The liver is the largest biochemical laboratory in our body. It is involved in more than 500 reactions. Therefore, any changes in her condition may affect her well-being. Everyone knows its important role and has heard about such a terrible diagnosis as cirrhosis, many want to clean it and take special medications. Some are looking for folk remedies, others trust more in the developments of the pharmaceutical industry. The question remains, what will actually be effective?
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What about the liver?
You might think that the liver is just waiting for us to help it. This is wrong. The compensatory and regenerative capabilities of the liver are enormous. If 25% of the healthy organ is preserved, it can recover on its own. We will never feel how a healthy liver works. There are no nerve endings in it, so it never hurts. Liver cells are hepatocytes. If a cell dies, its load is redistributed among the remaining ones. So, if a significant part of the liver is destroyed, there may be no symptoms or even changes in tests.
On the one hand, this is good, the liver does not bother us over trifles like the stomach, which can twist after bad food, and after 3 days we have already forgotten about it. But if symptoms appear, this may indicate serious problems that cannot be easily gotten rid of. If you have liver problems, the following functions may be affected:
- filtration and processing of toxic products coming from the gastrointestinal tract;
- the production of protein molecules, their accumulation, the transformation of amino acids, the formation of urea and the synthesis of creatine;
- formation and storage of glycogen;
- storage and transformation of many vitamins (A, PP, B, D, K), metal ions of iron, copper, zinc, manganese, molybdenum, etc.;
- production of enzymes involved in metabolic processes;
- maintaining a balance between the coagulation and anticoagulation systems of the blood, the formation of heparin;
- deposition of blood plasma and formed elements, regulation of the blood system.
Problems with the gallbladder, pancreas, spine and many others are mistakenly mistaken for liver problems. Pain in the liver can appear when it is enlarged and stretches its own capsule, but usually these are already advanced problems.
Problems with the gallbladder, pancreas or spine are often mistaken for liver problems.
Diseases of the bile and hepatic ducts and their manifestations
Causes of diseases of the bile ducts:
- parasites;
- tumors of the mucous membrane and submucosal layer;
- heterogeneous consistency of bile;
- damage to the duct by calcifications.
The main risk group is women, because they are more likely than men to experience hormonal problems and suffer from excess weight.
Blocked ducts
Most often, the ducts become blocked due to cholelithiasis. Obstruction can also be caused by a tumor, inflammation of the walls of the ducts, a cyst, helminthic infestation, or a bacterial infection. Narrowing of the ducts (strictures)
The main reason for this pathology is a previous operation to remove the gallbladder or tumor, cyst in the duct. Inflammation persists for a long time after surgery, which leads to narrowing. The patient loses appetite, experiences pain in the right side, and his body temperature rises.
Screeds and scars
The walls of the duct are replaced by scar tissue due to inflammation caused by sclerosing cholangitis. As a result, the outflow of bile is disrupted, it is absorbed into the blood and stagnates in the gallbladder. There are no symptoms, but as the disease progresses, liver cells die.
Swelling
The walls of the bile ducts become denser due to catarrhal inflammation. In this case, overcrowding of the blood vessels occurs, the mucous membrane of the duct swells, leukocytes accumulate on the walls, and the epithelium exfoliates. Often this disease becomes chronic. At the same time, he constantly experiences discomfort in the right side, he is tormented by nausea, and vomiting occurs.
Cholelithiasis
Stones in the biliary system are formed due to stagnation of bile in the gallbladder and disruption of cholesterol metabolism. For treatment, medications are prescribed, under the influence of which the stones leave the gallbladder through the ducts. The patient feels a stabbing, cutting pain in the right side. A large stone may partially or completely block the duct. This is called gallbladder spasm. Its symptoms are pain, nausea, vomiting.
Tumors and metastases in cancer
Klatskin tumor is often found in older patients with biliary problems. In 50% of cases, a malignant tumor forms in the common bile duct. If left untreated, metastases appear, affecting regional lymph nodes, pancreas, and liver. The disease can be detected at an early stage if the symptoms are not ignored: pain in the right hypochondrium, which radiates to the neck and shoulder blade.
