Cause steatosis. Steatosis of the liver - what is it? Causes, symptoms and treatment

Alcoholic fatty liver, alcoholic fatty liver, alcoholic steatosis

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Alcoholic fatty liver [ fatty liver] (K70.0)

Gastroenterology

general information

Short description

Steatosis of the liver(fatty hepatosis, fatty infiltration of the liver) - the most common hepatosis Hepatosis is the common name for a number of liver diseases characterized by degenerative changes in the hepatic parenchyma in the absence or slight severity of signs of inflammation.
in which fat accumulates in the liver cells. The accumulation of fat can occur as a reaction of the liver to various toxic effects or in connection with certain diseases and pathological conditions of the body.

Alcoholic liver steatosis(fatty degeneration) - the initial stage of structural changes in the liver due to chronic alcohol intoxication. It is one of the forms of alcoholic liver disease and can act both as its initial stage and proceed in parallel with its other forms (stages). In the latter case, the diagnosis is made on the basis of the predominance of morphological signs of a particular process, according to the most severe identified process (for example, when foci of fibrosis are detected against the background of alcoholic liver steatosis, it is more appropriate to code the disease as "Alcoholic fibrosis and sclerosis of the liver" - K70.2).

Classification

Alcoholic fatty liver (liver steatosis), according to the general classification of alcoholic liver lesions (Loginov A.S., Dzhalalov K.D., Blok Yu.E.), is divided into the following forms:

1. Without fibrosis.
2. With fibrosis.
3. In combination with acute alcoholic hepatitis.
4. With intrahepatic cholestasis.
5. With hyperlipemia and hemolysis (Ziwe's syndrome).

Etiology and pathogenesis

Etiology
The risk of developing alcoholic liver disease occurs with the use of more than 40 g of pure ethanol per day for men and 20 g for women. 1 ml of strong alcohol contains approximately 0.79 g of ethanol. Previously, long-term alcohol consumption was thought to be a prerequisite for the onset of the disease, but it is now noted that alcoholic liver steatosis occurs after drinking moderate or large amounts of alcohol, even for a short period of time.

The question of a direct correlation between the degree of liver damage and the amount of alcohol taken is considered controversial by some authors: according to some studies, less than 50% of people who drink alcohol in dangerous doses have severe forms of liver damage (hepatitis and cirrhosis). Apparently, many other factors also play a role (see the section "Factors and Risk Groups").

Alcohol acts as a direct hepatotoxic agent. Its metabolism involves a number of enzymatic systems that convert ethanol to acetaldehyde, and further, acetaldehyde dehydrogenase Acetaldehyde dehydrogenase is an enzyme found in the human liver and is responsible for the breakdown of acetaldehyde (converts acetaldehyde to acetic acid).
(ALDH) metabolizes to its acetate. The main factor in the development of alcoholic liver disease is the high content of acetaldehyde in the blood and liver cells. This causes most of the toxic effects of ethanol, including through increased lipid peroxidation, the formation of stable complexes with proteins, impaired mitochondrial function, and stimulation of fibrogenesis.

Pathomorphology
On external examination, the liver is large, yellow with a greasy sheen; hepatocytes are loaded with fat, signs of inflammation or fibrosis are not detected. Fatty degeneration of the liver is diagnosed when the fat content in the liver exceeds 10% of its wet mass, while more than 50% of the liver cells contain fat droplets, the size of which reaches the size of the nucleus of the liver cell or exceeds it. Fatty degeneration is often accompanied by moderate siderosis of stellate reticuloendotheliocytes.

Epidemiology

Prevalence sign: Common

Sex ratio (m/f): 0.5

The true prevalence of alcoholic fatty liver disease is unknown. It is believed that this disease is present in 90-100% of alcohol abusers.
In intravital liver biopsies performed for other reasons, the disease is detected in 3-9% (USA and Canada). At autopsy, liver damage is determined in 65-70% of people who abuse alcohol at a dose of more than 60 g of ethanol per day.
Naturally, the incidence of alcoholic hepatic steatosis correlates with the prevalence of alcoholism itself and can vary significantly in countries with a greater or lesser prevalence. Therefore, international morbidity statistics are estimated at 3-10%.

Age: mostly 20-60 years old.
Race: Whites have a statistically lower rate of all forms of alcoholic liver disease.
Gender: Women are thought to be more at risk for the disease. There are several hypotheses in this regard (hormonal background, low levels of alcohol dehydrogenase in the gastric mucosa, high levels of autoantibodies to the gastric mucosa in drinking women), but none of them has been confirmed.

Factors and risk groups

Risk factors for the development and progression of alcoholic fatty liver disease:
1. Reception from 40 grams of ethanol per day (for women - more than 20 g) for 10-12 years.
2. Genetically determined phenotypes of enzymes that provide a high rate of ethanol metabolism and accumulation of acetaldehyde; genetic polymorphism of enzymes involved in ethanol metabolism.
Alcohol dehydrogenase (ADH) is encoded by five loci on the fourth chromosome. With the predominance of a more active isoenzyme (ADH2), there is an increased formation of toxic acetaldehyde (most characteristic of the Mongoloid race).
Acetaldehyde dehydrogenase (ADH) is encoded by four loci on four different chromosomes. The presence of the abnormal AlDH2 × 2 allele also leads to excessive accumulation of acetaldehyde.
3. Infection with hepatotropic viruses.
4. Overweight.
5. Non-Caucasian race.
6. Dyslipidemia Dyslipidemia is a metabolic disorder of cholesterol and other lipids (fats), which consists in a change in their ratio in the blood
.
7. Diabetes.
8. Metabolic syndrome.
9. Female.

Clinical picture

Clinical Criteria for Diagnosis

Anorexia, nausea, abdominal discomfort, dull pain in the right hypochondrium, epigastric pain, hepatomegaly, jaundice, palmar erythema, alcohol abuse.

Symptoms, course

Alcoholic steatosis is usually asymptomatic in outpatients.

Possible manifestations of severe fatty infiltration of the liver:
- symptoms of malaise, weakness, loss of appetite, nausea and abdominal discomfort;
- jaundice (present in 15% of patients with alcoholic steatosis admitted to the hospital);
- weakness of skeletal muscles;
- dilated cardiomyopathy Dilated cardiomyopathy (DCM) is a condition in which the heart's ability to pump blood is reduced due to enlargement and weakening of the left ventricle (the main pumping chamber of the heart), which reduces the ejection fraction (the amount of blood the heart pumps out with each beat)
;
- pancreatitis Pancreatitis - inflammation of the pancreas
;
- peripheral neuropathy;
- gynecomastia, hypogonadism are often detected Hypogonadism is a pathological condition caused by reduced secretion of sex hormones and characterized by poor development of the genital organs and secondary sexual characteristics.
, Dupuytren's contracture, white nails, spider veins, palmar erythema.
On palpation, the liver is moderately enlarged in 70% of patients, smooth with a rounded edge.

A careful history, especially regarding the amount of alcohol consumption, is essential in determining the role of alcohol in the etiology of abnormal liver test results. Questioning family members can reveal alcohol-related problems in the past.
The American Association for the Study of Liver Diseases (AASLD) in its 2010 guidelines emphasizes the importance of using special questionnaires to clarify the anamnesis in patients for whom the anamnesis data collected by conventional methods seems unreliable. Also, the use of the questionnaire is recommended in cases of suspected (clinically, laboratory, instrumental) alcoholic liver steatosis.

Diagnostics

The criterion for the diagnosis of alcoholic fatty degeneration of the liver is the presence of an alcohol history and histological examination of the biopsy. The diagnosis is considered reasonable if at least 50% of hepatocytes contain large lipid vacuoles that push the cell nucleus to the periphery of the cytoplasm (see section "Etiology and pathogenesis"). However, in practice, biopsy is rarely used, and imaging methods are the leading methods for confirming the diagnosis.

1.Ultrasound:
- different echogenicity of the structure of the liver parenchyma (with non-alcoholic steatosis, as a rule, only bright hyperechoic changes are noted);
- for alcoholic steatosis of the liver, a sonographic picture of both focal and diffuse lesions is characteristic (at the stage of alcoholic hepatitis, only diffuse lesions are noted).
Alcoholic hepatic steatosis, like any other steatosis, is identified by ultrasound only in the presence of more than 30% liver tissue damage. The sensitivity of the method is about 75%.

2. Computed tomography, magnetic resonance imaging are sensitive methods, but do not testify in favor of the alcoholic etiology of steatosis.

3. Laparoscopy Laparoscopy (peritoneoscopy) is a study of the abdominal organs by examining them with the help of medical endoscopes inserted into the peritoneal cavity through a puncture of the abdominal wall.
with liver biopsy allow to describe the surface of the liver and morphologically confirm the diagnosis. These studies are carried out only in the absence of contraindications to them. For example, percutaneous puncture liver biopsy is often not feasible due to contraindications (primarily coagulopathy) and is associated with a large number of diagnostic errors.

3.Radioisotope study of liver function with I 31- at present, this diagnosis is practically not carried out.

Laboratory diagnostics

Signs of alcohol abuse:

1. A sharp increase in the level of gamma-glutamyl transferase (GGT) in the blood serum and its sharp decrease against the background of withdrawal. The test has low specificity and sensitivity. Approximately 70% of people who abuse alcohol have normal GGT values ​​(against the background of withdrawal Withdrawal is a condition that occurs as a result of a sudden cessation of the intake (introduction) of substances that caused substance abuse, or after the introduction of their antagonists.
). However, against the background of alcohol excess, the sensitivity of the test is characterized in the region of 70%.

2. An increase in the concentration of non-carbohydrate transferrin (desialized transferrin, asialotransferrin, CDT) is a specific (80-100%) and sensitive (75-100%) test for patients with alcohol consumption exceeding 60 g per day.
A decrease in total transferrin is present in approximately 28% of alcohol abusers. Therefore, to narrow down the diagnosis, transferrin testing can be done initially rather than the costly multi-wavelength liquid chromatography test for CDT.

3. Blood and urine amylase can be increased only during the period of acute alcohol intoxication and only indicates the fact of alcohol intake up to 36 hours before the analysis.

4. Macrocytosis. The test has low sensitivity (27-52%) and high specificity (85-91%).

Signs of liver damage:
1. Increasing the level of aminotransferases by more than 2 times. The absolute values ​​of AST and ALT are almost always less than 500 IU / l and the ratio of AST / ALT > 2. An increase in transaminases is often the only laboratory sign of alcoholic liver steatosis.

