.

How NAFLD manifests itself, symptoms of fatty hepatosis

Clinically, fatty liver hepatosis in the initial stages is characterized by an asymptomatic course, and pronounced fibrosis manifests itself with characteristic signs liver cirrhosis. Possible symptoms are discomfort in the right hypochondrium and hepatomegaly (enlarged liver).

Diagnosis of fatty liver disease (NAFLD)

The main diagnostic method for examining the liver is ultrasound, which reveals not only the size, but also the structure of the liver, including the presence of signs of fatty degeneration in the liver. However, the sensitivity of ultrasound examination allows one to detect the presence of adipose tissue in the liver if it already makes up about 30% of the liver. A much more accurate and informative method is indirect elastometry using the new generation Fibroscan device, which makes it possible to quickly and without invasive intervention detect fatty hepatosis when 5% of the liver is affected.

The new generation Fibroscan has a special sensor for measuring the density of adipose tissue, which shows which part of the liver no longer performs its functions. The severity of the disease is determined by the degree of fatty lesion: S1, S2 and S3, of which the third degree can be associated with the formation of cirrhosis and corresponds to a state when more than 60% of the liver is adipose tissue and not liver.

Fatty hepatosis (liver steatosis) is difficult to treat, but necessary. The goal of treatment is to remove fat from the liver (drug treatment), as well as normalize metabolic processes to stop internal obesity. During the treatment process, to assess its effectiveness and timely correction, it is important to monitor the degree of steatosis using the Fibroscan device. The final recovery (the goal of treatment) is the complete removal of fat from the liver (S0 according to elastometry).

Only in our center is it possible, using this unique technology for measuring fatty liver degeneration, to correctly diagnose and carry out treatment under control of its effectiveness during the entire course of therapy until complete recovery.

Risk factors for the development of cirrhosis are female gender, age over 50 years, arterial hypertension, increased alkaline phosphatase and GGT, and low platelet levels. Lipid spectrum disorders are often observed.

An important risk factor for the development and progression of NAFLD and fatty liver disease is genetic factor – gene polymorphismPNPLA3/148 M.

Treatment of NAFLD, fatty hepatosis

Currently, there is no standard treatment for NAFLD, so the main goal is to improve the biochemical parameters characterizing cytolysis (destruction of liver cells) and inflammation, slowing down and blocking fibrosis.

In any case, treatment begins with lifestyle changes, which means both a change in diet and an increase in physical activity.

Physical exercise increases sensitivity to insulin, helps reduce fatty tissue in internal organs, and reduces the level of liver steatosis.

To achieve these goals, 3-4 sessions of aerobic exercise per week are considered sufficient. It has been proven that a decrease in body weight by 8-10% is accompanied by an improvement in the histological picture of NAFLD. The most physiological is considered to be a decrease in body weight by 500–1000 g per week, which is accompanied by positive dynamics of clinical and laboratory parameters, a decrease in insulin resistance and the degree of liver steatosis. Losing weight too quickly leads to worsening of the disease.

Drug treatments as a standard include insulin sensitizers (drugs that increase tissue sensitivity to insulin), hepatoprotectors and antioxidants. It is important to correct metabolic disorders by overcoming insulin resistance using insulin sensitizers (metformin). In addition, the use of ursosan is indicated to normalize metabolic disorders and as a hepatoprotector to improve the histological picture of the liver.

Treatment tactics for patients with NAFLD and metabolic syndrome due to hepatitis C

If concomitant liver damage is detected in patients with HCV as a result of metabolic syndrome (non-alcoholic fat disease liver - steatosis) it is necessary to conduct an additional examination for indicators of metabolic and hormonal disorders characteristic of this disease.

Treatment tactics depend on the degree of liver damage as a whole, and separately for each damaging factor. Treatment with antiviral drugs can be started immediately, and further treatment of metabolic syndrome after receiving SVR.

If the degree of liver damage from the virus is significantly less than from metabolic syndrome, it is possible to begin antiviral therapy after treatment of metabolic syndrome.

In cases of concomitant liver diseases, it is necessary to set the goal of treatment not only to obtain SVR, but also to preserve and restore the liver damaged by other pathological factors.

The most important component of successful treatment of NAFLD and fatty liver disease is proper nutrition.

There is no diet that suits everyone without exception. Patients with fatty hepatosis first of all need to reduce the calorie content of their daily diet. One of the recommendations may be advice on limiting the consumption of foods rich in saturated fatty acids and replacing them with foods containing monounsaturated or polyunsaturated fats (milk, olive oil, fish oil).

Nutritional balance

The main parts of food are proteins, fats, carbohydrates, water, minerals and vitamins, which must be strictly balanced. The ratio between proteins, fats and carbohydrates should be 1:1:4.

Animal proteins should make up about 60% of the total protein. Of the total fat, 20-25% should be vegetable oils as a source of polyunsaturated fatty acids.

The balance of carbohydrates is expressed in the ratio of starch, sugar, fiber and pectin. Sugars should be represented by fruits, berries, dairy products, and honey. It is extremely important to maintain a balance of vitamins and minerals, which must be supplied to the body daily in accordance with daily requirements.