Parasites
Trematodes, Giardia, and flukes may appear in the gallbladder and ducts. They cause chronic inflammation of the walls of the gallbladder and disrupt the contractile function of the ducts.
Free or paid treatment?
Dyskinesia
With this disease, the consistency of contraction of the walls of the gallbladder and its ducts is disrupted. As a result, bile enters the duodenum in deficiency or excess, which disrupts the process of digestion and absorption of nutrients.
Cholangitis
Inflammation of the bile ducts occurs when they become blocked or liver secretions become infected with bacteria. There are three types of inflammation:
- acute, occurring unexpectedly - a person has a headache, the skin turns yellow, a stabbing pain appears in the right hypochondrium, which radiates to the shoulder and neck;
- chronic – mild pain on the right side, increased body temperature, bloating of the upper abdomen;
- sclerosing - there are no symptoms, and if left untreated, liver failure develops, which cannot be cured.
Extension
Most often it occurs due to increased contractility of the walls of the gallbladder. There are other reasons - blockage of the common duct with a tumor or stone, improper functioning of the sphincters. As a result, the pressure in the biliary system increases and the ducts expand.
Biliary atresia
This is a blockage or absence of the bile ducts. The disease is found in newborns. The child's skin becomes yellow-green, the urine darkens, and the feces become white-gray. If the pathology is not treated, the child will not live more than one and a half years.
Drugs
Liver problems can develop for more than 10 years and not bother you at all. The average life expectancy with a diagnosis of cirrhosis is 9 years. Therefore, even if you have liver problems, you can fight them. There are about 1000 types of drugs used in hepatology. Therapy not only treats the disease itself, but also supports the liver in order to create the most favorable conditions for recovery. One of these groups of drugs are hepatoprotectors. Hepatoprotectors help restore metabolic processes in the liver, increase the organ’s resistance to destructive factors, normalize functional activity and stimulate regenerative processes in the liver.
Requirements for hepatoprotectors
Since the liver is the organ through which many substances are exchanged, drugs must not only be powerful, but also meet certain safety requirements, as well as:
- well absorbed;
- have a “first pass” effect through the liver;
- have the property of neutralizing or preventing the formation of substances that damage the liver;
- reduce the activity of inflammatory processes;
- slow down scar formation;
- help liver regeneration;
- do not cause rejection in case of liver pathology;
- extensive enterohepatic circulation;
- have no toxic effect.
Despite the fact that the requirements are known, the ideal drug has not yet been created. More than half of the presented products are of plant origin, the rest is divided between phospholipids, synthetic derivatives, organic preparations and amino acids.
Despite the fact that the requirements for liver drugs are known, the ideal one has not yet been created.
List of medications
Groups of hepatoprotectors are divided depending on their composition.
Group I: milk thistle flavonoids can include both natural extracts from plants and those produced synthetically:
- Legalon;
- Karsil;
- Gepabene;
- Silimar.
These products contain a substance from milk thistle - silymarin (silibinin). It protects and stabilizes cell membranes. Milk thistle has a powerful antitoxic effect and can help with poisoning with toadstool. True, in this case a modification with intravenous administration is used. It also has antioxidant and metabolic effects and accelerates the regeneration of hepatocytes. The formation of scar tissue in the organ slows down.
Cholestasis, that is, obstructed outflow of bile, may be a contraindication for use. If this is ignored, drug congestion may worsen.
Usually the course of treatment is about 4 weeks, then take a break.
Group II: other flavonoids, except milk thistle:
- Katergen;
- Chophytol;
- LIV 52;
- Hepaliv.
Chophytol has a choleretic and hepatoprotective effect due to the content of artichoke leaf extract. It can also reduce the level of “bad” cholesterol in the blood if the level is initially high. The advantages of the drug include its low toxicity.