2. An increase in the level of alkaline phosphatase is possible (about 20-40% of patients) in the range of 200-300%.
3. Hyperbilirubinemia (detected in 30-35% of patients), apparently associated with alcoholic hemolysis or concomitant cholestasis.

Notes

1. Ziwe's syndrome is a rare clinical form of fatty hepatosis in chronic alcoholism. With a pronounced fatty degeneration of the liver, the following are noted:
- an increase in serum lipids (hypertriglyceridemia, hypercholesterolemia, hyperphospholipidemia);
- hemolysis (the development of hemolysis in Ziwe syndrome is associated with an increase in the sensitivity of erythrocytes to peroxidases due to a decrease in the level of vitamin E in blood serum and erythrocytes);
- an increase in the amount of bilirubin.

2. Changes in fasting insulin and glucose levels should alert the clinician to the potential for impaired glucose tolerance that often accompanies steatosis.

3. In most patients, there is a mild decrease in the absorption-excretory function of the liver according to the bromsulfalein test (currently rarely used).

Differential Diagnosis

Alcoholic liver steatosis is differentiated from non-alcoholic fatty liver disease, anicteric forms of viral hepatitis, hemochromatosis, obstruction of the biliary tract.
Of particular difficulty is the differential diagnosis between various forms alcoholic liver disease and non-alcoholic steatohepatosis.

Complications

In alcoholic liver steatosis, continued drinking can lead to the development of alcoholic hepatitis or cirrhosis.
fatty liver without signs of fibrosis is not a pre-cirrhotic disease, since the structure of the liver can be restored when alcohol is stopped.
Identification of perivenular and pericellular fibrosis in liver biopsy specimens of patients with fatty hepatosis Fibrosis is an overgrowth of fibrous connective tissue occurring, for example, in the outcome of inflammation.
(40% of patients) indicates the possibility of developing cirrhosis. Although perivenular fibrosis can be considered as a marker of an increased risk of cirrhosis, there is no evidence of progression of the disease when alcohol is stopped.
In one population-based study, there was an increase in mortality and an increase in the risk of cancer (especially liver cancer) among patients discharged with a diagnosis of alcoholic fatty liver disease.

Pathology associated with alcoholism (alcoholic stigmas detected during examination) should be distinguished from complications:
- expansion of the vessels of the nose and sclera;
- enlargement of the parotid glands;
- atrophy of the muscles of the shoulder girdle;
- bright spider veins;
- gynecomastia Gynecomastia - an increase in the mammary glands in men
;
- Dupuytren's contracture Dupuytren's contracture (synonymous with palmar fibromatosis) - painless cicatricial degeneration and shortening of the palmar tendons; It is manifested by a violation of the ability to unbend the fingers, a nodular thickening of the skin on the palms.
;
- testicular atrophy;
- the presence of lesions of other organs and systems (pancreatitis, dilated cardiomyopathy, peripheral neuropathy).

Treatment abroad

Hepatic steatosis is the result of excessive accumulation of fats inside the liver cells (hepatocytes). As a rule, this disease develops as a result of damage to its tissues by various factors, including alcohol, toxins, and obesity. Steatosis is considered one of the most common liver diseases.

What is hepatic steatosis?

Due to the high prevalence of alcohol abuse and obesity, more and more people are coming to doctors asking what liver steatosis is and how to treat it.

Liver steatosis (also known as fatty liver disease, hepatosteatosis) is the accumulation of triglycerides and other fats in hepatocytes.

Fats accumulate in the liver slowly; steatosis is said to be when fats make up at least 5% of the weight of the liver.

According to the distribution of fatty deposits, focal and diffuse hepatic steatosis are distinguished. With focal fatty degeneration, these deposits are located in the thickness of the liver in the form of nodes, which is why it is necessary to conduct a differential diagnosis with benign or malignant neoplasms. With diffuse steatosis, fats are relatively evenly accumulated by all hepatocytes, that is, the entire liver is affected.

Most often, fatty degeneration is a completely benign disease, which under normal conditions does not lead to liver damage. However, with an excess of fat, it becomes vulnerable to other lesions that cause inflammation and tissue fibrosis.

Causes of steatosis

The accumulation of excess fats in the liver is the result of impaired fatty acid metabolism due to various causes. Risk factors for developing steatosis:

• Alcohol abuse.
• Signs of the metabolic syndrome are type 2 diabetes mellitus or impaired glucose tolerance, abdominal obesity, dyslipidemia, high blood pressure.
• Polycystic ovaries.
• Fasting or rapid weight loss, including bariatric surgery (weight loss surgery).
• Total parenteral nutrition.
• Viral hepatitis B and C.
• Taking certain drugs (amiodarone, tamoxifen, glucocorticoids, estrogens, methotrexate).
• Metabolic diseases (for example, Wilson's disease, galactosemia, etc.).

Types and stages of liver steatosis

From a clinical and etiological point of view, doctors distinguish two types of steatosis:

• Alcoholic liver disease.
• Non-alcoholic fatty degeneration of the liver.

Also, doctors separately distinguish acute fatty degeneration of the liver in pregnant women, which is characterized by a severe course and a significant danger to the life of a woman.

Alcoholic steatosis

Alcoholic hepatic steatosis is the result of excessive alcohol consumption, which leads to excessive accumulation of fats in hepatocytes.

Causes and risk factors

The only cause of alcoholic steatosis is alcohol consumption. However, there are factors that contribute to its development and accelerate the progression. For example, this disease develops more often and faster in people who drink beer, liquor or strong alcohol(rum, whiskey, vodka, cognac) than those who drink wine. In women, ethyl alcohol is metabolized more slowly, so they develop steatosis faster. Evidence confirms that women are twice as susceptible to liver damage from alcohol as men. Also, the development of alcoholic steatosis is influenced by genetic predisposition, hepatitis C, and obesity.

Drinking alcohol is absorbed in the stomach and intestines into the blood, which passes through the liver. Hepatocytes contain enzymes that metabolize ethyl alcohol. These enzymes break down alcohol into simpler substances that are excreted through the lungs and urine. Hepatocytes can only metabolize a certain amount of alcohol per hour.

stages

Alcoholic steatosis has the following stages:

• Alcoholic fatty degeneration. Alcohol abuse, even for a few days, can cause the accumulation of fats inside hepatocytes. With the cessation of alcohol consumption, steatosis completely disappears and the liver is restored.
• Alcoholic hepatitis is a potentially dangerous disease that is caused by prolonged alcohol abuse. With alcoholic hepatitis in the liver, damage to hepatocytes is observed and an inflammatory process develops. Even after stopping the use of alcoholic beverages, the liver is not fully restored, but the progression of the disease stops.
• Alcoholic cirrhosis- This is an irreversible stage in which a lot of scar tissue forms in the liver. If a person does not stop drinking, they have only a 50% chance of survival over the next 5 years.

Symptoms

Symptoms of alcoholic steatosis in the stage of fatty degeneration of the liver, as a rule, are absent. Only a few patients with a pronounced accumulation of fats in hepatocytes may experience general weakness, nausea, abdominal pain, loss of appetite, and a feeling of malaise.

In alcoholic liver steatosis in the hepatitis stage, symptoms include abdominal pain due to hepatomegaly, jaundice, spider veins on the skin, general fatigue, fever, nausea, and loss of appetite.

In the early stages of alcoholic cirrhosis, the patient may feel tired and weak, their hands may be shriveled, and the palms may be red. Patients lose weight, suffer from itching, insomnia, abdominal pain and loss of appetite.

In the advanced stages of alcoholic cirrhosis, patients may experience hair loss, further weight loss, jaundice, dark urine, black or light-colored stools, dizziness, fatigue, decreased libido, increased bleeding, edema, vomiting, muscle cramps, shortness of breath, palpitations, ascites , personality changes, confusion, increased susceptibility to infections.

Diagnostics

These symptoms, combined with a history of alcohol abuse, may lead doctors to suspect alcoholic steatosis. To clarify the diagnosis can be carried out:

• A biochemical blood test, in which an increase in the level of liver enzymes (AST and ALT) is detected.
• Coagulogram - in the stage of alcoholic hepatitis or cirrhosis, blood clotting indicators decrease.
• Ultrasound, which can detect liver damage.
• Computed or magnetic resonance imaging.

To confirm the diagnosis, a biopsy is sometimes done, during which a small sample of liver tissue is taken. This sample is then examined in the laboratory under a microscope.

Treatment

Many patients are interested in how and how to treat hepatic steatosis. The main treatment for alcoholic steatosis is to completely stop drinking alcohol. There is no such remedy that can cure the disease without this necessary condition.

In the case of alcoholic fatty degeneration, cessation of alcohol consumption leads to complete recovery of the liver within a few weeks. With alcoholic hepatitis or cirrhosis, stopping alcohol is the only way to prevent progression of the disease.

In addition, rational nutrition is important, as people who drink very often eat poorly, which is why they develop a deficiency. nutrients and depletion of the body.

Treatment of alcoholic steatosis with medications still causes controversy among doctors, many of whom do not believe in its effectiveness. In cases of hepatitis, corticosteroids and pentoxifylline are sometimes used, which reduce the activity of the inflammatory process. For cirrhosis, the only treatment that can save the patient is a liver transplant.

Folk remedies and herbal medicine

Treatment of alcoholic liver steatosis with folk remedies and herbal remedies - infusions and decoctions of various herbs or vegetables (for example, from radish, beets, cabbage, dill, pumpkin, corn stigmas, calendula, immortelle, St. John's wort) is very popular. Before using any of these drugs, you should consult with your doctor. It must be understood that hepatosteatosis is a disease in which the use of any folk method or a phytopreparation can be effective only if the use of alcoholic beverages is completely stopped.

One of the most popular means of herbal medicine and traditional medicine is infusions, decoctions, extracts from milk thistle. This plant contains silymarin, a substance with strong antioxidant and hepatoprotective properties. At the pharmacy, you can buy preparations based on milk thistle.

Prevention

To prevent alcoholic steatosis, do not exceed the following permitted drinking limits:

• Men should not drink more than 4 units of alcohol per day, 14 units per week. They should have at least two days a week without alcohol.
• Women should not drink more than 3 units of alcohol per day, 14 units per week. They should have at least two days a week without alcohol.

1 unit of alcohol is equal to 10 ml of pure ethyl alcohol.

Complications

Complications of alcoholic steatosis develop in the stage of liver cirrhosis. These include:

• Portal hypertension and varicose veins.
• Ascites.
• Liver failure and encephalopathy.
• Liver cancer.