Diet

This is the number of meals and the interval between them during the day. For healthy people 3-4 times a day at 4-5 hour intervals. For some concomitant diseases, such as obesity, it is necessary to eat 5-6 times a day.

Nutrition for liver diseases

The diet for fatty hepatosis should be gentle and create maximum liver rest. It is necessary to reduce the amount of fat and enrich the diet with foods that are sources of complete proteins and vitamins, reduce the sugar content and increase the amount of fluid. Meals should be frequent and in small portions.
It is necessary to exclude fatty meats, smoked meats, spices, spicy, rich dough. Alcohol is absolutely prohibited.

To find a diet that is right for you, consult your doctor.

Which doctors treat fatty hepatosis?

The result of treatment for NAFLD and fatty hepatosis can be complete recovery.

These diseases are treated by two doctors: a hepatologist and an endocrinologist.

An endocrinologist treats the cause of the disease (hormonal and metabolic disorders), and a hepatologist treats the consequence (liver damage).

Our center’s specialists have extensive experience in identifying specific signs of hepatosis and successfully treating fatty liver disease.

Results of treatment of fatty hepatosis

Patient review:

"Dear Bella Leonidovna!

Dear Nelly Nikolaevna Tsurikova, Mushinskaya Kira Vladimirovna, girls at the reception, ultrasound diagnostic doctor, thank you all so much for organizing the treatment of my illness. You guys work wonders as a team! High-level professionals and people with a capital “P!” I am grateful to fate that I found your clinic, which really saved my life and changed it 180 degrees. Thanks to your efforts, qualifications and attention, I have become a completely healthy person. I lost 23.5 kg in 9 months, my liver has become a real factory that now works perfectly!

In general, I wish your team all the best. Do not stop! You really do a great job for people, help overcome serious illnesses.

On the eve of the New Year 2019, I would like to wish you health, family joys and love too! with best wishes, your patient from Kazan" >>>

Rustem
05.12.2018

Result:

After treatment of fatty hepatosis, weight loss of 25 kg and complete removal of fat from the liver - according to Fibroscan, the degree of steatosis after treatment is s0

This disease depends on a person's diet and lifestyle. Hepatosis rarely occurs in acute form - only with intoxication with poisons. In other cases, it is a chronic disease, the result of fat accumulation that disrupts liver function. Only detected in the early stages, hepatosis is completely cured. You need to know the causes and symptoms of the disease.

What is fatty liver disease

The disease is caused by a person’s lifestyle and the influence of environmental conditions. What is hepatosis? This is a chronic disease, fatty degeneration of the liver, in which diffuse changes occur in the cells of the organ. There is an increase in parenchyma - tissue consisting of hepatocytes, responsible for the normal functioning of the organ. Doctors use several names for this disease when diagnosing and treating:

• fatty infiltration of the liver;
• hepatosteatosis;
• liver steatosis.

The liver performs about five hundred functions in the body. When metabolic processes are disrupted, dystrophic changes begin. The structure of the cells deteriorates and they become filled with fat. There is a gradual development of fatty hepatosis:

• the appearance of deposits in individual cells;
• development of diffuse accumulations;
• accumulation of fat by hepatocytes;
• violation of oxygen supply;
• slowing blood circulation;
• cell death.

Fatty liver degeneration is coded K76.0. according to ICD-10 - the international classification of diseases. If treatment is not started, the process of cell replacement with connective tissue occurs, which disrupts the functioning of the liver and affects the entire body. Serious consequences may occur: cirrhosis and hepatitis may develop. Diffuse changes will occur in the pancreas. There is a possibility of cells degenerating into atypical ones - the development of malignant formations.

Causes

Physical inactivity and consumption of fast food can provoke the appearance of hepatosis. Diets followed by overeating and fasting are harmful. Among the causes of fatty hepatosis:

• overweight;
• diabetes;
• alcohol consumption;
• pregnancy;
• gastrointestinal problems;
• hepatitis viruses;
• toxic poisoning;
• taking antibiotics;
• eating fatty foods;
• vegetarianism;
• medications with toxic effects.

Hepatosis in pregnant women

When a woman is expecting a child, the liver experiences increased stress. The reason is a violation of the formation and outflow of bile due to an increase in the amount of estrogens and the processing of waste products of the fetus. This occurs in the last weeks of pregnancy. Hepatosis is poorly diagnosed due to the fact that palpation is difficult - an enlarged uterus interferes, and many research methods are contraindicated.

Hepatosis in pregnant women often has hereditary roots. It manifests itself as skin itching, a feeling of heaviness, and lightening of the stool. Yellowing of the sclera, nausea, and pain in the liver area are possible. The fatty form is rare. The cholestatic type predominates, in which the following is observed:

• thickening of bile;
• disruption of cholesterol metabolism;
• decreased tone of the biliary tract.

Alcoholic

One of the most common liver diseases is alcoholic hepatosis. When it enters the body, alcohol is converted into substances that destroy hepatocytes, which are responsible for the removal of toxins and the production of bile. When connective tissue grows in cells, this means that all processes are disrupted. If the disease is not treated, liver cirrhosis will develop. Hepatosis manifests itself as pain in the right side, causing:

• feeling of heaviness;
• bloating;
• uncontrollable irritability;
• nausea;
• weakness;
• decreased performance.

