According to the observation of most medical workers, over the past decade, the number of patients with diseases of the digestive system has increased significantly. These include hepatomegaly. It begins with slight discomfort, pain, a feeling of pressure in the right side, but without timely treatment, it progresses to severe liver pathologies.
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What is hepatomegaly?
Hepatomegaly is a syndrome in which the volume of the liver increases. As a symptom, it occurs with certain diseases of the heart and blood vessels, immune disorders, acute viral and bacterial infections, etc. An analysis of the pathology allows us to determine the nature of the disease, the degree of neglect, and associated symptoms.
Hepatomegaly is diagnosed with an enlargement of the liver up to 12 cm along the right midclavicular line or with palpation of an organ in the upper abdomen.
The causes of the disease
The most common factors that trigger the appearance of the syndrome:
- circulatory disturbance, stagnation of fluid in vessels adjacent to the liver;
- inflammation due to exposure to a virus or bacterial pathogen;
- the process of formation of neoplasms in the liver tissue;
- violation of the filtering processes in the liver (as a result of an unhealthy lifestyle, lymphatic pathologies, other diseases);
- diffuse changes in the liver, for example, associated with a deficiency of elements that are involved in liver activity.
The most common cause of liver enlargement is called circulatory disorders - the defeat of blood vessels adjacent to the organ by blood clots. Another option is the extremely rare Budd-Chiari syndrome - a thrombotic formation in the hepatic veins, which leads to the inflow of the inferior vena cava into the system. Oncological processes affecting blood cells, for example, leukemia are a rare cause of hepatomegaly of this kind.
The second most frequent is the group of viral and bacterial diseases that deform the liver parenchyma (liver tissue), bile ducts, or portal vein. Possible detection of diseases:
- amoebic abscess;
- purulent thrombophlebitis;
- viral hepatitis;
- bacterial mononucleosis;
- cholangitis.
Hepatomegaly becomes a sign of the formation of neoplasms in the liver. It is unlikely that the organ became the focus of the appearance of a malignant tumor, but metastatic lesion is often detected (the movement of cancer cells through the body through blood or lymph, fixing and further progression to a new oncological formation). The syndrome is also noticed in the presence of benign formations - hemangiomas and liver adenomas.
Improper lifestyle, obesity of various nature, alcohol dependence, dramatic weight loss, diabetes mellitus provoke steatohepatitis (inflammation of the liver) and steatohepatosis (accumulation of fat in the liver tissue), which appears as hepatomegaly.
Congenital pathologies, impaired immune function of the body, hormonal imbalance, physical damage to the liver are less frequent but likely causes of organ hypertrophy.
Symptoms and signs in children and adults
Symptoms are directly dependent on the cause of liver enlargement. At the initial stage, they practically do not appear or cause slight discomfort. Later, heterogeneous pains were detected in the right side, nausea, discoloration of the skin, dizziness, skin rashes, stool disorders, etc.
Damage to blood vessels and the heart, insufficiency of the right ventricle lead to a moderate enlargement of the liver, a dull pain of a constant nature quickly appears.
Hypertrophy against the background of infections does not occur for a long time, patients complain of a pulling feeling under the ribs, dull pain that becomes more pronounced during physical exertion, dyspeptic disorders, rashes are observed.
Hepatomegaly on the background of hepatitis is detected as a pain syndrome, compaction of the liver structure (this is easy to detect by feeling the affected area), the skin acquires a yellowish tint, similar to eye proteins. With cirrhosis of the liver, constant pain and parenchyma thickening are accompanied by an earthy complexion, increased bleeding, an arbitrary increase in body temperature, nausea and vomiting.
Primary neoplasms lead to a slow proliferation of liver tissue, so the symptoms are mild and can be detected late. The clinical picture is supplemented by signs: dull pain in the side, swelling, digestive disorders, icteric complexion. When the organ reaches a significant size, abdominal distension is observed, a feeling of compression of adjacent organs.