Forecast

In the case of alcoholic fatty degeneration - subject to abstinence from drinking alcohol - the prognosis is favorable. If a person continues to drink alcohol, dystrophy progresses to hepatitis, and then to cirrhosis. In this case, the life expectancy of these people is significantly reduced.

Non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is a term that describes the accumulation of fat in hepatocytes caused by various diseases, with the exception of alcohol abuse. The main cause of NAFLD is obesity.

stages

Non-alcoholic steatosis has the following stages:

• Non-alcoholic fatty liver disease- this is, in principle, a harmless accumulation of fats in hepatocytes, which can only be detected with the help of additional examination methods. With the elimination of factors contributing to the development of steatosis, the liver in this stage of the lesion is completely restored.
• Non-alcoholic steatohepatitis- the next stage of the disease, in which damage to hepatocytes and inflammation develops in the liver.
• Fibrosis of the liver- the formation of connective tissue in the liver, caused by a constant inflammatory process.
• Cirrhosis of the liver- the latest stage, developing with severe fibrosis. Cirrhosis is an incurable disease that can lead to liver failure or liver cancer.

Symptoms

The symptoms and treatment of liver steatosis depend on the stage of the disease. In the early stages, as a rule, there are no signs of the disease. With steatohepatitis or fibrosis, some patients may experience:

• Pain in the right hypochondrium.
• Fatigue and weakness.
• Unexplained weight loss.

In the stage of cirrhosis, patients have more severe symptoms, including jaundice, pruritus, swelling in the legs, and ascites.

Diagnostics

The diagnosis of NAFLD is established on the basis of the clinical picture and additional examination methods, including blood tests, ultrasound, liver fibroscan, biopsy.

Treatment

Currently, there is no specific treatment for non-alcoholic steatosis. These patients are advised to change their lifestyle and diet, as well as to treat the underlying disease (eg, high blood pressure, diabetes mellitus). If cirrhosis develops, patients may need a liver transplant.

Prevention

Prevention of non-alcoholic fatty liver disease consists in identifying risk factors for this disease and eliminating them in a timely manner - for example, normalization overweight through a sensible diet and exercise.

Complications

Complications develop in the stage of cirrhosis. They are the same as in alcoholic liver disease.

Forecast

The prognosis depends on the stage of the disease:

• Non-alcoholic fatty degeneration has a good prognosis with weight loss. Cirrhosis develops over 20 years in 1-2% of patients.
• Steatohepatitis in 10-12% of patients turns into cirrhosis within 8 years.

Diet for liver steatosis includes:

• Reducing the amount of unsaturated fats.
• Increasing the amount of saturated fat.
• Increasing fructose content.

Therefore, patients with hepatic steatosis are advised to follow a balanced diet, the menu of which includes a large number of fruits, vegetables, proteins and complex carbohydrates and a small amount of fat, sugar and salt. In addition, it is recommended to eat in small portions, but more often.

Steatosis is the most common liver disease in which excess fat accumulates in hepatocytes. The main causes are alcohol abuse and obesity. Without elimination of the etiological factor, steatosis progresses to the stage of cirrhosis, during which there is a significant deterioration in liver function.

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Steatosis: signs, stages

It must be remembered that if at least one symptom is noted, of those that we will now list, you should immediately go to the hospital, undergo a diagnosis, and begin the treatment prescribed by the doctor.

The variability of steatosis lies in the fact that it does not show any signs during the course of the first stage. This stage of the course of the disease is characterized by the fact that fatty inclusions gradually begin to be deposited in the human liver, do not cause any violations of hepatocytes.

For this reason, it is impossible to feel the presence of the disease, there are no symptoms. The next stage is very different from the first. Fatty degeneration begins to affect most of the liver, fatty inclusions gradually connect with each other, forming cysts. This is what contributes to the death of their own liver cells. In this case, the patient has a feeling of weakness, he is often sick.

He will also complain about such symptoms of steatosis as recurrent pain in the liver that occurs without any reason, heaviness in the hypochondrium on the right side, pain in this hypochondrium during palpation. Among other signs, there is a reluctance to eat fried, fatty foods, as well as bloating.

Features of the third stage

If you do not pay attention to the emerging symptoms in time, do not consult a doctor and start treatment, steatosis will move into the third stage. How is it different from the previous ones? Since during this period the connective tissue grows, replacing its own hepatic tissue, the integrity of the structure of the vital organ - the liver - is violated. This organ is significantly enlarged, the patient has a violation of the outflow of bile. You can determine the presence of stage 3 steatosis due to such symptoms as:

• nausea;
• yellowing of the skin, whites of the eyes;
• itching of the skin, the appearance of rashes.

It is worth noting that due to a severely weakened immune system, patients often complain that colds occur.

Causes of the disease

About five percent of fat is present in the liver in all people without exception. But, as mentioned above, a disease called steatosis begins to develop only when the amount of fat reaches ten percent or more. It is important to know that with a complex course of the disease mass fraction fat can be from 50 to 60%.

Factors that provoke steatosis

There are many factors that provoke this disease. For example, steatosis often occurs against the background of impaired metabolism. For example, in the presence of pathologies of the thyroid gland, with type 2 diabetes. Also, a disease indicates a disturbed metabolism, which is characterized by the production of hormones by the adrenal glands in excessive quantities. This disease is called Itsenko-Cushing's syndrome.

The next causes of steatosis are the influence of toxins on the human body. First of all, toxic substances are present in alcoholic beverages, to which many people, especially males, are addicted. The development of fatty degeneration of the liver very often begins due to alcohol consumption.

This kind of disease has an owl name - alcoholic stetosis. However, toxins are also present in some drugs. For example, in tetracycline antibiotics, cytostatics, corticosteroids. More toxic substances secrete drugs used to treat tumors, tuberculosis. Therefore, long-term treatment with such medications can serve as an impetus for the development of hepatic steatosis.

Improper nutrition, hypoxia

Foods that are too fatty or high in carbohydrates put a lot of stress on the liver. This organ cannot remove all incoming fats, and eventually deposits them in hepatocytes. As a result of such deposition, people begin to develop ulcerative colitis, chronic pancreatitis.

It often happens that liver steatosis develops due to the presence of such a problem as oxygen starvation of the tissues of the human body. Most often this happens in those who are concerned about diseases of the cardiovascular system, lungs. It is important to know that steotosis can appear in both a child and an adult. According to long-term statistics, this insidious disease can disturb elderly people with diabetes, those who abuse alcohol (usually men), have excessive body weight (mostly women).

The main types of disease

Depending on the degree of violation of the structure of hepatocytes, diffuse and focal steatosis are distinguished. The focal degree is also called focal. It is characterized by the fact that fat accumulates only in one specific place. It is worth noting that blotches of fat can easily connect with each other, forming fatty cysts. This type of disease indicates the presence of a benign formation in the liver. They can be found in both the right and left lobe.

This neoplasm is most easily detected by ultrasound diagnostics, and not by liver scintigraphy. Scintigraphy is used only if the minimum diameter of the formation is 4 cm or more. It is noteworthy that the total number of neoplasms in two lobes (left and right) can be 40-45 pieces.

diffuse steatosis

If a person is diagnosed with diffuse steatosis, blotches of fat will be located throughout the liver. During the course of such an ailment, the dystrophic process completely affects the parenchyma. But it should be noted that sometimes there are small areas with a holistic, intact structure.

In most cases, such areas are located near the gates of the liver. They may appear echogenic and are very difficult to distinguish from neoplasms that are hypoechoic. But still they can be distinguished from tumors. They have a wedge shape. There are no deformations of the contours of the organ or the vascular pattern. If a person is diagnosed with diffuse steatosis, the size of his liver will undoubtedly be increased.

Treatment: drugs, folk remedies

Do not forget that any symptom inherent in steatosis is a reason for immediate medical attention. Only he can prescribe the correct diagnosis of the disease and adequate treatment. So, what is the treatment of this insidious disease? The initial task of a specialist is to identify the cause of its occurrence, that is, those factors that negatively affect the liver, causing this disease.

Most often, it is difficult to determine the cause. But gastroenterologists are well helped by the problems indicated in the anamnesis of patients. These include, for example, alcoholism, the presence of diabetes, overweight. Treatment can be carried out without going to the hospital, if you follow all the recommendations of the attending doctor, respond to the symptoms in time. But with an exacerbation of the patient, they must be placed in a hospital, physiotherapy, drugs, bed rest and everything that is needed for recovery is prescribed.

Medications

Doctors prescribe such modern effective drugs, how:

• vitamins B12, B4;
• lipoic acid;
• methionine;
• antibiotic metronidazole;
• folic acid.

In addition, hepatoprotectors are sure to come to the rescue. This:

• Heptral;
• Karsil;
• Essentiale;
• other drugs that perform functions to protect the liver.

It is very important in the treatment of steatosis to follow a special diet, which primarily consists in minimizing fat intake.
Doctors advise patients and some physiological procedures. Among them are useful and necessary:

• the impact of ultrasound on the patient's body;
• ozone therapy;
• spending time in a pressure chamber.

If liver steatosis has not developed to stage 3, doctors will be able to treat it. If the disease has already passed to this stage, then everything is much more complicated. All that can be done is to eliminate the influence of the provoking factor, to prescribe special medicines, which will help prevent further breakdown of liver cells, the transition to cirrhosis of the liver. In the case of the transition of the disease to cirrhosis (this happens in 15% of cases), a person has about 5-10 years to live.

Alternative treatment

If the doctor sees folk remedies can help in combination with medications, he prescribes them. Consider a few effective recipes.

1. Bran. The inclusion of bran in the diet will help in the fight against fatty deposits in the liver. They need to pour 200 ml of boiling water, then cool and strain. You need to use two tablespoons three times a day.
2. Apricot kernels. They are very useful for patients with steatosis, because the bones contain a large amount of vitamin B15. In order for the liver to start working properly as quickly as possible, doctors recommend using seven cores throughout the day.
3. Healing cocktail. The ingredients that make up this cocktail are carrot juice, warm milk. You need to take one hundred milliliters of each of the components and connect them together. Drink on an empty stomach, in small sips 30 minutes before meals.
4. Herbal decoctions. Consider another good recipe. It is necessary to take in a ratio of 1: 1 the roots of dandelion in crushed form and milk thistle seeds. Then you need to add to them a tablespoon of goldenrod, dried nettle leaves, birch. Prepared raw materials should be poured into a thermos, pour boiling water. Infuse the decoction for about 20 minutes, then filter, drink 200 ml in the morning and evening.

