Sunday, February 5, 2012

The clinical symptoms of liver disease

Introduction

Liver disease is expressed in many different ways. Indicators of liver diseases that are of particular importance as jaundice, cholestasis, increased liver, portal hypertension, ascites, hepatic encephalopathy and liver failure.

Liver disease doctor diagnosed based on symptoms described by patients and physical examination.


The main clinical symptoms of liver disease

Jaundice (icterus)

Enlarged liver (hepatomegaly)

The fluid in the abdomen (ascites)

Confusion because of encephalopathy

Gastrointestinal bleeding due to varices

Portaina hypertension

Skin

• Varicose veins like spider

• Red palms

• ruddy appearance

• Itching

Blood

• Reduced number of red blood cells (anemia)

• Reduced number of white blood cells (leukopenia)

• Reduced number of blood platelets (thrombocytopenia)

• A tendency to bleed (coagulopathy)

Hormones

• High levels of insulin, but the weak response to it

• Cessation of menstruation and decreased fertility (in women)

• Impotence and effeminate appearance (in men)

Heart and blood vessels

• The acceleration of heart rate and amount of blood ejected

• Reduced blood pressure (hypotension)

General symptoms

• Fatigue

• Weakness

• Weight loss

• Poor appetite

• Nausea

• Fever





Icterus

(Jaundice)

• Introduction • Symptoms • Diagnosis and Treatment



Introduction

Jaundice is a yellow discoloration of the skin and scleral (white of the eye) prouzročeno abnormally high levels of bile pigment bilirubin in the blood stream.



Old or damaged red blood cells (erythrocytes) from the circulation largely removes the spleen.During this procedure, hemoglobin, red blood cells of which carries oxygen, is decomposed into

bilirubin. Bilirubin is transferred to the liver and excreted into the intestine as a component of bile. If the excretion of bilirubin is disabled, the excess bilirubin passes into the bloodstream, which results in the formation of jaundice.



High levels of bilirubin in the blood may be due to inflammation or other abnormalities of liver cells, which prevents the excretion of bilirubin in the bile. Alternatively, bile ducts outside the liver may be blocked gallstone or tumor. Less frequently high levels of bilirubin may result from destruction of a large number of red blood cells, as sometimes occurs in newborns with jaundice.



In Gilbert's syndrome, the bilirubin level was slightly elevated, but usually not enough to cause jaundice. It is sometimes hereditary condition usually discovered during a routine search results (screening) of liver function, the state has no other symptoms or causes problems.



Symptoms

In jaundice the skin and whites of the eyes yellow. The urine is often dark because of bilirubin excretion by the kidneys. There are also other symptoms depending on the cause of jaundice, for example. liver inflammation (hepatitis) can cause loss of appetite, nausea and vomiting, and fever. Stopping the bile can cause symptoms of cholestasis.



Diagnosis and Treatment

To determine the cause of jaundice doctor uses laboratory tests and imaging tests. If the problem is the disease of the liver, for example. viral hepatitis, jaundice will usually disappear as the state of liver repair. If the problem is in the common bile duct occlusion, it is usually as quickly as possible to do surgery or endoscopy (a procedure using flexible tubes to observe the surgical connections) to be blocked bile path to reopen.







Cholestasis (cholestasis)

• Introduction • Symptoms • Diagnosis • Treatment



Introduction

Cholestasis is to reduce or halt the flow of bile.

The flow of bile can be weakened at any point between the liver cells and duodenum (upper small intestine). Even when the bile does not flow, the liver continues to adapt the bilirubin, which escapes into the bloodstream. Then the bilirubin deposited in the skin and comes into the urine, causing jaundice.

For the purpose of diagnosis and treatment of causes of cholestasis are divided into two groups: those

derived from the liver and those who cause beyond the liver.



Causes within the liver include hepatitis, alcoholic liver disease, primary biliary cirrhosis, the effects of drugs and the effects of hormonal changes during pregnancy (a condition called cholestasis maternity).



Causes outside the liver are gall stones in the water, a narrowing (stricture) duct, common bile duct cancer, pancreatic cancer and pancreatitis.



Symptoms

Jaundice and dark urine originate from the large amounts of bilirubin in the skin and urine. The chair is sometimes pale due to lack of bilirubin in the intestine. Stool may contain too much fat (a condition called steatorrhea) because bile in the intestine there to help digest fat from food.



Lack of bile in the intestine also means that calcium and vitamin D is not absorbed properly. If cholestasis persists, the lack of these nutrients can cause bone loss, which can lead to pain and fractures. Poorly absorbed substances that are necessary for blood clotting, which creates a tendency to bleed easily.