Symptoms

At the beginning of the disease, no symptoms are observed. Patients may accidentally find out about it while undergoing an ultrasound for another reason. The disease is diagnosed by echo signs. Symptoms of fatty liver hepatosis appear in the second stage of the disease, and the following is observed:

• nausea;
• heaviness in the right hypochondrium;
• deterioration of coordination;
• severe pain, nausea;
• bloating;
• the appearance of a rash;
• decreased visual acuity;
• constipation;
• aversion to food;
• weakness;
• monotony of speech;
• signs of jaundice.

Treatment of liver hepatosis

It is possible to completely restore liver function only with early detection of the disease. How to cure fatty hepatosis? It is necessary to improve blood flow and reduce the viscosity of bile. It is necessary to correct carbohydrate metabolism, remove fat from cells, and normalize liver function. Treatment includes:

• weight loss;
• diet;
• use of medications;
• herbal medicine;
• physiotherapy;
• hirudotherapy;
• traditional medicine recipes.

To remove excess fats and cure hepatosis, medications are prescribed:

• Essentiale Forte, Phosphogliv - hepatoprotectors containing phospholipids that help cell restoration;
• Taurine, Methionine – stimulate processes in the liver;
• Troglitazone – relieves inflammation;
• Ursosan – helps with alcoholic hepatosis;
• Gemfibrozil – reduces blood fat levels;
• Pentoxifylline – improves blood flow.

Folk remedies

Doctors advise using traditional recipes at home. How to treat liver hepatosis with herbs and plants? Recommend:

• drink tea with lemon balm and mint every day;
• eat a teaspoon of shelled pine nuts;
• eat more greens: parsley, lettuce, dill;
• drink infusion of rose hips;
• Brew milk thistle - spoon into 2 cups of boiling water.

Drinking fresh carrot juice on an empty stomach breaks down fats well. A very effective herbal mixture, to prepare it you need to pour 2 tablespoons of the mixture into a thermos in the evening and add 1.5 liters of boiling water. Drink the decoction a day. The composition contains in parts:

• sequence – 3;
• licorice root – 4;
• sage – 2;
• raspberry leaves – 3;
• wormwood – 2;
• birch leaves – 3;
• yarrow – 1;
• chamomile – 1;
• calamus root – 1;
• linden – 1.

Diet for fatty hepatosis

When fatty liver degeneration is diagnosed, diet is considered one of the most important methods of treatment. By normalizing your diet you can significantly speed up the healing process. Its main tasks:

• restoration of all organ functions;
• normalization of fat metabolism;
• stabilization of bile production;
• supply of the required amount of glucose;
• lowering cholesterol levels.

It is advisable to organize nutrition for fatty liver hepatosis so that the patient eats often - up to 7 times a day, but in small portions. During the diet you will need:

• limit salt, sugar;
• reduce animal fats;
• eat a lot of fiber;
• eliminate cholesterol;
• drink more water;
• change cooking technology - boil, bake, steam.

Fatty liver requires excluding hot and carbonated drinks from the menu, and stopping drinking coffee and tea. Not recommended for diet:

• tomatoes;
• radish;
• garlic;
• fatty dairy and meat products.

It is advisable to use:

• vegetable, milk soups;
• carrot;
• porridge: rice, semolina, buckwheat;
• lean meat;
• milk;
• jelly;
• low-fat dairy products: cheese, yogurt, kefir;
• poultry meat without fat.

Hepatosis of fatty liver is a disease of non-inflammatory nature, which is characterized by degenerative changes in cells with their subsequent transformation into adipose tissue.

For a long time, people suffering from obesity may not even know what fatty liver disease is and what consequences its development can have. The main risk group for the incidence of hepatosis is represented by people over 40 years of age, and this liver disorder occurs predominantly in men.

What it is?

Fatty hepatosis (also known as fatty degeneration or fatty liver) is part of the group of reversible, dystrophic, chronic liver disease caused by the accumulation of large amounts of lipids. Currently, this disease is rapidly growing due to systematic nutritional disorders, as well as poor human lifestyle.

It is possible to stop the development of the disease by identifying the factors influencing the occurrence of fatty hepatosis. Changes for the better are observed after a month with timely treatment.

Causes

The liver is an organ that has an amazing regenerative ability and huge internal reserves; 1/7 of its mass is enough to maintain life. The liver can work under increased load for a long time as hepatocytes are restored, but everything has a limit. And when a person (especially from early childhood) loads the liver with excess fats, carbohydrates, flavor enhancers, preservatives, food additives, vegetable fats (palm, coconut oil) - the liver cannot withstand the colossal toxic load and its diseases occur.

The main reason for the development of this disease in men (70%) is alcohol; such hepatosis is called alcoholic fatty hepatosis. In adolescents, this is the abuse of energy drinks, the use of drugs - ecstasy, cocaine, opiates, etc.