Nutrition for liver steatosis

People suffering from steatosis are prescribed diet number 5. Such a diet is suitable for anyone who has diseases of the liver, biliary tract or gallbladder.
It is allowed to include crackers, pastries from yeast-free dough, as well as Rye bread. Of all types of meat, poultry is allowed to eat chicken, beef, turkey meat. As for fish, it should be lean. Fish, like meat, is recommended to boil, bake.

From fats with steatosis, you can eat only a small amount of vegetable, butter. Kefir, cottage cheese with a low percentage of fat content, cheeses, skim milk, buckwheat and oatmeal, pilaf have a good effect on the patient's body. It is worth noting that only one yolk of a soft-boiled egg can be eaten per day. You can also cook an omelette from proteins, which are so necessary for the body. Nutrition includes the inclusion in the diet:

• dried fruits;
• berries;
• honey;
• tea (black, green, tea with milk);
• juices;
• rosehip decoction.

Vegetables can be baked, stewed, eaten raw. Very useful dishes for liver steatosis are low-fat herring, zucchini caviar, seafood salads, boiled meat. You can eat not too sour sauerkraut, but you can not eat raw onions.
A timely appeal to a specialist will allow you to start diagnosing and proper treatment sooner. Remember, self-treatment is dangerous! Any questions regarding this disease, other liver ailments, you can ask our doctor.

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Causes

The etiology of the disease is different:

• Constant toxic effects on the body of alcohol, toxic substances, as well as medications, side effect which is hepatotoxicity. These include antibiotics from the tetracycline series, cytostatics, tuberculostatic drugs, corticosteroids.
• The development of myxedema - a severe form of hypothyroidism (pathology of the thyroid gland)
• Violations of metabolic processes and functions of the endocrine system - the development of diabetes mellitus, insulin resistance, hyperlipidemia and obesity.
• Severe cardiovascular insufficiency, hypoxia, pulmonary insufficiency and anemia (lead to cell necrosis and degeneration).
• Digestive imbalance - improper and irrational nutrition, constant dieting or frequent overeating. As a result, the enzyme systems that neutralize toxins in the liver are disrupted.
• Itsenko-Cushing's syndrome (hypercorticism) is a pathology in which the adrenal glands produce an excessive amount of hormones, which in turn adversely affect the human body.
• Malabsorption syndrome in the digestive system: it includes chronic pancreatitis, celiac disease, cystic fibrosis, ulcerative colitis.

Symptoms

The disease is characterized by slow development and a chronic form of the course. The peculiarity of the disease is that it can proceed without the manifestation of vivid symptoms, therefore, it is often possible to detect a violation of the functioning of an organ only at a scheduled medical examination.

The following symptoms are among the first to appear: nausea, weakness, a feeling of heaviness, pain and pressure in the right hypochondrium. The liver acquires a smooth surface with rounded edges, becomes dense to the touch, painful on palpation. Splenomegaly and palmar erythema may develop.

Another suspicious symptom is the patient's tendency to catch colds, as well as infectious diseases due to a decrease in the protective ability of the body. In case of violation of liver function, symptoms of cholestasis are possible: yellow color of the skin, intense aching pain in the right hypochondrium, vomiting with bile and nausea.

In chronic alcoholism, patients have a more pronounced picture of the disease: hyperlipidemia and hemolytic anemia, obstructive jaundice. Often there is excruciating nausea and vomiting, severe abdominal pain, fever and edematous-ascetic syndrome.

In the dosage form of liver steatosis, intrahepatic cholestasis, fever, blood leukocytosis and jaundice are observed, which is accompanied by hyperphosphatasemia, itching and other signs characteristic of liver failure.

Diagnostics

With liver steatosis, diagnosis is difficult: laboratory tests often do not show inflammatory processes occurring in the liver. A preliminary diagnosis can be made on the basis of the symptoms of the disease, taking into account the history data (frequent alcohol consumption, obesity or diabetes mellitus).

For an accurate diagnosis, the patient is sent for magnetic resonance imaging, computed tomography, ultrasound. The final diagnosis is made after an aspiration biopsy. As a result, after examining the material, fat drops are found in the liver cells, and the liver parenchyma in some places is replaced by fibrous tissue.

Stages of the disease

Liver steatosis begins to develop in case of excessive intake of fats in hepatocytes. First, drops of fat accumulate in single cells of the liver - disseminated fatty hepatosis develops. Then neighboring cells are involved in the process of obesity, and zonal fatty liver occurs. The process during which all hepatocytes of the liver are involved is diffuse fatty liver disease.

As a result of the accumulation of fat, the hepatocyte ruptures, a fatty cyst is formed, which in turn entails a mesenchymal-cellular reaction. As a result, the tissue around the cyst thickens, and then it degenerates into fibrous tissue. This condition is the beginning of cirrhosis of the liver, which ends in death.

There are the following stages of steatosis:

Treatment

Treatment of the disease occurs in several ways. Basic therapy is to eliminate the causes of the development of the disease and normalize metabolism. The basis of therapy is a diet containing proteins and vitamins. The next stage of treatment is aerobic exercise, which contributes to the correction of insulin resistance that develops against the background of diabetes mellitus.

Drug treatment consists in the use of lipotropic agents that eliminate fatty infiltration in the liver. Essential phospholipids are prescribed to patients, the role of which is to normalize the metabolism of lipids and proteins.

According to the doctor's indications, folic acid and drugs are prescribed that stimulate the synthesis of albumins and increase the supply of glycogen. With malabsorption syndrome, the patient takes amino acid mixtures.

In severe forms of liver steatosis, the patient is urgently hospitalized in a hospital. For treatment, vasoconstrictors, vasodilators are used. If the patient has ascites as a complication, then diuretics are prescribed to remove the fluid.

Forecast

The prognosis for timely and competent treatment is quite favorable. Even with the alcoholic form of the disease, subject to abstinence from drinking alcohol, recovery occurs after 3 weeks. If you stick to bad habits, then protein deficiency is accompanied by fatty degeneration of the liver, which will later lead to cirrhosis. Death can also occur from vascular-cardiac and liver failure, bleeding from the dilated veins of the esophagus.

Basic principles of nutrition

The following principles must be observed:

• provide the body with easily digestible complete proteins
• consume carbohydrates within the physiological norm, if necessary, a reduced amount
• carefully process culinary products: boil well, chop and wipe food
• Eat often, but in small portions
• Add fiber-rich foods to your diet.

From the diet it is necessary to exclude:

• Fat meat
• fried food
• Refractory fats
• Strong rich broth
• Chocolate
• canned food
• Spinach and mushrooms
• Alcoholic drinks
• Ice cream

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Treatment with folk remedies

The principles of treatment may include not only drug therapy, but also the use of traditional medicine. Rose hips, St. John's wort and other medicines are used for treatment.

Hepatocytes can be cleaned of fat with the help of bran, which must be poured with boiling water and left to cool. After that, drain the excess liquid, and eat bran 2 tablespoons at a time. You need to eat at least 3 servings per day. If necessary, you can mix bran with other cereals and soups.

It will “cleanse” the liver and a decoction of rose hips, which must be consumed 125 ml per day 15 minutes before meals. To prepare it, it is necessary to pour boiling water over the rose hips and insist for two hours, strain.

Another assistant is corn stigmas, 2 tablespoons of which must be poured with 500 ml of boiling water, and then simmer the broth over low heat for about 5 minutes. After the liquid is left to cool. Strain the resulting broth and drink 50 ml with an interval of 3 hours, regardless of the meal time.

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What is hepatic steatosis?

Liver steatosis is a disease of the liver, which is characterized by a metabolic disorder in the cells of this organ, resulting in their fatty degeneration. In this regard, the disease is also called fatty hepatosis.

In general, the causes of liver problems vary, but the most common are:

Alcohol abuse;

drug use;

drug and other intoxication;

unbalanced diet or starvation;

diabetes;

gastrointestinal disorders;

myxedema;

an excess of adrenal hormones in the blood (Cushing's syndrome).

In liver cells, an excess of fatty inclusions is formed due to various processes.

Thus, a large amount of fatty acids are formed in the intestines, then they enter the liver. But at the same time, in hepatocytes (the so-called liver cells), there are violations of the oxidative processes of fats, which causes difficulties in terms of removing fatty inclusions from the liver.

As a result, fats accumulate in the liver cells, causing fatty infiltration. In addition, problems with cholesterol metabolism begin in the liver, as the functions of certain enzymes change.

Types of steatosis:

Diffuse hepatic steatosis

If fat inclusions are 10% or more of the volume of the liver, then steatosis can be diagnosed. Most of the fat accumulates in the second and third hepatic lobes, and in more severe form of the disease, they are diffusely distributed.

Thus, the main characteristic of steatosis is that it can be either diffuse or focal. If focal steatosis is manifested in the fact that fats are grouped together, organizing a continuous fatty spot, then diffuse steatosis involves the location of fatty inclusions on the entire surface of the organ.

Fatty steatosis of the liver

As a result of progressive fatty infiltration, the liver not only increases, but also changes color to yellowish or red-brown. Liver cells store fats as triglycerides. The result of such pathological storage is that the fat drop of fat moves the cell organelles in the hepatocyte to the periphery.

As a result of a sharp fatty infiltration, liver cells can die. Drops of fat are combined into fatty cysts, and connective tissue continues to grow around the latter.

Fatty liver disease is often asymptomatic. In many cases, the disease is detected by chance - during an ultrasound of the patient.

Sometimes with liver steatosis, heaviness appears in the right side, which increases during movement. Patients may complain of nausea, weakness, fatigue.

In general, fatty hepatosis proceeds stably, progressing very rarely. With a combination of fatty infiltration with inflammation (steatohepatitis), a third of patients may develop fibrosis, and 10% - cirrhosis.

The primary phase of changes in the structure of the liver, which are caused by the chronic process of alcohol intoxication, is called alcoholic steatosis and is also called fatty liver.

There are many causes of this disease. For example, toxic effects on the body. The most common reason is the use of alcoholic beverages. And the higher the dose of alcohol consumption, the higher the rate and level of development of destructive changes in the liver cells.

The manifestations of this type of steatosis are mostly reversible. They are reduced after 4 weeks of withdrawal. However, alcoholic steatosis can progress to very serious liver damage. Clinical studies suggest that the severity of steatosis correlates with the risk of developing chronic liver disease.

The main forms of steatosis:

macrovesicular (one large fat vacuole contained in a hepatocyte);

microvesicular.