Retention of bile products in the circulation can cause itching (with resultant scratching and skin damage). Due to prolonged cholestatic jaundice created a dirty color and yellow fatty deposits in the skin. The causal agent of cholestasis determines whether people have other symptoms such as abdominal pain, loss of appetite, vomiting or fever.



Diagnosis

To determine whether the cause is within the liver, the doctor examines the symptoms of hepatitis, abundant intake of alcohol or taken drugs shortly that can lead to cholestasis. Small, spider-like blood vessels visible in the skin (called spider nevi), enlarged spleen and free fluid in the abdominal cavity (ascites) means the disease of liver cells. If the cause is outside the liver, the person may have chills, pain from the biliary system or pancreas, and gall bladder increased (the doctor can detect palpable or imaging tests).



For people with cholestasis is typical that their levels of an enzyme called alkaline phosphatase in the blood is very high. Blood test that measures the level of bilirubin indicates the severity of cholestasis, but not its cause.



If the results of blood tests were abnormal, almost always for U.S., CT, or both. This helps the doctor distinguish between liver disease and bile duct closure. If it appears that the cause in the liver, can do a liver biopsy (taking a sample of tissue for microscopic examination). Biopsy usually establishes the diagnosis. If it appears that the cause of the blockage of bile ducts, often this is an endoscopic procedure (using a flexible viewing tube) to clarify the nature of the blockade.



Treatment

The blockade outside the liver can usually be treated with surgery or therapeutic endoscopy (a procedure that involves the use of flexible pipe connections with surgery). Blockage within the liver can be treated in different ways depending on the cause. If the suspected cause of a medication, a person should stop taking it. If the blockade is responsible for hepatitis, then cholestasis and jaundice usually disappear when you stop hepatitis.



For the treatment of pruritus can be taken orally (by mouth) cholestyramine. This drug binds with certain bile products in the intestine, so they can re resorbirati and cause skin irritation.



As long as the liver is severely damaged by vitamin K intake can improve blood clotting. If cholestasis persists, often taking extra calcium and vitamin D, but they are not very effective in preventing bone disease. If too much fat in the stool extract, a person may give further triglycerides.





HEPATOMEGALIA

(Increase in liver)



Increase in liver (hepatomegaly) indicates liver disease. Although so many people with liver disease have normal liver size or even skvrčenu liver. Enlarged liver usually causes no symptoms. However, if the increase is strongly expressed, can cause an upset stomach or feeling of fullness. If the increase occurs rapidly, the liver may be sensitive to the touch. The doctor usually assesses the size of the liver during the physical examination, blindly through the abdominal wall.



Touching the liver, the doctor notes, and its structure (structure). Increased liver is usually soft in acute hepatitis, fatty infiltration, the delays (congestion), or blood in the early stages of narrowing (obstruction) of bile tract. Liver ječvrsta and illegal, if cirrhosis is the cause of its increase. Express nodes usually indicate cancer.





Hypertensio PORTALIS

(Portal hypertension)

• Introduction • Symptoms • Diagnosis and Treatment



Introduction

Portal hypertension is abnormally high blood pressure in the portal vein, large vein that carries blood from the intestines to the liver.

The portal vein receives blood flowing out of the whole intestine and the spleen, pancreas and gall bladder. After entering the liver, blood, forming a small ducts circulating liver. When blood leaves the liver, flows back through the hepatic vein into the general circulation.



In the portal blood vessels can increase blood pressure, two factors: the volume of blood flowing through blood vessels and increased resistance to blood flow through the liver. In Western countries, the most common cause of portal hypertension is increased resistance to blood flow caused by cirrhosis.



Portal hypertension leads to the development of venous blood vessels (called collateral vessels) that connect the portal system to the general bloodstream, thus bypassing the liver. Because of this detour, the substances that are normally removed by the liver from the blood can enter the general circulation. Collateral vessels develop in special places, most of which is the lower end of the esophagus. There vessels become swollen and sinuous, ie. become varicose veins (called esophageal varices). These swollen veins are very fragile and sometimes prone to bleeding. The other collateral vessels can develop around the navel and the rectum.



Symptoms and diagnosis

When portal hypertension is often an enlarged spleen. The fluid may come out of the liver and expand the abdominal cavity, and that the free fluid in the abdomen called ascites. Varicose veins in the lower end of the esophagus and gastric mucosa bleed easily, sometimes a lot.Varicose veins in the rectum may also bleed, although this is much rarer.