Other causes:

1. Any toxic damage to the body - any poisoning, taking certain medications, the presence of toxic substances in water, air, food, emissions from industrial enterprises, pesticides in vegetables, household chemicals, regardless of the route of entry into the body - provoke fatty liver hepatosis.
2. Diseases such as diabetes mellitus and high blood cholesterol levels (see normal blood cholesterol levels) are markers of the presence of a disorder in fat metabolism in the liver. In addition, chronic hepatitis (especially viral hepatitis C), chronic pancreatitis is also accompanied by fatty hepatosis.
3. Oxygen deficiency in diseases of the heart, bronchi and lungs leads to hepatosis.
4. In addition, excess fat in the liver, oddly enough, can also form in thin people with a deficiency of protein in their diet (vegetarians), as well as in those who are fond of various diets and lose weight sharply (Auschwitz prisoners with skin dystrophy and bones”, there was a high content of internal fat in the body).

If there is an excessive intake of lipids into the liver, small droplets of fat settle in its cells; if this happens rarely, then the hepatocytes have time to process them and remove the fat; with a frequent and intense intake of lipids, they accumulate, and the hepatocytes cannot cope with their functions.

Such droplets begin to stretch the liver cells and destruction of its internal structure occurs, which leads to a delay in the timely removal of toxins and processed foods, while the blood supply is disrupted and the supply of oxygen to the liver tissue is reduced.

The progression of this condition leads to the next stage - hepatitis (inflammation of the liver); with the death of hepatocytes (they are replaced by connective tissue), liver failure develops and its extreme degree - cirrhosis.

Symptoms of fatty liver disease

In the initial stage of fatty liver hepatosis, there are no symptoms at all. Later, discomfort appears, a feeling of heaviness in the right hypochondrium, fatigue, and slight jaundice of the skin. The liver is enlarged and the patient feels pain upon palpation.

Ultrasound accurately determines the size of the organ and how much the original boundaries of location are exceeded. A blood test shows elevated levels of aminotransferase and cholesterol.

The amount of fibrous tissue in the liver serves to determine the severity of the disease. There are 4 stages, with “0” this is a healthy organ, and the fourth stage is advanced cirrhosis of the liver.

There are risk factors for the formation of fatty liver disease, including:

• high blood pressure;
• female;
• decreased platelets;
• increased alkaline phosphatase and GSH;
• PNPLA3/148M gene polymorphism.

Diagnostics

There are several diagnostic methods that allow you to do this both in the early stages and in the latter stages. The first thing the doctor will do is a general examination of the patient. It involves palpation in the area of ​​the right hypochondrium, where the liver is located. An enlarged liver (hepatomegaly) will be immediately detected during the initial examination.

• first of all, you need to do an ultrasound, with its help echo signs of this disease are revealed, and such a diagnosis is good during pregnancy;
• magnetic resonance therapy, which can be prescribed by a doctor, will help determine the presence of affected areas of the liver, as well as what form (stage) of the disease it is;
• computed tomography also helps to establish liver hepatomegaly, which is one of the main signs of this disease;
• the diagnosis of this disease is also revealed if a special micropreparation is introduced into the blood, which, when it enters the liver, shows heterogeneity in the liver tissue on x-ray, but before such a microspecimen is administered, the patient should not eat food for some time;
• Liver biopsy, that is, a test in which a sample of the liver (tissue) is taken using a special needle and sent for examination; fat cells may be detected.

When conducting a study, an experienced specialist can also prescribe other studies that will be aimed at establishing the causes of the disease and concomitant diseases of the body, in order to begin comprehensive treatment of the whole body.

Treatment

When it becomes clear what fatty liver hepatosis is, you need to decide on treatment methods. Diet therapy comes first: it can save the patient from fatty liver degeneration. Treatment is carried out mainly at home.

The diet involves limiting heavy foods and dosed intake of proteins, microelements and vitamins into the body. Alcohol and fast food are completely excluded. Smooth weight loss promotes rapid recovery (no more than 500 g per day). Sudden weight loss, on the contrary, can complicate the disease.

Medicines for liver diseases, in particular for fatty hepatosis, have an auxiliary effect. Prescribed:

• vitamins B6 and B12;
• folic and lipoic acids;
• Essentiale.

Lipid-lowering statins could theoretically reduce fatty deposits in the liver, but their strong hepatotropic properties often prevent the use of these drugs for hepatosis. Hepatoprotectors are prescribed without fear; they have a beneficial effect on the parenchyma.

Diet for fatty hepatosis

When fatty liver degeneration is diagnosed, diet is considered one of the most important methods of treatment. By normalizing your diet you can significantly speed up the healing process. Its main tasks:

• stabilization of bile production;
• supply of the required amount of glucose;
• restoration of all organ functions;
• normalization of fat metabolism;
• lowering cholesterol levels.

It is advisable to organize nutrition for fatty liver hepatosis so that the patient eats often - up to 7 times a day, but in small portions. During the diet you will need:

• eat a lot of fiber;
• eliminate cholesterol;
• drink more water;
• limit salt, sugar;
• reduce animal fats;
• change cooking technology - boil, bake, steam.

Fatty liver requires excluding hot and carbonated drinks from the menu, and stopping drinking coffee and tea. Not recommended for diet:

• radish;
• tomatoes;
• garlic;
• fatty dairy and meat products.

It is advisable to use:

• lean meat;
• milk;
• jelly;
• vegetable, milk soups;
• carrot;
• porridge: rice, semolina, buckwheat;
• low-fat dairy products: cheese, yogurt, kefir;
• poultry meat without fat.