In the liver, mixed micro- and macroforms are also often found, and therefore it can be assumed that they represent certain stages in the development of the disease. Thus, the microvesicular form is an acute manifestation of steatosis, and the macrovesicular form is a chronic one.

Steatosis mainly develops in connection with the violation of lipid metabolism in hepatocytes, which is caused by changes in the hepatocellular redox potential. But during chronic intoxication (alcohol), normal values ​​of redox potential return, regardless of the development of steatosis, which means that other factors are also involved in alcohol liver damage.

Non-alcoholic hepatic steatosis

In turn, non-alcoholic steatosis has many names (infiltration or fatty degeneration, non-alcoholic fatty disease). All these are the names of the initial stage of liver disease or a syndrome that is formed due to an excess of fatty inclusions (mainly triglycerides) in this organ.

It should be noted that with non-intervention during the course of the disease, in the future, in 14% of patients, it tends to develop into steatohepatitis, in 10% - into the development of fibrosis, and sometimes into cirrhosis of the liver.

Such statistics today make it clear why such a problem is of public interest. After all, if you clarify the etiology and pathogenesis of the disease, it will become clear how you can effectively fight and get rid of this fairly common pathology. It should be taken into account that some patients may have a disease, and some - only a symptom.

The main risk factors for the occurrence of non-alcoholic steatosis are:

overweight;

type 2 diabetes mellitus;

presence of ileocecal anastomosis;

a sharp decrease in body weight (about 1.5 kg in a few days);

parenteral nutrition;

an increased number of bacteria in the intestines;

most medications (antiarrhythmic drugs, corticosteroids, anticancer drugs, etc.)

As mentioned above, unfortunately, with the help of a laboratory study, it is almost impossible to identify fatty infiltration. As a rule, the indicators of bilirubin, prothrombin and albumin are normal, while there is a slightly increased activity of serum transaminases.

In addition, the echogenicity of liver tissues, even with ultrasound diagnostics may turn out to be without any special deviations, or slightly above the norm, which does not contribute to the establishment of a reliable and correct diagnosis. Therefore, in some situations, the detection of the disease is possible only thanks to magnetic resonance imaging.

However, even at the same time, the final diagnosis should be based on a histological examination of the liver tissue taken during a biopsy.

Focal hepatic steatosis

As a rule, there are no laboratory studies of deviations in the framework of a general clinical blood test. Sometimes it is possible to determine a slight excess of the activity of cholestasis and cytolysis enzymes.

Diagnosis of benign hepatic tumors is carried out in the course of instrumental studies. Scintigraphy in this case does not provide the necessary information, since it can be used to detect focal lesions in the liver that have a diameter of only more than 4 cm. Thus, it would be more appropriate to refer the patient to ultrasound after a physical examination.

The formation of a benign tumor is evidenced by focal hyperechoic formations with even and clear outlines with different diameters in the liver parenchyma. The number of such formations can vary from 1 to 45, and not only in one, but in two shares.

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Diet for liver steatosis

One of the 15 main therapeutic diets (sometimes they can also be called tables) is diet number 5, prescribed for liver diseases, as well as problems with gallbladder and penitent bile ducts. Its goal is to provide a complete diet for the patient, which helps to stabilize the functions of the liver, improve bile secretion, given the sparing regimen directly for the liver itself.

Bakery products: pastry products (you can use boiled meat filling), rye bread, croutons or cookies.

Soups: milk soup with pasta, vegetable broth soup, cereal soup, vegetarian borscht, beetroot soup.

Poultry and meat: beef, turkey, chicken, pilaf with boiled meat, rabbit, lean lamb.

Low-fat fish: best boiled, fish meatballs, you can diversify by baking fish after boiling.

Fats as vegetable refined and butter.

Dairy products: low-fat and semi-fat cottage cheese, puddings, kefir, not very fatty (and not too spicy) cheese, low-fat milk, sour cream, lazy dumplings.

Eggs: protein omelette, soft-boiled, but no more than one yolk per day.

Cereals - oatmeal and buckwheat, all kinds of cereals, pilaf with carrots, pasta will be especially useful.

Vegetables: various vegetable dishes prepared from boiled, stewed or raw foods. You can use them not only as side dishes, but also in the form of salads and independent dishes. Sauerkraut is allowed (not very sour!), green peas in pureed form, onions, but not raw, but only in boiled form.

Snacks: fruit salads, low-fat herring (soaked), vinaigrettes, seafood and boiled meat salads, squash caviar, milk sausage, a variety of vegetable salads.

Fruits and berries, compotes, dried fruits, jam, honey, sugar.

Drinks: black, green tea, juices, coffee with milk, various decoctions (for example, from wheat bran or rose hips).

Thus, you can create suitable diet options for yourself and paint them by day.

The first day

For breakfast: fruit salad, steamed beef cutlets, coffee.

For an afternoon snack: a glass of fermented baked milk.

For lunch: vegetarian borscht, baked hake with stewed cabbage, berry jelly.

For dinner: spaghetti with butter and cheese, mineral water.

Before bed: banana.

Second day

For breakfast: steamed protein omelette, rye toast with berry jam, fruit juice.

For an afternoon snack: pear.

For lunch: vegetable cream soup, stewed carrots with boiled chicken, raisin and dried apricots.

For dinner: mashed potatoes with baked vegetables, tea. Before going to bed: Borjomi.

Day Three

For breakfast: penne with stewed rabbit meat, tea.

For an afternoon snack: fruit and berry juice.

For lunch: potato soup, carrot cheesecakes, jelly.

For dinner: baked omelet, cheese, tea.

Before going to bed: a glass of fermented baked milk.

Day four

For breakfast: pilaf, cottage cheese casserole with sour cream.

For an afternoon snack: carrot-apple salad.

For lunch: chicken meatballs with buckwheat, fruit compote.

For dinner: potato and cabbage zrazy, baked corop, mineral water.

Before going to bed: a baked apple.

The above diet is followed along with medication and physiotherapy. It is not worth starting it on your own, it is necessary to get the advice of your doctor without fail.

Such a nutrition system is able to quickly achieve remission of the disease, relieve exacerbations, and normalize the imbalance of the digestive organs. In addition, the diet has another positive side - thanks to it, weight is significantly reduced, general well-being improves and an energy boost is observed.

For patients who are concerned about diseases of bile and liver, it is extremely important to refrain from eating prohibited foods, not only for the period of the diet itself, but also after it ends. First of all, this applies to smoked meats, spicy and fat-rich dishes, and alcohol. Otherwise, the effect will be minimized and the course of treatment may have to be repeated.

Steatosis, or fatty degeneration of the liver, is a pathological condition in which fat accumulates in hepatocytes in the form of droplets. So much fat can form that the hepatocyte ruptures, and fat accumulates in the intercellular space in the form of fatty cysts that disrupt the structure of the liver.

This is a common disease that can occur even in childhood, but people over 45 are most susceptible to it, women are more likely than men to suffer from non-alcoholic steatosis, men - steatosis that has developed as a result of alcoholism. Liver steatosis can be an independent pathology, or a symptom of some other primary diseases (for example, type 2 diabetes mellitus).

Causes of steatosis

There are two main causes of hepatic steatosis. This is excessive alcohol consumption, and a violation of fat-carbohydrate metabolism. Currently, non-alcoholic hepatic steatosis is predominant. The development of non-alcoholic steatosis is associated with excessive intake of fat in the body, very often obese people suffer from it.

There is evidence of the influence of genetic factors on the development of hepatic steatosis - its risk increases if the family has cases of steatosis, diabetes, and obesity to a large extent.

Steatosis can develop under the influence of certain long-term medications (medicated hepatic steatosis), such as tetracycline antibiotics, corticosteroids, and cytotoxic drugs.

Steatosis is a disease that develops for a long time, it is characterized by a slow, chronic form of the course. Symptoms of steatosis may be absent altogether, in which case it is discovered by chance, during a medical examination for another reason. The most common symptoms of steatosis include weakness, nausea, liver enlargement, a feeling of heaviness and pressure in the right hypochondrium. There may be spontaneous pain in the right hypochondrium. Another symptom of steatosis is susceptibility to colds and other infections due to reduced immunity. Steatosis can lead to violations of the outflow of bile, in this case, symptoms of cholestasis (stagnation of bile) join the symptoms of steatosis: yellowness of the skin, itching, intense pain in the right hypochondrium, nausea and vomiting with an admixture of bile.

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Development, stages and complications of steatosis

Hepatic steatosis develops when excess fat enters the liver cells. Initially, single hepatocytes are involved in the process (disseminated fatty hepatosis), then groups of hepatic cells (zonal obesity), then steatosis covers the entire liver tissue (diffuse obesity). Fat accumulates in the hepatocyte, then the fat drop increases so much that it ruptures the hepatocyte, resulting in the formation of a fatty cyst. The fatty cyst affects the surrounding tissue of the liver, causing a mesenchymal-cellular reaction, which leads to thickening of the tissue around the cyst and its degeneration into fibrous tissue. This is the start of cirrhosis of the liver, a condition that can be fatal.

There are the following stages of steatosis:

• simple obesity. Fat accumulates inside the hepatocyte, hepatocytes are intact;
• Obesity, combined with necrobiosis of hepatocytes. Fatty cysts are formed in the liver tissue, there is a mesenchymal-cellular reaction;
• precirrhotic stage. Around fatty cysts, areas of growth of connective tissue are formed, disrupting the structure of the liver.

Diagnosis of steatosis

Diagnosing steatosis can be challenging, as laboratory tests often do not show changes that are characteristic of inflammatory processes in the liver. A preliminary diagnosis can be made on the basis of the symptoms of steatosis, taking into account the history data (obesity, diabetes mellitus, alcoholism).

To confirm the diagnosis, computed tomography or magnetic resonance imaging is performed; the final diagnosis can only be confirmed after taking a targeted biopsy under the control of computed tomography. Detection of fat droplets, as well as areas of fibrous tissue, serves as a diagnostic sign of liver steatosis.

Treatment of steatosis

Treatment of steatosis consists in eliminating the cause that caused fatty degeneration of the liver and normalizing metabolism.

With exacerbation of steatosis, treatment is carried out in a hospital. Bed rest, drug therapy and diet therapy are prescribed. After the acute phenomena subside, the patient is discharged home, and the treatment of steatosis is carried out on an outpatient basis.

Since the disease is associated with excess fat intake, diet plays an important role in the treatment of steatosis. The fat content is sharply limited, preference is given to dairy and vegetable food, special attention is paid to a sufficient amount of easily digestible protein. It is recommended to take food fractionally, in small portions. The patient must observe a sparing regimen, with limited physical and emotional-mental stress. Outside the exacerbation phase, non-burdensome physical education is recommended, which contributes to the normalization of metabolism.