The doctor can usually palpable spleen increased through the abdominal wall. The liquid in the abdominal cavity can be detected by observing and listening to the abdomen nateknutog muklih sounds during tapping (percussion) of the abdomen. Rtg UZ and provide considerable information on the portal hypertension. UZ can be used to examine blood flow in the portal blood vessels and can detect the presence of fluid in the abdomen.



To test the increased vein can be used, and CT. The pressure in the portal system can be directly measured with a needle which pierces the abdominal wall to the liver or spleen.



Treatment

In order to reduce the risk of bleeding from esophageal varices, the doctor tries to reduce the pressure in the portal vein. One way is by giving propranolol, a drug used to treat high blood pressure.



Bleeding from esophageal varices is a medical emergency. Drugs such as vasopressin or octreotide can be given intravenously to constrict the veins that bleed, and blood transfusions are given to replace blood lost.



Endoscopic examination is usually done to confirm bleeding varices. Veins can clog rubber bands or giving chemical substances through the endoscope. If bleeding continues, through the person's nose and down into the esophagus can be brought into the catheter with a balloon on the end. Balloon inflation pressures are varicose veins and usually stops the bleeding.



If bleeding continues or occurs again, we can make a surgical bypass procedure (called a shunt) between the portal venous system and the general (systemic) venous system. This lowers the pressure in the portal vein, because the pressure in the general venous circulation is much lower. There are different types of operations portal-systemic shunt, including those that can be done in the radiological department using special devices under the control of X-rays. Shunt surgery is usually successful in stopping the bleeding, but are relatively dangerous. They also increase the risk of disruption of brain function due to liver failure (hepatic encephalopathy).





ASCITES

• Introduction • Causes • Symptoms • Diagnosis and Treatment



Introduction

Ascites is the accumulation of free fluid in the abdominal cavity.

Ascites occurs more often in long-term (chronic) than in short-term (acute) conditions. It most often occurs in cirrhosis, especially if caused by alcoholism. Ascites can also occur in conditions that do not affect the liver such as cancer, heart failure, kidney failure and tuberculosis.



In patients with liver disease, fluid leaks from the surface of the liver and intestines. Responsible is a combination of factors including the portal hypertension, decreased ability of blood vessels to retain fluid, fluid retention in the kidneys and changes of various chemical substances and hormones that control body fluids.



Causes of ascites

Liver Disease

• cirrhosis, especially cirrhosis caused by alcohol

• Alcoholic hepatitis without cirrhosis

• Chronic hepatitis

• Blockage of hepatic vein

Extrahepatic

• Heart failure

• Kidney failure, nephrotic syndrome, especially

• constrictive pericarditis

• carcinomatosis in which the cancer has spread to places in the abdominal cavity

• Tuberculosis, which affects the abdominal membrane

• Reduced active thyroid

• Inflammation of the pancreas



Symptoms and diagnosis

Small amounts of fluid in the abdomen do not usually make the symptoms, but large quantities causing abdominal distension and discomfort and dyspnea. When the doctor perkutira (bitch) the abdomen, the fluid makes a dull sound. When the stomach contains large amounts of fluid, the abdomen is tense, and the belly button (umbilicus) straight or even convex. In some people with ascites when excessive tekućini swollen ankles (edema).



If the existence or cause of ascites is not clear, it can be used with. Alternatively one can take a small sample of fluid penetration of the needle through the abdominal wall, a diagnostic procedure called paracentesis. In identifying the causes can help laboratory fluids.



Treatment

Thorough treatment of ascites is bed rest in bed and no salt diet, usually combined with drugs called diuretics, which cause more fluid excretion in the urine. If ascites is causing difficulty in breathing or eating the food, the fluid can be removed with a needle, a procedure called therapeutic paracentesis.



If the person does not take diuretics, the fluid tends to accumulate in the stomach again. Often the blood into the abdominal cavity are losing large amounts of albumin (the most frequent protein in the blood), and albumin may be given intravenously.



For unclear reasons, sometimes infects tekućina ascites, especially in people with alcoholic cirrhosis. This infection is called spontaneous bacterial peritonitis treated with antibiotics.





ENCEPHALOPATHIA hepatis

(Hepatic encephalopathy)

• Introduction • Symptoms • Diagnosis and Treatment



Introduction

Hepatic encephalopathy (also called portal-systemic encephalopathy, hepatic encephalopathy or hepatic coma) is a disorder in which brain function deteriorates because they accumulate in the blood of toxic substances, which would normally remove the liver.



