Cups per day leads to cirrhosis
The liver is the largest organ in our body, weighing 1200-1500 mg, and makes the fiftieth part of total body weight.The child is relatively larger, and makes her part of the eighteenth. It is located in the right upper abdomen and protected by the ribs.
The upper edge of the liver is projected at the level of the nipple. We distinguish two liver lobes: left, lower, and right, which is six times higher.
The functional unit of the liver lobules or režnjić. The liver plays a central role in the metabolism of proteins, carbohydrates, fatty acids, vitamins and minerals, hormones, and bile production in the detoxification of drugs. For these reasons, the liver is called "chemical factory" of the body.
Spiders on the skin (spider naevus)
Among the most important clinical manifestations of liver disease include: weakness, fatigue, loss of appetite, jaundice, itchy skin. Disruption of water and electrolyte metabolism manifested consequent swelling of the abdomen and legs. Skin manifestations are arachnoids moles on the skin above the nipple, tendon contractures and red palms. Due to disturbances in the metabolism of hormones, there may be a breast enlargement in men, hair loss, shrinking of the testicles and impotence and loss of menstrual periods in women. Impaired liver function leads to disruption of blood clotting that can manifest bleeding into the skin and mucous membranes. Because of impaired blood flow through the liver harmful compounds from the gut can directly enter the bloodstream and lead to impairment of mental status.
Laboratory parameters for assessment of liver function are: bilirubin, liver enzymes - transaminases (AST and ALT), alkaline phosphatase (AP) and gamma-glutamyl transpeptidase (GGT), the concentration and composition of proteins in blood plasma and blood clotting factors. Transaminase achieve the highest concentration in the blood in conditions of acute liver damage (several tens times higher than normal) and are proportional to the damage to liver cells. AP and GGT were increased in cholestatic liver disease, in whom we have a disturbance in the flow of bile. AP increased during growth and development of children is not a sign of liver damage, but a consequence of building bone. Isolated increased GGT is a sensitive indicator of microsomal enzymes in liver cells, and is usually increased in alcohol liver injury. In determining the causes of liver disease, furthermore, determine the viral markers, autoantibodies (antibodies against its own tissues), the amount of iron and copper in blood and urine, etc..
From diagnostic imaging methods, usually using ultrasound. For quality inspection is necessary that the subject is fasting, a day before consuming food that does not produce large quantities of gas in the intestines. In addition to using computed tomography (CT) and magnetic resonance imaging (MRI).
Liver biopsy is the only diagnostic procedure that provides direct insight into the nature and gravity of damage to the liver parenchyma, because there is no reliable correlation between clinical and laboratory findings, and actual liver damage. Nowadays, most commonly performed percutaneous biopsy a needle under ultrasound control.
By cause of liver disease can be divided into:
• hereditary metabolic liver diseases caused by disorders of metabolism of proteins, fats, carbohydrates, bile salts, copper (Wilson's disease), iron (hemochromatosis) and deficiency of the enzyme alpha-1-antitrypsin,
• viral hepatitis (A, B, C, D, E, G),
• liver damage caused by drugs,
• alcoholic liver disease,
• fatty liver (fatty liver and nonalcoholic steatohepatitis),
• Autoimmune hepatitis (primary biliary cirrhosis and primary sclerosing hepatitis),
• Vascular disease of the liver.
Thirsty liver
Alcohol is the most common cause of liver disease in the Western world, responsible for 40-80% of cases of liver cirrhosis. Alcoholism in the whole world is a major socio-medical problem, particularly because of the constant increase in the number of registered alcoholics. The amount of alcohol consumed and length of drinking well correlated with the occurrence of alcoholic liver disease. Average consumption of alcohol is best stated as the number of units of alcohol a week (1 unit = one glass of wine, 270 ml of 3.5 to 4% of beer or small measure žestog drinks that contain 37 or 40% alcohol), with one unit of alcohol contains seven grams of alcohol. The amount of alcohol consumed can be expressed as the number of grams of alcohol per day, a number of grams of alcohol in a drink can be calculated by multiplying the volume of drink in milliliters by the percentage of pure alcohol in the drinks (spirits = 40% = 12% wine, beer = 5%) and the specific weight of alcohol (0.8). The risk of developing alcoholic liver disease increases dramatically when changing the threshold of 80 grams of alcohol per day for men and only 20 grams of alcohol per day for women. Proved the association between alcohol intake, development of cirrhosis and death from cirrhosis. Threshold amount of alcohol consumed is required for the development of cirrhosis is about 40 units of alcohol a week, or 600 kg cumulative dose of alcohol for men and significantly lower - 150-300 kg for females. Such a cumulative dosage is achieved by consuming a liter of wine a day for 20 years.However, the ability to metabolize alcohol hereditary influences decreased or increased individual sensitivity to alcohol. This phenomenon is recognized, and patients with liver cirrhosis often asked question: "Why is my friend, who is as drunk as me, is diagnosed with liver cirrhosis?"
Alcoholic liver disease is usually divided into three stages, namely: fatty infiltration, alcoholic hepatitis and cirrhosis. Cirrhosis is the final stage of liver disease, characterized by complete disorder of its structure and function. The causes of cirrhosis may be other liver diseases, but the most common cause is alcohol.
The basic assumption is the treatment of alcoholic liver disease strict abstinence from alcohol.
Other significant causes of liver disease viruses. A total of six identified hepatitis viruses that cause liver disease as the first manifestation of infection and a number of viruses, the hepatitis as a manifestation of the disease, while, equally or even more, and affect other organs.
Hepatitis A is known popularly as "infectious hepatitis". It is spread by fecal-oral route (dirty hands), a common source of infection is contaminated water. Preventive measures include adherence to hygiene, and people traveling to endemic areas should drink bottled water or prefabricated, and should not eat fresh fruits and vegetables.
Hepatitis B is a significant public health problem. Picture of acute hepatitis B ranges from asymptomatic forms to the most severe form of liver failure. If the infection persists for longer than six months, we're talking about chronic hepatitis B. In untreated patients, in whom the virus actively multiplies, it comes to the development of liver cirrhosis within five years in 15-20% of patients. Furthermore, in those patients at high risk for developing liver cancer cells.
Prevention of hepatitis B include personal protection measures against contact with infected material, blood tests, pregnancy testing, vaccination and passive immunization as needed.
The acute form of hepatitis C in most patients have no symptoms and the disease is discovered incidentally. The problem is the transition of acute to chronic form of the disease, with subsequent liver cirrhosis and the risk of liver cancer cells. There is currently no vaccine for hepatitis C.
Cause of hepatitis D is also called delta - agent because it is an incomplete virus, which is required for replication of hepatitis B.
Hepatitis E does not exceed the chronic form. The disease is spread contaminated water. Pregnant women may have more severe asthma, which can lead to death of the mother or fetus.
Hepatitis G has only recently been identified, particularly among patients who received transfusions or their transplanted organs.
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