Medical treatment steatosis consists in prescribing a long course of lipotropic (fat-breaking) drugs: vitamin B 12, lipoic acid, methionine, essentiale, anabolic steroid drugs, etc.

Physiotherapeutic effects are also used: ozone therapy, stay in a pressure chamber, ultrasound.

In general, treatment of steatosis is usually successful, and the process reverses quite quickly after the start of effective therapy. The exception is stage 3 liver steatosis, in which connective tissue has formed in the liver parenchyma. This stage of steatosis is irreversible, however, vigorous therapeutic measures and the elimination of the damaging factor, as well as strict adherence to medical prescriptions, can stop further degeneration of the liver and the development of cirrhosis.

Video from YouTube on the topic of the article:

What is hepatic steatosis grade 1?

As mentioned earlier, grade 1 fatty liver disease, or simple steatosis, is an early manifestation of excess lipid accumulation, which can be either local or diffuse (spread throughout the organ). However, the boundary between an easily reversible degree and fatty hepatitis is not clear. The similarity of alcoholic and non-alcoholic liver inflammation highlights the role of steatosis in the progression of liver damage. Let us consider in more detail the causes and symptoms of this disease.

Symptoms

Fatty hepatosis of the 1st degree proceeds, as a rule, asymptomatically.

Due to a violation of metabolic processes and a decrease in the basic functions of the liver (detoxification, protein synthesis, digestive, metabolic), there is a decrease in the body's resistance, general fatigue and weakness. With a deterioration in the outflow of bile, pain in the right hypochondrium may periodically occur, which may be associated with cholelithiasis.

Rarely side effects nervous system- the appearance of spider veins and palmar erythema.

Causes

Since the symptoms of fatty lesions are not specific, it should be understood which people are at risk. They are subject to long-term observation and regular diagnostics in order to notice the progression of the pathology in time.

Alcoholic steatosis actually develops in anyone who consumes more than 60 grams of alcohol per day. Due to regular toxic effects in hepatocytes, energy reserves become thinner, hypoxia and a violation of fat metabolism begin. Men are more susceptible to this form of the disease.

Among the causes of non-alcoholic dystrophy are drug lesions(reception of a methotrexate, amiodaron), disturbances at surgical interventions (gastroplasty), however most common causes are obesity and type 2 diabetes. Most often, obese women suffer from this form, although there are cases in thin and perfectly healthy-looking people against the background of hereditary diseases (Wilson-Konovalov's disease).

As with diabetes, the sensitivity of cells to insulin is impaired, which increases the level of glucose in the body. In the process of its transformations and participation in carbohydrate-fat metabolism, the level of sugar in the body increases (as with increased consumption of sweets), which leads to increased accumulation of fat. A vicious circle is formed, where the accumulation of glucose causes obesity, and lipid deposits in the liver disrupt metabolism, preventing the excretion of sugars and leading to the progression of hepatic steatosis.

Other names for the disease

Liver steatosis is often referred to as:

• fatty liver,
• fatty degeneration,
• steatohepatosis,
• fatty liver.

All these names are correct and reflect the essence of pathological changes in one disease.

Since the percentage of fatty inclusions in the parenchyma reaches from 10 to 50% of the mass of the liver, we can talk about obesity, because with the accumulation of body weight, lipids are deposited not only in the subcutaneous tissue, but also in many internal organs.

The term “dystrophy” refers to a violation of the trophic (nutritional) functions of the liver, which changes the structural integrity and vital activity of hepatocytes.

Steatohepatosis reflects inflammatory processes that are present even with grade 1 disease. Well, the prefix “steat-” itself indicates the fatty etiology of all changes.

Treatment

physical activity and proper nutrition are the main treatments for fatty liver of the 1st degree. For quality weight loss physical exercise held at least 3 times a week for 30-40 minutes.

Of the medicines, preference is given to:

1. Hepatoprotectors.
2. Bile acid preparations.
3. Amino acids and vitamins.

Most often, among hepatoprotectors, Essentiale, Gepabene, Enerliv, Karsil are prescribed. They stabilize the membranes of hepatocytes, prevent the effects of toxins, reduce inflammation.

Bile acid preparations include ursodeoxycholic and chenodeoxycholic acid, as well as their derivatives Urosan, Urodez and Henochol. These drugs have a choleretic effect, eliminate lipid breakdown products, thereby reducing fat accumulation and inflammation.

Of the amino acids, thioctic acid prevents the death of hepatocytes. According to its pharmacological properties, it belongs to the inhibitors of lipid peroxidation, that is, it does not allow toxic breakdown products of fats to damage the cell membrane.

Of the vitamins, group B drugs are used - methotrexate and levocarnitine. They reduce general inflammation, participate in the processes of liver regeneration and normalize the metabolism in the body.

Diet

With fatty hepatosis of the 1st degree, treatment and diet are complementary concepts. Among the treatment tables, table number 5 is preferred, which is aimed not only at reducing kilocalories in the diet, but also at reducing the chemical load of the liver.

One of the most important stages of treatment is the complete rejection of alcohol, which is not only incompatible with medications, but is also completely capable of leveling everything. positive effects therapy and diet.

The main principles of the therapeutic diet are:

1. Fractional diet (5-7 times a day).
2. The balance of vegetable and animal proteins should be 1:1.
3. The recommended amount of fat should not exceed 70 g per day, of which vegetable lipids should predominate.
4. The predominance of natural vegetable carbohydrates - vegetables and fruits.
5. Reducing salt in the diet to 5 g per day.
6. Maximum chemical sparing of the liver (no fatty, fried, smoked and spicy foods).
7. Sufficient replenishment of water and electrolyte balance (up to 2-2.5 liters of water per day).
8. The diet should contain enough fiber for the normal functioning of the gastrointestinal tract.

Forecast

With the timely detection of the disease (that is, already at the 1st degree of steatohepatosis) and the treatment started, a complete recovery is possible. However, the restoration of all functions of the body can take a long time, and the existing predisposition to the accumulation of fat remains for life.

Therefore, it is extremely important to maintain a proper lifestyle and physical activity. The treatment of the disease that initially caused liver damage also plays a significant role in the prognosis. For example, with further progression of diabetes mellitus, repeated changes in the liver will be inevitable.

Symptoms of hepatic steatosis

One of the reasons why liver steatosis is so dangerous is the symptoms on early stage diseases are not expressed.

The danger of steatosis is exacerbated by the asymptomatic course of the disease in its first stage. At this time, steatosis in most cases is diagnosed by chance, during the examination. External manifestations of fatty hepatosis are detected later, when the changes become significant.

Signs of liver steatosis stage I:

• laboratory is not always possible to determine when conducting general analyzes.

Signs of liver steatosis stage II:

• nausea - constant or attacks,
• heaviness of the right hypochondrium,
• pain sensation that appears on palpation of the hypochondrium on the right side,
• pain in the liver,
• feeling of discomfort, tightness of the organs,
• weakness.

The appearance of the listed symptoms is explained by the changes occurring at this stage:

• fatty degeneration affects most of the liver,
• fatty formations merge, enlarge, form cysts,
• some of the liver's own cells begin to die (necrosis).

Symptoms of stage III steatosis:

• skin yellowness,
• yellow tint of the eye sclera,
• nausea (possibly with vomiting),
• skin rashes,

Stage III steatosis is a pre-cirrhotic condition, at this time there is a significant destruction of the organ. The liver's own parenchyma is replaced by growing connective tissue, as a result of which the liver increases significantly in size, and the outflow of bile is disturbed. The study of a macropreparation in liver steatosis allows the naked eye to detect significant changes.

An indirect symptom of stage II and III steatosis is an increase in the frequency of colds associated with a decrease in immunity.

Causes

All factors contributing to the occurrence of hepatic steatosis can be divided into several groups.

Toxic effect

Drugs may have toxicity that can cause fatty hepatosis. These include some antitumor drugs, antibiotics of the tetracycline group, cytostatics, corticosteroids, tuberculostatic drugs.

Fatty hepatosis caused by the toxic effects of alcohol is very common. The amount of alcohol consumed directly affects the intensity of the development of the disease. Unlike forms of a different etiology, such cases are diagnosed as alcoholic steatosis.

Metabolic disease

Steatosis of the liver (fatty) may be the result of a metabolic disorder, which in turn is caused by another disease, including:

• excess of adrenal hormones (Itsenko-Cushing's syndrome),
• type II Diabetes,
• disorders in the thyroid gland.

Nutritional imbalance

The most dangerous are foods high in protein and fat. When the liver is overloaded, it is unable to remove fats in large quantities, so excess fat is deposited in the cells. In the presence of pancreatitis or colitis, the risk of liver steatosis from an unbalanced diet is much higher. The deposition of fats in the liver cells can also be the result of malnutrition, as well as a deficiency of essential substances - minerals, proteins, vitamins.

Tissue hypoxia

Insufficiency of oxygen supply (hypoxia) of tissues is often observed in those suffering from pulmonary diseases or cardiovascular insufficiency. The lack of oxygen in the required amount disrupts the functioning of the organs, which leads to metabolic steatosis of the liver.

Diagnostics

Diagnosis of liver steatosis is required to be carried out comprehensively - the conclusion about the existence of the disease and its stage is made on the basis of symptoms and the results of various studies.

Tests for liver steatosis

When determining the presence of fatty hepatosis, the main indicators are the results of the following tests, which allow not only to assess the state of the liver, but also to distinguish between hepatosis and other diseases similar in manifestations.

• A biochemical blood test with an assessment of iron metabolism and genetic testing together make it possible to exclude hereditary (idiopathic) hemochromatosis.
• Serological blood test reveals all forms of viral hepatitis.

In a patient with liver hepatosis, prothrombin, bilirubin, and albumin levels may remain normal. There is a slight increase in serum transaminases and alkaline phosphatase. If the cause of steatosis is alcohol intoxication (alcoholic fatty liver), there is an increase in the level of the enzyme g-glutamyl transpeptidase.

Ultrasound procedure

Ultrasound of the liver is used as an auxiliary or primary diagnostic tool. Ultrasound examination is able to determine the increase in the size of the liver and the presence of fatty cysts, but it is not capable of separating hepatosis and other pathologies that cause similar changes. When conducting ultrasound, the echogenicity of the liver is also determined. It is also advisable to examine the spleen - with steatosis II and III degree, it also often increases in size.