Folk remedies

It is better to combine diet and drug treatment of fatty liver hepatosis with folk remedies. The positive effects of eating pumpkin have been repeatedly proven. This vegetable protects the liver and helps cells recover faster.

For this, pumpkin honey is prepared. Recipe: cut off the lid of a ripe fruit and remove the seeds. Fill to the brim with honey, return the lid to its place, and leave the pumpkin to infuse for 2 weeks at room temperature. Then the honey is poured into a clean, dry jar and stored in the refrigerator. For hepatosis, take 1 tablespoon 3 times a day.

Infusions and decoctions are prepared from medicinal herbs. We will not provide recipes - this requires agreement with the attending physician.

Prevention

Prevention of fatty liver hepatosis is not difficult. It is enough to follow the following recommendations:

1. Reduce your consumption of animal fats to a minimum. A complete rejection of them is also unacceptable.
2. Eat often and in small portions. This way the liver will not be overstrained.
3. Maintain at least a minimum level of physical activity: physical inactivity has an extremely negative effect on liver function.
4. Drink alcohol with caution, and never abuse it.

All these tips will help you avoid liver problems in the future.

Fatty liver hepatosis is characterized by high danger due to the risk of degeneration into cirrhosis. To prevent problems, you should rationalize your diet and physical activity regimen. And if trouble does occur, you should urgently consult a doctor for advice. It is much easier to treat hepatosis in the initial stages. This way the patient will help both himself and the doctor.

Fatty hepatosis (fatty degeneration, steatosis) of the liver is a pathology in which hepatocytes degenerate into fat cells. Hepatosis is becoming increasingly common - statistics show that about a quarter of the population of developed countries suffer from this disease. Fatty degeneration occurs in children and adults, but the likelihood of its development increases with age.

It has been noted that approximately ¾ of patients with hepatosis are women over 40 years of age.

Exceeding the normal fat content in the liver leads to the destruction of cell membranes, which can subsequently provoke diseases such as cirrhosis or cancer of the organ. Therefore, it is important to know the main signs of the disease and the most effective treatment methods.

In more than half of patients, the development of steatosis occurs unnoticed. Very often, the disease is diagnosed accidentally, during medical examination or when patients complain of hypertension, obesity, neuropsychiatric disorders or other symptoms. It is very important to see a doctor who will conduct a full examination and be able to identify hepatosis in the early stages, and not prescribe completely unnecessary medications.

Over several years, the disease can slowly progress with periods of remission and exacerbation. Most patients with exacerbations feel a deterioration in their general condition, weakness, headaches, and increased fatigue during physical activity.

As a rule, deterioration in health is associated with the consumption of alcoholic beverages, fatty foods, emotional fatigue and various inflammatory processes in other organs.

But few patients pay attention to these symptoms, attributing them to lack of sleep, increased stress at work, or physical overexertion.

Some patients periodically begin to feel discomfort and heaviness under the right rib, bitterness in the mouth, bloating, abnormal bowel movements or lack of appetite. These symptoms can accompany overeating, various gastrointestinal diseases and other diseases, so it is necessary to examine not only the liver, but also all digestive organs.

The main signs of fatty degeneration can be identified:

As the disease progresses, intoxication develops, accompanied by severe dyspeptic disorders, impaired cardiovascular activity, neurological disorders, jaundice and exhaustion of the body.

Alexander writes:“I have always been overweight - I really love fast food and other unhealthy but tasty foods. But suddenly the weight began to decline, I suddenly lost almost 30 kg, there were no other symptoms. I had an ultrasound and tests - they diagnosed fatty hepatosis and prescribed a diet and treatment. The doctor said that if I give up junk food, then recovery is possible.”

Manifestations in men and women

The clinical signs of such dystrophy in men and women are no different, with the exception of women in late pregnancy. Gender division is used only in statistical data - men suffer from this disease less often than women. Men more often develop steatohepatosis - replacement of hepatocytes with adipose tissue due to alcoholic liver damage.

The prevalence of steatosis in women is explained by frequent changes in hormonal levels. This is affected by menstrual cycles, pregnancy, childbirth, breastfeeding, menopause. Oral contraceptives containing estrogens may also have an effect.

Fatty disease in pregnant women in the early stages is not very common, and it is rarely diagnosed, since many of the symptoms resemble toxicosis. Statistics show that acute development of the disease in pregnant women occurs in 1 case out of 14,000.

But since most often the symptoms appear after the 30th week of pregnancy, pregnant women are admitted to the hospital with suspicion of late toxicosis, poisoning or acute infection. Diagnosis is difficult - due to the enlarged uterus, it is impossible to palpate the liver, and many diagnostic methods cannot be used during pregnancy. In addition, the serious condition of the pregnant woman often requires emergency delivery.

Steatogapathosis in pregnant women occurs with pronounced symptoms:

The enlarged uterus puts pressure on the abdominal organs, which leads to disruption of the outflow of bile and the development of symptoms of cholestasis. Most often, men are diagnosed with the disease in late stages, as they do not pay attention to the symptoms and do not like to go to the doctor.

Experts also say that men do not follow doctors’ recommendations as strictly as women. Therefore, treatment and restoration of the liver in representatives of the stronger half of humanity is not always possible or requires more time.