Substances absorbed into the bloodstream from the intestine pass through the liver, where toxins are removed. In hepatic encephalopathy toxins are not removed, because the damaged liver. In addition, since the connections are created between the portal system and the general blood circulation (as a result of liver disease), some poisons can completely bypass the liver.The same effect can have bypass surgery that is built to improve portal hypertension (porto-systemic shunt). Whatever the cause, the outcome is the same: to get the poisons can damage the brain and its functions. What substances are toxic to the brain is not fully known, however, seems to be a role with high levels of degradation products of proteins, such as ammonia.



In people with long-term liver disease trigger encephalopathy is usually an event, eg. acute infection or a party where the drinking large quantities of alcohol, which increases the already existing liver damage. The trigger may be taking a lot of foods rich in protein which increases the level of their degradation products in the blood. The accumulation of degradation products of proteins, which can directly damage the brain, can cause bleeding in the digestive system such as that from esophageal varices. Some medicines, especially some sedatives, analgesics and diuretics, can also be a trigger for the formation of encephalopathy. When the causative factor is removed, the encephalopathy may disappear.



Symptoms and diagnosis

Symptoms of hepatic encephalopathy as a result of reduced brain function, particularly impaired consciousness. In the earliest stages appear slight changes in logical thinking, personality and behavior. There may be changes in the patient's mood disorder and judgment.



With the disorder progresses, the person usually becomes drowsy and confused, a speech and movements become sluggish. It is a common confusion. A person with encephalopathy may be agitated and excited, but not often. Epileptic seizures are also rare. Finally, a person can lose consciousness and fall into a coma.



Symptoms of the damaged brain function in people with liver disease provide a strong key to the diagnosis. Person's breath can have a sweet smell. When a person stretched out arms, hands can not keep still, but shows a rough shaking (tremor).



The early diagnosis of hepatic encephalopathy may aid EEG (electroencephalogram). It shows abnormal brain waves, even in mild cases. Blood tests usually show abnormally high levels of ammonia.



Treatment

The doctor asks and seeks to remove the cause, such as infection or medication that a person takes. The doctor is also trying to remove the hose from toxic substances. Removed from the diet is protein, a major source of carbohydrate calories become taken orally (by mouth) or given intravenously. Synthetic sugar (lactulose), taken orally (by mouth), has three beneficial effects: it removes the acidity of the intestine by changing the type of bacteria present, reduces the absorption of ammonia and acts as a laxative.



They can be given and enema to clean. Sometimes a person instead of lactulose may take an antibiotic, neomycin. Neomycin reduces the intestinal bacteria that normally help to digest protein.



Hepatic encephalopathy is often the treatment can recover. In fact a full recovery is possible, especially if the encephalopathy was precipitated some fixable cause. However, the difficult people in a coma, which is the result of an acute inflammation of the liver, a condition in spite of intensive treatment in 80% of fatalities.





Liver failure

• Introduction • Symptoms • Diagnosis and Prognosis and treatment



Introduction

Liver failure is difficult to deterioration of liver function.

Hepatic failure may be due to any kind of liver disorders including viral hepatitis, cirrhosis and liver damage by alcohol or drugs such as acetaminophen. To lead to liver failure has to be damaged by its substantial part.



Symptoms and diagnosis

A person with liver failure usually has jaundice, tendency to bruising or bleeding, ascites, damaged brain function (hepatic encephalopathy) and generally poor health. Other common symptoms include fatigue, weakness, nausea and loss of appetite.



In liver failure strongly suggests clinical indicators alone. Blood tests usually show a severely damaged liver function.



Prognosis and treatment

Treatment depends on the cause and specific clinical indicators. The person is usually placed on the restricted diet. Carefully controlled protein intake: too much protein can cause damage to brain function and cause weight loss too.



Intake of sodium should be reduced to a small amount to affect the accumulation of fluid in the abdomen (ascites). Alcohol should be completely avoided because it can worsen liver damage.



Liver failure is fatal if untreated or if the liver disease progresses. Hepatic failure may be impossible to repair, even after treatment. In terminal cases, the exhaustion of the liver, a person can die of kidney failure (hepatorenal syndrome). Liver transplantation, if done early enough, the person can return to normal, but is acceptable only for small number of patients with liver failure.