Liver biopsy

When conducting this study, a puncture is performed with a material sampling for examination under a microscope and determining the presence of fat droplets in the cells. The biopsy distinguishes between hepatic steatosis and a range of diseases, including: granulomatosis, non-specific forms of reactive hepatitis, and chronic hepatitis C.

Computed and magnetic resonance imaging

Tomographic studies make it possible to determine the degree of density of liver tissues, which indicates diffuse changes in the liver according to the type of steatosis in them and allows us to draw conclusions about the area of ​​distribution of these changes.

Sometimes, when diagnosing hepatosis, an endoscopic comprehensive study is also performed (of the liver and other organs located in the abdominal cavity).

Treatment of hepatic steatosis

The course of treatment of liver steatosis at the Pokrovsky Gates Medical Center is compiled individually for each patient, taking into account the results obtained during the studies. Identify potential causes of the disease can determine the level of cholesterol, ceruloplasmin, increased enzymes. For accurate diagnosis, data on antimitochondrial and antinuclear bodies, the level and phenotype of a-antitrypsin, etc. are also important.

The reason for such close attention to the etiology of the disease is due to the need, first of all, to ensure the cessation negative impact on the liver.

• With any form of the disease (alcoholic and non-alcoholic steatosis of the liver of all stages), the patient is prescribed a diet. Its general principle for all patients is the low calorie content of meals and the balance of proteins, the absence of “empty” carbohydrates. Taking into account concomitant diseases, the general condition of the body and other features, the diet is individually adjusted for each patient.
• Drug treatment of steatosis is aimed at protecting the liver (hepatoprotectors - Geptran, Karsil, Ursosan, Hofitol, Essentiale, etc.) and improving fat metabolism (vitamin B12, folic, lipoic acids, choline chloride).
• In patients with diabetes mellitus, drugs of the biguanide class (Metformin and others) are used for liver steatosis.
• If a patient is diagnosed with hepatic steatosis, treatment should include auxiliary methods. Physical activity is especially necessary for those patients whose hepatic steatosis is caused by obesity or diabetes. A set of exercises is selected individually.

Forecast

• The most favorable prognosis can be made in the treatment of grade I hepatic steatosis. It is enough to eliminate the cause of pathological changes, and the deposition of fats in the cells of the organ will stop in a few weeks. With the use of drug treatment, this period is reduced. If symptoms of hepatic steatosis are detected, treatment should begin immediately. The medical center "Pokrovsky Gates" makes it possible to get rid of the pathology without consequences.
• Treatment of stage II fatty steatosis of the liver will be successful with full compliance with the doctor's prescriptions, and this includes not only taking medications, but also dieting and exercising.
• With advanced stage III hepatosis, treatment is aimed at stopping the process of decay of liver cells and is supportive.

The likelihood of resuming the process of fat deposition in liver cells, the development of fibrosis and necrosis depends on a number of factors. Among patients with hepatosis who are not at risk, when observed for 10 years, complications and further development of the disease were detected in 5%. In the presence of factors that increase the risk, the probability of an adverse outcome increases and can reach 20% or more. Understanding what liver steatosis is, its treatment is prescribed taking into account risk factors, which include:

• elderly age,
• excess weight,
• elevated levels of glucose, triglycerides, ALT in the blood serum,
• oxidative stress (increased levels of malondialdehyde, glutathione).

There is evidence that non-alcoholic hepatic steatosis (NAFLD) is more likely to be completely cured than alcoholic hepatic steatosis.

Complications

Steatosis of the liver - what is it? The body ceases to fully fulfill its functions, which means that immunity can significantly decrease, inflammatory diseases become more frequent - from common colds to pneumonia.

The most severe complication of liver steatosis is cirrhosis - decomposition and tissue necrosis.

Prevention of hepatic steatosis

Prevention of hepatosis can be considered a healthy lifestyle - a balanced diet (the absence of not only excessive food intake, but also malnutrition, unverified and inconsistent diets and starvation), physical activity (during "sedentary" work, it is important to do gymnastics, walking, ideally - sports), minimal or total abstinence from alcohol.

In hepatic steatosis, symptoms and treatment may vary from patient to patient, even at the same stage of the disease.

Nutrition for liver steatosis

The diet for liver steatosis provides for the consumption of fats in a minimal amount. First of all, it concerns fats of animal origin. Much less harmful polyunsaturated fats can be consumed, so a diet for liver and pancreas steatosis may include nuts and fish. Without fail, fruits and vegetables containing vitamin A are included in the menu for liver steatosis.

Excluded from the menu:

• fried food,
• fatty foods,
• savory soups,
• smoked meats,
• carbonated drinks,
• legumes,
• coffee.

Speaking generally about how to treat steatosis of the liver and pancreas, the rules can be formulated as follows: foods that are high in carbohydrates and fats are excluded. Obviously, if alcoholic liver steatosis is meant, the treatment is primarily to avoid alcohol.

Liver steatosis is a disease of the liver, which is characterized by a metabolic disorder in the cells of this organ, resulting in their fatty degeneration. In this regard, the disease is also called fatty hepatosis.

In general, the causes of liver problems vary, but the most common are:

Alcohol abuse;

drug use;

drug and other intoxication;

unbalanced diet or starvation;

diabetes;

gastrointestinal disorders;

myxedema;

an excess of adrenal hormones in the blood (Cushing's syndrome).

In liver cells, an excess of fatty inclusions is formed due to various processes.

Thus, a large amount of fatty acids are formed in the intestines, then they enter the liver. But at the same time, in hepatocytes (the so-called liver cells), there are violations of the oxidative processes of fats, which causes difficulties in terms of removing fatty inclusions from the liver.

As a result, fats accumulate in the liver cells, causing fatty infiltration. In addition, problems with cholesterol metabolism begin in the liver, as the functions of certain enzymes change.

Types of steatosis:

Diffuse hepatic steatosis

If fat inclusions are 10% or more of the volume of the liver, then steatosis can be diagnosed. Most of the fat accumulates in the second and third hepatic lobes, and in more severe form of the disease, they are diffusely distributed.

Thus, the main characteristic of steatosis is that it can be either diffuse or focal. If focal steatosis is manifested in the fact that fats are grouped together, organizing a continuous fatty spot, then diffuse steatosis involves the location of fatty inclusions on the entire surface of the organ.

Fatty steatosis of the liver

As a result of progressive fatty infiltration, the liver not only increases, but also changes color to yellowish or red-brown. Liver cells store fats as triglycerides. The result of such pathological storage is that the fat drop of fat moves the cell organelles in the hepatocyte to the periphery.

As a result of a sharp fatty infiltration, liver cells can die. Drops of fat are combined into fat, and connective tissue continues to grow around the latter.

Fatty liver disease is often asymptomatic. In many cases, the disease is detected by chance - during an ultrasound of the patient.

Sometimes with liver steatosis, heaviness appears in the right side, which increases during movement. Patients may complain of nausea, weakness, fatigue.

In general, fatty hepatosis proceeds stably, progressing very rarely. With a combination of fatty infiltration with inflammation (steatohepatitis), a third of patients may develop fibrosis, and 10% - cirrhosis.

The primary phase of changes in the structure of the liver, which are caused by the chronic process of alcohol intoxication, is called alcoholic steatosis and is also called fatty liver.

There are many causes of this disease. For example, toxic effects on the body. The most common reason is the use of alcoholic beverages. And the higher the dose of alcohol consumption, the higher the rate and level of development of destructive changes in the liver cells.

The manifestations of this type of steatosis are mostly reversible. They are reduced after 4 weeks of withdrawal. However, alcoholic steatosis can progress to very serious liver damage. Clinical studies indicate that the risk of developing chronic liver disease correlates with severity.

The main forms of steatosis:

macrovesicular (one large fat vacuole contained in a hepatocyte);

microvesicular.

In the liver, mixed micro- and macroforms are also often found, and therefore it can be assumed that they represent certain stages in the development of the disease. Thus, the microvesicular form is an acute manifestation of steatosis, and the macrovesicular form is a chronic one.

Steatosis mainly develops in connection with the violation of lipid metabolism in hepatocytes, which is caused by changes in the hepatocellular redox potential. But during chronic intoxication (alcohol), normal values ​​of redox potential return, regardless of the development of steatosis, which means that other factors are also involved in alcohol liver damage.

Non-alcoholic hepatic steatosis

In turn, non-alcoholic steatosis has many names (infiltration or fatty degeneration, non-alcoholic fatty disease). All these are the names of the initial stage of liver disease or a syndrome that is formed due to an excess of fatty inclusions (mainly triglycerides) in this organ.

It should be noted that with non-intervention during the course of the disease, in the future, in 14% of patients, it tends to develop into steatohepatitis, in 10% - into the development of fibrosis, and sometimes into cirrhosis of the liver.

Such statistics today make it clear why such a problem is of public interest. After all, if you clarify the etiology and pathogenesis of the disease, it will become clear how you can effectively fight and get rid of this fairly common pathology. It should be taken into account that some patients may have a disease, and some - only a symptom.

The main risk factors for the occurrence of non-alcoholic steatosis are:

overweight;

Thus, you can create suitable diet options for yourself and paint them by day.

The first day

For breakfast: fruit salad, steamed beef cutlets, coffee.

For an afternoon snack: a glass of fermented baked milk.

For lunch: vegetarian borscht, baked hake with stewed cabbage, berry jelly.

For dinner: spaghetti with butter and cheese, mineral water.

Before bed: banana.

Second day

For breakfast: steamed protein omelette, rye toast with berry jam, fruit juice.

For an afternoon snack: pear.

For lunch: vegetable cream soup, stewed carrots with boiled chicken, raisin and dried apricots.

For dinner: mashed potatoes with baked vegetables, tea. Before going to bed: Borjomi.

Day Three

For breakfast: penne with stewed rabbit meat, tea.

For an afternoon snack: fruit and berry juice.

For lunch: potato soup, carrot cheesecakes, jelly.

For dinner: baked omelet, cheese, tea.

Before going to bed: a glass of fermented baked milk.

Day four

For breakfast: pilaf, cottage cheese casserole with sour cream.

For an afternoon snack: carrot-apple salad.

For lunch: chicken meatballs with buckwheat, fruit compote.

For dinner: potato and cabbage zrazy, baked corop, mineral water.

Before going to bed: a baked apple.

The above diet is followed along with medication and physiotherapy. It is not worth starting it on your own, it is necessary to get the advice of your doctor without fail.