Signs depending on the stage of the disease

The symptoms of the pathology are ambiguous and depend on the stage of development of steatosis:

Diagnostic methods

Symptoms of fatty degeneration are characterized by a variety of liver pathologies. The peculiarity of the disease is that very often biochemical tests remain within normal limits, which does not exclude the development of hepatosis. Therefore, the diagnosis is made after excluding other diseases, which requires a complete examination of the liver and many different tests.

In addition to standard blood tests - general and biochemical - tests are often prescribed to detect hepatitis viruses, rubella, cytomegalovirus, Epstein-Barr virus and others. Be sure to examine the blood for the presence of autoimmune markers that can affect organ damage. The results of a coagulogram are necessary - with hepatosis, unlike many liver diseases, blood clotting remains normal or is slightly reduced.

Instrumental diagnostic methods are necessary to assess the condition of the liver and identify morphological changes:

Treatment regimen

Fatty degeneration is very treatable, especially in the early stages of development. If signs of the disease appear, you should contact a gastroenterologist or hepatologist, but consultations with other specialists may be necessary, depending on concomitant diseases.

Principles of treatment

The acute form of hepatosis requires hospitalization to relieve symptoms of intoxication. In addition, patients with primary acute hepatosis must be urgently examined and other diseases excluded, and this is best done in a hospital setting under the supervision of specialists. The chronic course of the disease does not require hospitalization, but the patient must regularly visit the doctor, undergo examinations and receive treatment prescriptions.

The success of treatment depends on the patient’s willingness to get rid of provoking factors:

Treatment can be prescribed only after a complete examination and an accurate diagnosis, while the doctor must take into account the stages of the disease, the presence of other diseases, the patient’s age, and the severity of the inflammatory process in the liver parenchyma.

The main methods of treating hepatosis:

1. Therapeutic diet.
2. Medications.
3. Folk remedies.

In addition, it is possible to use alternative methods - hirudotherapy, autohemoozone therapy, ultrasound treatment, singlet oxygen therapy. Acupuncture, acupressure and other methods of Tibetan and oriental medicine are used as auxiliary treatment.

Valentina writes:“We treated my husband’s steatohepatosis with leeches - it helped a lot, his condition improved and an ultrasound showed that the liver had almost returned to normal. Will undergo treatment 2-3 times a year. But I advise you to find a good hirudotherapy specialist.”

Drug effects

Medicines for liver diseases are prescribed with caution so as not to increase the load on the diseased organ. For steatosis, drug treatment is supportive in nature, since for recovery the most important thing is to eliminate the negative influence of provoking factors.

Treatment of hepatosis depends on the cause of the disease, and in the early stages, regardless of the cause, experts prefer not to resort to drug treatment, but to prescribe drugs only in severe cases of the disease.

What drugs are prescribed:

Hepatoprotectors are considered universal drugs for liver diseases. They are prescribed to normalize liver function at the cellular level, prevent the development of the inflammatory process, improve metabolic processes and restore damaged cells. The following drugs are prescribed:

But even the best drugs should be prescribed only by your doctor. Depending on the stage and cause, the specialist will select the best drug for each patient.

Hepatologist's opinion:“I believe that the most effective drugs for fatty hepatosis and other liver diseases are essential phospholipids. In addition to their hepatoprotective effect, they improve the body’s immune response and normalize blood biochemistry parameters.”

Traditional methods

Traditional medicine can help remove excess fat from the body and liver, normalize the activity of hepatocytes and cleanse the liver of toxins. It should be remembered that non-traditional remedies should be used with caution and, preferably, after consultation with a specialist.

The liver constantly accumulates toxins and toxic substances, but a healthy organ cleanses itself. With liver diseases, many functions are impaired, so it is necessary to cleanse the liver with folk remedies.

1. Mix plantain, agrimony, mint, horsetail, tansy flowers, corn silk, immortelle and St. John's wort in equal quantities. Infuse two tablespoons of the mixture in 2 cups of boiling water for 2 hours. Take 100 ml three times a day half an hour before meals. The course of treatment is 15 days, a break of 10, then repeat.
2. Take one spoon each of St. John's wort, bearberry, knotweed and corn silk. Pour 2 liters. water, bring to a boil and simmer for 5 minutes. After cooling, strain and refrigerate. Warm the decoction before taking. For 2 weeks, take half a glass, for the second 2 weeks, drink a glass before meals. After the course, take oatmeal broth for 2 weeks instead of tea.

Therapeutic diet

The cleansing course must be accompanied by a diet. If you do not adhere to a diet during the cleansing period, then the effect of cleansing will not be. The principles of diet for fatty liver disease do not differ from nutrition for other diseases of the organ. In order for the treatment and diet to be effective, the following rules must be followed:

1. Eat 5-6 times a day in small portions.
2. Consume no more than 80 g of fat and no less than 110 g of protein per day.
3. Introduce fiber-rich foods into your diet.
4. Completely avoid fried foods, spices, marinades, canned food and fast food.
5. Replace sugar with honey.
6. Instead of sweets, there are crackers, biscuits, and crackers.
7. Don't eat food that is too cold or hot.

What should always be in your diet:

1. Lean meats and fish.
2. Puree vegetable soups.
3. Cereals.
4. Fruits, vegetables, herbs.
5. Low-fat dairy products, cottage cheese.
6. Compotes, herbal decoctions, natural juices.