Liv 52 helps strengthen the liver's defenses against toxins and contains components widely used in Indian medicine. But the use of the drug in the acute inflammatory phase is unsafe and can increase inflammation. Therefore, it is recommended to use the drug when the regeneration phase is active and the liver needs support.
Group III: hepatoprotectors from animal organs:
- Hepatosan;
- Sirepar.
Hepatnosan – dried animal hepatocytes. In the intestines it absorbs toxins. Once digested, the nutritional components of the cells are absorbed and delivered to the liver. They work as protective factors at the level of liver cells and restore the activity of hepatocytes. The drug helps accelerate reparative processes.
Sirepar is a hydrolyzate of cattle liver extract. Contains 10 mg of cyanocobalamin per ml. Promotes liver regeneration and has a cleansing effect. It should not be used during the active phase of the disease, as the inflammatory process may intensify. It is taken for chronic hepatitis and cirrhosis, poisoning with toxins and drugs.
Some drugs should not be used during the active phase of the disease, as the inflammatory process may intensify.
Group IV: drugs containing essential phospholipids:
- Essentiale forte;
- Essliver forte;
- Phosphogliv forte.
Phospholipids, including phosphatidylcholine, are the most important component, from which most of the membranes of the liver cells themselves consist, like bricks. Phospholipids have been isolated and studied for almost 50 years, various experiments have been carried out. By restoring cell membranes, the liver normalizes its function. They are used for a very wide range of diseases. The course of treatment usually lasts about 3 months in the absence of contraindications and undesirable effects.
Funds from other groups not included in the first four:
- Lipoic acid;
- Hepa-mertz;
- Non-steroidal anabolics (methyluracil, sodium nucleinate);
- Ursofalk;
- Heptral.
From this group, we will analyze in detail Ursofalk, as a drug that is widely used among doctors. The active substance (ursodeoxycholic acid) helps protect the organ and has a choleretic effect. Used to dissolve gallstones. Reduces toxic effects on the epithelium of the bile ducts in the liver and hepatocyte membranes. Facilitates the removal of bile from the ducts, thereby facilitating the removal of toxins.
It has contraindications in the form of a non-functioning gallbladder, inflammatory bowel diseases, bile ducts, gallstones with a high calcium content (visible on an x-ray), in general, any conditions that will interfere with the increased outflow of bile from the liver. Also cirrhosis is in the stage of decompensation.
Types of diseases
There are a large variety of gallbladder diseases, but they can all be divided into main types:
- Inflammatory processes - caused by fungi, viruses, infections, can cause a disease such as non-calculous cholecystitis;
- Stagnation of bile. Due to the disturbance in the composition of bile, there is an increased risk of cholelithiasis;
- Neurological diseases. Due to a disruption in the flow of impulses into the gallbladder, the release of the required amount of gastric juice fails;
- Hereditary predisposition and genetic abnormalities. Most often, a congenital bend of this organ is observed;
- neoplasms in the gallbladder: polyps, malignant tumors.
Conclusion
There are many hepatoprotectors, they differ in composition and mechanism of action. Doctors have an ambiguous attitude towards them; many of them are used and produced only for the territory of post-Soviet countries. Sometimes you can find reviews that a person, after quitting an alcohol binge, drank a certain drug for 3 months and his tests improved. This could have happened not because of the drug, but because the toxins stopped affecting the liver, and it was able to recover to a certain extent.
When exposure to toxins ceases, the liver itself can recover to a certain extent.
The main thing in treating the liver is not taking medications to compensate for the damage we cause ourselves, but stopping exposure to toxins and other destructive factors. That is, you need to give up alcohol, smoking and extra pounds (the risk of non-alcoholic fatty hepatosis). Because by alternating courses of medications with an unhealthy lifestyle, we create the illusion of well-being. If you suspect that something is wrong with your liver, be sure to consult a doctor. Incorrect self-medication for liver problems can only cause harm.