Toxic damage (excessive use of alcohol or drugs, other chemicals) is often determined only in the form of hepatomegaly, jaundice and an allergic reaction are less often noticed. Inflammatory processes, fatty liver disease have mild symptoms, dull pains and discomfort in the area of the disorder, dyspeptic disorders are recorded.
In children, the phenomenon occurs as a reaction to a viral disease, and with getting rid of the pathogen, the size of the liver independently normalizes. If the cause is another negative factor, possible signs of hepatomegaly:
- weakness, tearfulness, drowsiness;
- yellowing of the skin;
- pain under the ribs;
- lack of appetite;
- rash and manifestation of the vascular network in the affected area;
- disorders of the stool.
Types of liver enlargement
The pathological condition is classified due to the occurrence, degree of tissue hypertrophy and the location of the process.
Within the first criterion, hepatomegaly is isolated due to violations:
- blood circulation;
- metabolism;
- viral and bacterial nature;
- filtering functions;
- hematological nature;
- local character.
The second criterion distinguishes three types:
- moderate hepatomegaly (slight deviation from the normal volume of the liver);
- severe hepatomegaly (an increase in tissue up to 10 cm from the norm);
- diffuse hepatomegaly (size 10 cm more than normal).
Partial hepatomegaly is distinguished - an increase in one lobe of the liver, right or left.
The last criterion - the localization of the violation - distinguishes lesions:
- parenchyma (liver tissue);
- bile ducts;
- adjacent vascular ducts;
- connective tissue.
Diagnostic measures
It is not difficult for a modern hepatologist to identify hepatomegaly - a palpation procedure is performed (palpation of the affected area - the right hypochondrium), percussion (tapping), and ultrasound and CT scan (computed tomography) from the hardware diagnostic methods; a blood test is also required.
But the determination of the fact of liver enlargement itself is practically useless, without establishing the cause of hepatomegaly, it is impossible to prescribe a specific treatment.
The doctor will prescribe a number of procedures and tests to rule out specific causes. For example, to ensure that liver hypertrophy is non-viral in nature, the level of aminotransferases in the blood is measured.
Hepatomegaly in children is detected by palpation and requires immediate treatment.
Treatment methods
The treatment of hepatomegaly directly depends on the nature of the syndrome. To get rid of the unpleasant phenomenon, complex therapy of the disease-cause is required. It includes medicines, traditional medicine and special nutrition aimed at reducing the load on the liver.
Drugs and antibiotics
The main types of drugs that are used for hepatomegaly are hepatoprotectors and antibacterial agents (due to the high frequency of diagnosing viral and microbial diseases).
The table shows the main causes and medications that help to cope with the violation.
| Disease | Preparations |
|---|---|
| Disorders of the blood supply to the liver |
|
| Viral and bacterial infections |
|
| Tumor formations |
|
If the patient has a benign neoplasm, then it requires treatment only in case of significant pressure on neighboring organs.
Folk remedies
The idea of treating hepatomegaly with folk remedies is skeptical of traditional medicine, but when used correctly, they alleviate the symptoms of an enlarged liver and accelerate recovery. It is not recommended to use this type of treatment as an independent one, only with uncomplicated forms of the disease-causes of hepatomegaly and with prior consultation with a specialist.
The main means of traditional medicine for the treatment of enlarged liver include:
- milk thistle preparations;
- peppermint infusion;
- decoction of immortelle inflorescences;
- infusion of chamomile.
Milk thistle preparations are sold in pharmacies in finished form. It is recommended to use 1 teaspoon of the product 3 times a day.The course of treatment depends on the disease, on average - 1 month.
Peppermint infusion is prepared according to the instructions: send 2 tablespoons of dry raw materials to 1.5 liters of boiling water, leave to infuse overnight, preferably a day. The resulting amount of liquid is divided into three doses and consumed during the day during breakfast, lunch and dinner. The duration of treatment is 7-9 days.