The most suitable diet for steatohepatosis is diet No. 5. Many people think that it implies tasteless food, but if you look for recipes, you can diversify the menu, which will allow you to not only eat healthy, but also tasty.

Fatty hepatosis in the early stages has a reversible course, so it is important to consult a doctor when the first symptoms of the disease appear.

It should be remembered that the signs of steatohepatosis resemble other liver diseases, so choosing medications on your own is extremely dangerous. The patient with the diagnosis must follow all the doctor’s recommendations, otherwise the disease will begin to rapidly progress, provoking the development of cirrhosis or liver cancer.

Fatty hepatosis is a liver disease, the development of which is based on a disorder of metabolic processes in the liver cells, as a result of which dystrophic transformations of hepatocytes are observed. They provoke the replacement of functional (normal) cells with lipid tissue.

The development of fatty hepatosis is caused by the accumulation of complex lipid compounds in hepatocytes, which are converted into fat cells. This is a reversible process that can still be prevented if diagnosed in a timely manner.

Fatty hepatosis of the human liver, what it is and how to treat it with medication, clinical features, diagnostics, classification, severity - we will consider further.

Description of the disease

Hepatosis is not a specific disease. This is the collective name for gland diseases that provoke disruption of metabolic processes in the liver cells, which leads to damage to their structure and further dysfunction. Depending on the type of metabolic disorder, medical practice distinguishes between lipid and pigment hepatosis (pigment is a component that gives color to internal tissues).

When fatty compounds begin to accumulate in cells, they speak of steatosis. The process is reversible, the main thing is to start appropriate therapy on time. The accumulation of fats in the liver, even in minimal quantities, is not the norm (the presence of fats in the liver is something else, the norm).

Fatty infiltration is a common disease due to which fatty inclusions accumulate in the gland. If there is no drug effect, the cells are gradually replaced by lipid cells, which form adipose tissue.

This leads to hepatomegaly (the organ increases in size), the color of the gland changes, hepatocytes are destroyed, fatty cysts are actively formed (these are cavities of a pathological nature that form in the liver tissue), and the functionality of the organ is disrupted.

Against the background of fatty infiltration, in the absence of therapy, fibrosis develops - when normal organ tissue is replaced by coarse scar tissue - occurs locally or throughout the organ. And the last stage is cirrhosis. The pathology is irreversible, progresses rapidly, and normal tissues are actively replaced by scar tissue.

Morphological degrees of fatty degeneration of the organ

· Amoebiasis.

· Hepatic ascariasis.

Genetic predispositionThe absence of some liver vessels, underdevelopment of the organ, abnormal congenital disorders.

Who is at risk

Factors are identified that make it possible to assess the course of NAFLD and determine the likelihood of transition to cirrhosis or fibrosis. These include female gender, human age (over 45 years), BMI from 28 kg/m2, impaired absorption of blood sugar, persistent arterial hypertension.

Symptoms depending on stage

For a long time, fatty hepatosis is characterized by an asymptomatic course.

It is often diagnosed accidentally during an annual medical examination or during an examination for other patient complaints.

When the pathological process proceeds quickly, symptoms appear - this is the second stage.

The table shows the signs of the second stage:

Symptom	Clinical manifestations
Painful sensations	Discomfort, heaviness and pain in the liver projection area. In 99% of cases there is no relationship with food intake. It hurts when palpated.
Weakness	The symptom is triggered by a lack of energy reserves. The patient has aches all over his body, he doesn’t want to do anything, he gets tired quickly for no apparent reason.
Nausea (constant or intermittent)	Discomfort or heaviness in the epigastric region, aversion to food odors, increased salivation.
Decreased appetite	I don’t feel like eating, the usual portion size is reduced.
Decreased immune status	Frequent respiratory and cold pathologies, viral and infectious diseases.

In the third stage, yellowing of the skin appears. It becomes yellow in color of varying intensity. The patient suffers from itching and severe burning of the skin. Such symptoms tend to worsen at night. At this same stage, pathological rashes on the skin are often observed. Xanthomas and xanthelasmas appear.

Diagnosis of fatty hepatosis

To gather a complete picture, it is necessary to conduct a series of analyzes and instrumental studies to establish the type, form, stage and degree of fatty hepatosis in the patient.

Diagnostics includes taking an anamnesis, physical examination with palpation and using the Kurlov method, laboratory and instrumental tests.

Blood tests

Diagnosis is differential in nature to exclude other liver diseases. Conducted by the UAC.

Based on the indicators, anemia can be detected (the number of red blood cells and hemoglobin decreases).

ESR and an increase in leukocyte counts indicate an inflammatory reaction.

Thanks to biochemical research they can detect:

• (enzymatic substances of hepatocytes that accelerate the course of chemical reactions). AST and ALT increase, the ratio of these values ​​changes. During growth, destructive processes in cells are suspected.
• Protein metabolism disorder. The cholesterol profile changes, the concentration of lipoproteins (HDL) - a complex of high-density proteins and lipids - decreases.
• Carbohydrate metabolism is disrupted. Hyperglycemic state – high blood glucose.
• Hepatocellular failure – decreased albumin.