Such a nutrition system is able to quickly achieve remission of the disease, relieve exacerbations, and normalize the imbalance of the digestive organs. In addition, the diet has another positive side - thanks to it, weight is significantly reduced, general well-being improves and an energy boost is observed.

For patients who are concerned about diseases of bile and liver, it is extremely important to refrain from eating prohibited foods, not only for the period of the diet itself, but also after it ends. First of all, this applies to smoked meats, spicy and fat-rich dishes, and alcohol. Otherwise, the effect will be minimized and the course of treatment may have to be repeated.

Treatment of steatosis with folk remedies




It is useful to use decoctions of herbs. For example, from milk thistle seeds and crushed dandelion roots. To prepare a decoction, you must combine the above ingredients in equal proportions and add 1 tbsp to them. l. goldenrod, dried and. The mixture is poured into a thermos, and then poured with boiling water. It is infused for at least 15-20 minutes, and after the herbal infusion is well brewed, it should be filtered and consumed twice a day in a glass (morning and evening).

Regular consumption of bran good remedy to fight fat deposits in the liver. They should be poured with boiling water and left to cool, then strain. Then, three times a day, you need to eat two tablespoons of bran obtained in this way.

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Steatosis of the liver- one of the most common types of hepatosis (metabolic disorders in liver cells). The pathology is characterized by a latent, sluggish course, without any characteristic features liver disease.

However, do not underestimate her cunning and possible complications, as it can further progress up to cirrhosis. It is usually detected by ultrasound - by chance. But very often - not less than 30% of modern people.

The Sokolinsky System, which you can read about later in this article, allows you to influence the causes, eliminate the increased load on the liver. This is a 100% natural and physiology based approach.

Steatosis of the liver - what is it?

Steatosis of the liver(other names - fatty liver, fatty hepatosis) is the accumulation of fat in the liver cells. The disease develops as a result of a violation of fat metabolism in hepatocytes and leads to degenerative changes in the gland.

Often, the pathology develops without inflammatory lesions of the liver. But embracing a significant part parenchyma, it leads to liver failure and serious complications.

Causes

Congenital predisposition to pathology is extremely rare. In most clinical cases, the person himself is to blame for its appearance, no matter how cruel it may sound. Considering the patient's lifestyle, a distinction is made between non-alcoholic and alcoholic hepatic steatosis. In the latter case, its development is the result of alcohol abuse, which leads to toxic damage to liver cells and disrupts their metabolism.

As for non-alcoholic fatty liver disease, the following causes most often cause it.

General obesity.

Accumulation of so-called. visceral fat - on the abdomen.

Diabetes.

An unbalanced diet is an excess of fats, carbohydrates, a lack of protein, amino acids or vitamins.

Chronic diseases of the gastrointestinal tract, impaired absorption of nutrients from the intestines.

Wrong diet - starvation, overeating, passion for diets.

Incorrect (uncontrolled) intake of medications.

Regular contact with toxic substances.

Stagnation of bile

Disturbed intestinal microflora (provokes thickening of bile).

Steatosis of the liver - it's such a disease, which clearly demonstrates our lifestyle, eating habits and attitude to our own health status. Most often, women, people over 45 years of age and people leading a sedentary lifestyle suffer from it.

Forms of the disease

Depending on the amount of deposits of adipose tissue, experts distinguish several degrees of organ damage.

Initial degree - there are slight deposits of fat in individual cells.

I degree - larger deposits of fat are formed.

II degree - most of the liver cells are exposed to obesity.

III degree - diffuse hepatic steatosisaccompanied by the formation of multiple fatty cysts.

Due to the latent course of the disease, initial and I degree obesity, as a rule, is diagnosed by chance - during a planned ultrasound of the abdominal organs. And only II and III degrees of obesity can signal themselves with characteristic signs.

Symptoms

Initial signs of hepatic steatosis easily confused with general malaise and weakness of the body. Attributing them to fatigue and stress, patients are in no hurry to see a doctor. And only when the functions of the organ are already impaired by significant deposits of adipose tissue, characteristic symptoms of hepatic steatosis.

Discomfort in the right hypochondrium - a feeling of fullness, pain, heaviness or burning, which increase during physical exertion and after eating.

Nausea, diarrhea or constipation.

Skin itching and rashes.

Appetite disorders.

Sharp fluctuations in weight.

Deterioration of the skin, hair and nails.

burp, bad smell mouth, heartburn.

It's important to know! If signs of pathology are found, it is necessary to immediately contact a hepatologist or your treating therapist. Especially if the symptoms appeared on the background of obesity, metabolic disorders or alcohol abuse.

Diagnostics

Steatosis of the liver easily diagnosed by ultrasound examination of the gland - it shows increased echogenicity, indicating the presence of fat deposits. To confirm the initial diagnosis, a more detailed examination of the body and liver is prescribed.

Computed tomography - helps to identify an increase in the size of an organ and a decrease in its densitometric parameters.

Biochemical blood test - allows you to detect an increased content of liver enzymes. It is necessary to monitor the target indicators of transaminases, low-density and high-density cholesterol, alkaline phosphatase, bilirubin, GGT, for problems with diabetes + glycated hemoglobin.

Liver biopsy - the tissue of the gland is taken for a detailed study of their structure under a microscope. But this, of course, is a last resort, when there is already a suspicion of cirrhosis.

In addition, great importance is given to the collection of the patient's history. After all, the study of eating habits, lifestyle, previously transferred diseases allows us to identify the cause of the development of obesity. For successful treatment, it must be eliminated or corrected.

Treatment

Treatment of hepatic steatosis- not so difficult, but a long process. It begins with a review of your lifestyle, nutrition and elimination of bad habits (smoking and alcohol abuse). It is also important to maintain physical activity - swimming, gymnastics, running, cycling. This is because it is necessary not only to reduce the calorie content of the diet, but also to teach the liver to properly distribute the calories received: instead of storing them in fat, store them in the form of glycogen and not spend them on energy in the muscles.

Medical treatment is carried out by a doctor. It involves most of all the intake of hepatoprotectors and phospholipids. But, in fairness, you rarely see appointments aimed specifically at fatty hepatosis. Therefore, you can use natural remedies at home, aimed at deep causes.

It's important to know! Before taking any drugs for the treatment of hepatic steatosis specialist advice is required. The use of natural remedies, which you will read about below, does not cancel or replace the appeal to him.

If we talk about what folk remedies for steatosis are really effective (tubages, herbal infusions, etc.), then it is impossible to say with certainty that there will be an effect. Unless, of course, there is some hereditary herbalist nearby and the ultrasound shows that the condition of your liver is improving - God forbid. But in most cases, it is more reasonable to use natural ingredients, the action of which is well studied. It is important not to waste time. Liver cells can regenerate, but their "patience" is not limitless!

What happens if the disease is not treated?

Without treatment, diet and physical activity, liver failure may develop. If an inflammatory process joins it, then fibrosis or cirrhosis of the liver develops. At the same time, it should be taken into account that with alcoholic fatty disease the risk of developing complications is higher than with non-alcoholic pathology.

Nutrition and diet

Eating with fatty liver is necessary often, in small portions. The daily diet includes easily digestible foods high in B vitamins, amino acids and protein. Fatty and carbohydrate-rich foods should be excluded from the diet. The menu should contain dishes based on the following foods.

Skimmed milk and dairy products.

Vegetables.

Fruits are low in sugar.

Whole grain cereals.

Bran.

Lean meats and fish.

Seafood.

Dried fruits.

Animal fats are best replaced with vegetable fats. Drink as a thirst quencher mineral water without gas or green tea without sugar.

It's important to know! The use of alcohol-containing drinks is contraindicated in any type of hepatosis and degree of obesity!!!

Prevention

Steatosis of the liver are considered diseases that are easier to prevent than to cure. The following simple measures are suitable as its prevention.

Refusal of fatty and sweet foods.

Maintaining an active lifestyle.

Control of body weight and body fat, especially in the abdomen.

Refusing or reducing the amount of alcohol consumed.

The "Sokolinsky System" uses the following sequence of taking natural remedies: in the first month - cleansing the liver, intestines, blood from toxins, then another 2 months - normalization of the intestinal microflora, support for the utilization of fats with the help of active fibers NutriDetox + continues to support the liver with Liver 48 and LecithinUM is added in order to effectively “capture” fat directly in the liver.

As we said, it is important to make changes in the diet - it is not enough just to remove the unhealthy, it is important to add the necessary, preventive. Therefore, after the main course, it is worth doing an ultrasound of the abdominal cavity, making sure that the liver has become easier to live, enjoy the changes in general well-being and continue to take care of yourself. Liver support is valuable because it has a systemic effect on the body:

Increase in the diet of plant fibers (every day, 1-2 tablespoons in a fermented milk drink)

Harmonization of the intake of vitamins and minerals of natural origin into the body (for example, from spirulina, chlorella in the complex, add 1/3 teaspoon to smoothies or with water 3-4 times a week)

During the cold period, an increase in the amount of omega-3 acids from fish oil Megapolinol 1.4 g per day - 1 capsule from October to March

In warm weather - the inclusion of essential phospholipids in the diet (1-2 teaspoons in a fermented milk drink, salad or just with water)

Do not forget to listen to your feelings and regularly undergo examination.

As you have questions, do not hesitate to ask them to our specialists - use the convenient feedback form on our website. Take care of your liver and be healthy!

How to learn to solve several health problems at the same time and simply?

We have already been taught that there is a remedy for every single symptom. And this is right when you are in the hospital or faced with an acute illness. But if your task is to improve health and increase efficiency, everything will be exactly the opposite. In the body, everything is connected and the elimination of symptoms does not lead to a solution to health problems, but only masks them. Real change gives an impact on the causes of poor health.

If you want to feel better, influence the body with the help of deep universal mechanisms that simultaneously allow you to eliminate the same type of disorders in different organs: corrections in nutrition, a reasonable lifestyle, detox, nutrition and protection of nerve cells, restoration of microflora, normalization of digestion, natural anti-inflammatory drugs and antioxidants .

"The Sokolinsky System" offers a systematic naturopathic approach based on a deep understanding of physiology, modern research, proven in the practice of more than 10,000 people since 2002.

Natural remedies are produced specifically for use in the Sokolinsky System.

IS NOT A MEDICINE!

The system was developed by the famous Russian nutritionist Vladimir Sokolinsky, the author of 11 books on natural medicine, a member of the National Association of Nutritionists and Nutritionists, the Scientific Society of Medical Elementology, European Association Natural Medicine and the American Association of Nutrition Practitioners.