A decoction of immortelle is prepared on the basis of 10 g of plant flowers and 250 ml of warm water (not hot). The container with the components must be sent to a water bath and kept on low heat for 30-40 minutes. Strain, dilute with water to make a glass of liquid. Take 1 tablespoon three times a day.
From chamomile make infusion: 2 tsp. dry preparation (it is easy to find in a pharmacy) pour a glass of boiling water, stand for 4-5 hours in a thermos or tightly closed container. Take ¼ cup per day.
Diet for hepatomegaly
Liver lesions require a reduction in the burden on the organ by following a specific diet - table 5.
Depending on the complexity of the pathology, the severity of nutrition is determined by the doctor: sometimes it is enough to adhere to the basic principles of the table, and in other cases, an accurate calculation of the amount of nutrients for the body is required.
The purpose of the diet is to normalize the liver, improve bile secretion. The principles on which table 5 is based:
- the standard amount of protein and carbohydrates (with the exception of fast ones), but the restriction of consumed fats;
- the complete exclusion of food products that contain cholesterol, essential oils, purines, oxalic acid;
- fats that are oxidized during heat treatment are contraindicated;
- necessarily high consumption of fiber, pectins, lipotropic elements;
- fractional nutrition;
- food - in the form of mashed potatoes or carefully chopped;
- moderate salt intake;
- minimum fluid intake on an empty stomach.
Diet is not a treatment method, only a way to eliminate the negative factors that exacerbate the disease. You should not prescribe it yourself without a preliminary diagnosis and doctor's recommendation.
Features of the development of the disease during pregnancy
Hepatomegaly during pregnancy is due to the condition of the woman or acquires specific symptoms during this period.
Significant changes in the body caused by the bearing of a child can provoke undesirable reactions. For example, the situation becomes the cause of intravenous cholestasis in pregnant women. This is a benign formation that occurs in the third trimester and independently resolves after childbirth. Accompanied by skin itching, jaundice. The size of the liver changes uncritically. Treatment is necessary only to get rid of unpleasant symptoms.
More dangerous is another disease - acute fatty degeneration of the liver of pregnant women. Accompanied by weakness, drowsiness, vomiting. Later jaundice is detected, in advanced form - hepatic encephalopathy. Without timely treatment, progresses to fulminant liver failure.
Especially acute in pregnant women manifests viral hepatitis. It begins with severe fever and sharp pain in the right side under the ribs. It requires urgent treatment, otherwise the likelihood of mortality increases to 50%. After birth, the baby should also be examined for signs of the virus.
The most common form of thrombosis in pregnant women is Budd-Chiari syndrome. It begins with severe abdominal pain, a strong enlargement of the liver, ascites (the abdomen increases, weight quickly builds up). Often requires liver transplantation, especially in pregnant women.
Consequences and Complications
Without proper treatment, hepatomegaly, depending on the cause, can progress to cirrhosis, liver failure, liver dysfunction.
Violations of the blood supply to the liver can be complicated by thrombosis, internal hemorrhage.
The lack of treatment, especially when the body is damaged by acute viral infections, can lead to complete organ failure and death.
Benign neoplasms due to a critical enlargement of the liver can press on other organs, malignant ones can progress to a complicated cancerous tumor, which, as a result of metastasis, spreads throughout the body.
Preventative measures
Standard prevention includes measures to prevent the development of disease-causes. It is also necessary to minimize the impact of factors that increase the risk of developing a negative phenomenon:
- do not often eat foods rich in cholesterol, nutritional supplements, saturated fats;
- minimize the amount of alcohol consumed;
- observe personal hygiene rules to exclude viruses;
- special care should be taken with a genetic predisposition to impaired liver function.
Hepatomegaly is not a disease, but a sign of pathology. Do not immediately panic - an enlarged liver does not always indicate a serious violation. It is necessary to pass all the required tests and begin complex treatment.