Ultrasound, CT and MRI

During an ultrasound, the doctor can establish the following facts:

1. Increased echogenicity of some areas. This indicates a greater density of the organ.
2. Hepatomegaly - the cause is inflammation, accumulation of fatty compounds.
3. Fatty disease - when there are more than 30% lipid compounds in the tissues.
4. Heterogeneity of the organ, unclear edges.

Thanks to CT, it is possible to detect a decrease in liver density due to the accumulation of lipids, focal thickening of blood vessels, and pockets of fatty inclusions. If necessary, confirm the presence of other ailments - cholestasis, cholecystitis. Often, when the liver is damaged, there are problems with the pancreas.

CT scanning is not performed for cholestatic hepatosis in pregnant women, for mental disorders, and for body weight over 150 kg.

MRI is prescribed in the following cases:

• When it is necessary to visualize an organ in more detail.
• The presence of a cyst, pathological neoplasm.
• If you need to compare the results with CT.

MRI is prohibited against the background of mental disorders, claustrophobia, in the presence of metal implants, or a pacemaker.

Biopsy

This is an invasive research technique. For manipulation, an ultrasound is first performed to determine from which area the biological material will be taken. Afterwards, a special hollow needle is inserted (all under the control of an ultrasound machine), and a small piece of liver tissue is removed. They are sent to the laboratory for histological examination.

With the help of a biopsy it is possible to establish:

1. Morphological degree of the disease and type of liver damage.
2. The presence of structural transformations, stage.
3. The presence of other pathological processes in the liver.
4. Inflammation.

A biopsy is not performed against the background of ascites, with a tendency to bleeding, mental and infectious ailments, or purulent processes in the gland.

Elastography

A non-invasive study performed with a special device – a fibroscan. The procedure allows you to accurately determine the degree of fibrosis. This is an alternative to collecting biological material.

Treatment of fatty degeneration

Therapy is required, since the disease tends to progress and leads to complications - cirrhosis, which can lead to disability and death. There are no specific medications that will help get rid of fatty infiltration.

It is important to eliminate or completely neutralize the harmful effects of the factors that led to fat transformation.

It is also necessary to strengthen the body as a whole and restore hepatocytes. For this purpose, a number of medications are prescribed in the form of tablets and powders.

Therapeutic strategy

Medicines are prescribed to the patient individually according to the specific picture of the disease. The doctor determines the dosage and course duration. Hepatoprotectors are recommended to protect the liver.

Treatment strategy:

Purpose of application	Group of drugs	Representatives
Protect cells from destruction, speed up the recovery process.	Hepatoprotectors	There are the following groups: 1. Essential phospholipids (Essentiale Forte). 2. Herbal medicines (Karsil). 3. Products containing ursodeoxycholic acid (Livodex). 4. Amino acid derivatives (Heptral). 5. Dietary supplements (Ovesol – helps cleanse the organ, accelerates regeneration).
Increase cell sensitivity to insulin	Hypoglycemic agents	Metformin, Siofor.
Reducing the concentration of fats in the body	Lipid-lowering drugs	Statins (Atorvastatin) and fibrates (Clofibrate).
Weight loss	Other lipid-lowering agents	Orlistat
Protecting cells from destruction in oxidation processes	Antioxidants	Ascorbic acid, retinol, tocopherol, Mexidol.

Hepatoprotective dietary supplements should be used only as prescribed by a doctor. With self-therapy there is a high risk of negative consequences. Additionally, proper nutrition is recommended - table No. 5, physical exercise, complete abstinence from alcohol and smoking.

Folk remedies against the background of fatty hepatosis also act effectively. Many pharmacological preparations contain herbs (for example, milk thistle) that have a positive effect on the liver. The beneficial effect of medicinal plants is observed only at the early stage of pathology.

The purpose of using folk remedies is to improve liver functionality, restore hepatocytes, and cleanse the body of toxins and toxic compounds. Herbs help reduce total body fat and promote weight loss.

Medicinal plants are used separately or combined in collections - they are better because they act faster and stronger. Treatment with unconventional methods is not recommended during pregnancy or childhood.

• Milk thistle seeds have antioxidant properties and help improve immune status. To prepare the tincture, add 2 tsp to 250 ml of boiling water. seeds, leave for an hour. Take 80 ml three times a day 30 minutes before meals. The approximate course of treatment is 1 month.
• Immortelle inflorescences provide a choleretic effect and normalize metabolic processes in the liver. The inflorescences are filled with 250 ml of water and heated in a water bath. Then you need to dilute with clean water to the original amount. Drink two tablespoons 4 times a day. Take 10 minutes before meals or a few hours after.
• Rose hips help cleanse the body of toxic components and replenish the deficiency of minerals and vitamins. Infuse 50 g of fruit in 500 ml of hot liquid (12 hours). Drink 150 ml three times a day.
• Calendula inflorescences provide an anti-inflammatory and choleretic effect. In 200 ml of water 15 g of dry component, leave for 5 hours. Take 80 (1/3 cup) with a frequency of 3 times a day. Duration of treatment is 30 days.

Steatosis requires mandatory treatment, since disease progression is inevitable. In the absence of therapy, fibrosis and cirrhosis develop - and the only way to help the patient in this case is liver transplantation.