Risk factors for liver disease

The liver is the largest gland in the human body - it weighs around 1500g and has a number of important functions - over than 500 One is the secretion of bile. Bile is necessary for the breakdown of fats and helps in the absorption of fat soluble substances, including vitamins A, D, E and K. Bile is stored in the gall bladder and secreted during digestion. All substances that are absorbed from the intestine to the liver with blood coming into a place where many important metabolic processes, under which the synthesis of various substances necessary for the functioning of the organism, as well as the detoxification of certain harmful products products (converts harmful and toxic substances from the bloodstream into harmless compounds which is easily excreted from the body). 
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The liver is important for the regulation of glucose and cholesterol levels (involved in the metabolism of carbohydrates, fats, vitamins and minerals), for the synthesis of most proteins that circulate in the blood and carry out immune functions. Despite the fact that the liver is being held in many important life processes, and to liver disease are the tenth leading cause of death, the liver and its diseases, are often not given enough attention. The reason is the insufficient knowledge of the functions of the liver, but the fact that the symptoms of liver disease are usually nonspecific and occur gradually.
Liver damage from any cause can affect these functions that lead to various disorders and diseases, such as. elevated levels of cholesterol, digestive disorders (including constipation), vomiting, hypersensitivity syndrome, cancer, allergies, abnormal blood sugar levels, chronic fatigue and pain.
Do liver function abnormalities may occur due to various causes, for example due to viral hepatitis, liver disease caused by the excessive consumption of alcohol or other substances toxic to liver cells, liver cirrhosis, liver cancer and other diseases of the liver and other organs.When liver blood is elevated concentrations of liver enzymes that are running out of damaged cells.
The symptoms reflect dysfunction and liver damage include fatigue, weakness, abdominal pain, loss of appetite, yellowing of the skin and mucous membranes (jaundice), itching of the skin, easy bleeding, formation (due to disturbance of blood clotting factors). In advanced liver disease with cirrhosis, there are accumulation of fluid in the lower legs (edema) and abdomen (ascites), the propensity to bacterial infections, a tendency to bleeding in the digestive system, mental confusion and coma, and renal failure.
Risk factors for the disease jestre are many - some are congenital (a disorder of metabolism of certain elements and substances in the body), and many have acquired. The most common cause of liver damage in developed countries is excessive alcohol consumption (liver is the primary site of metabolism of alcohol). It is estimated that approximately 600 000 people in Croatia, excessive alcohol, and the number of registered alcoholics was about 240 000thAccording to recent sources, 20% of the population drinks too much, while 50% had family problems with alcohol. At the same time, it is estimated that in Croatia there are 40% of overweight, the percentage suffering from obesity or have elevated blood fats (hyperlipidemia, high triglycerides and LDL, low HDL), which are also risks for liver damage / disease. The negative effects of cigarette smoke usually considered in the context of a negative effect on the lungs and is often forgotten that smoking is a burden to the liver. Tobacco smoke is rich in toxic compounds (benzapirenom, polycyclic aromatic hydrocarbons, cyanide, tar, etc..) That mature in the blood of smokers, and the task of the liver is the detoxification of each compound.
Also  risk of liver disease and carry the presence of diabetes, use of drugs that damage the liver function (large doses of paracetamol and other NSAIDs, corticosteroids, cytotoxic drugs, amiodarone, tetracyclines), bad hygiene, drug abuse and promiscuous behavior (exposure to hepatitis viruses) .

What to eat for healthy liver?

The food that loves my liver
Nature was very generous when it came to his fingers, kidneys, eyes ... but unfortunately we did not endowed with a spare liver. Liver disease can be found at the tenth place when we talk about the causes of death, and therefore deserves much more attention than it currently pays. The liver is the "quiet authority", I protested, and was largely ignored until something goes seriously wrong.

The physiological functions of the liver
The liver is the largest gland in the human body and also the only internal organ that can regenerate. The liver has many important functions, the most important is the secretion of bile.Bile is stored in the gall bladder and secreted during digestion. This liquid is necessary for the breakdown of fats and helps in the absorption of substances soluble in fats, including fat-soluble vitamins - A, D, E and K. Known is the role of bile in the assimilation of calcium, and the conversion of beta carotene into vitamin A.

The absorption of nutrients takes place as part of a large participation of the liver. All substances that enter the body coming to the liver, which are classified as toxins and other molecules. Strong system of detoxification medication and the liver converts toxins into molecules that can be eliminated from the body via the kidneys (urine) or intestines (feces). The liver is responsible for the synthesis of most proteins that circulate in the blood, and is the organ that plays a key role in regulating blood sugar levels. Physical needs for glucose recorded in the liver, and glucose provides an organism or food digestion breakdown of glycogen - the storage of sugar in the liver and muscles. With prolonged fasting, when it is not possible to ensure blood glucose digestion and reserves in the liver are consumed, the liver starts the process by which amino acids or other molecules of glucose occurs. Fat metabolism is also closely related to the liver. Cholesterol in the liver occurs, and also be delivered to the liver and cholesterol from the blood. The elimination of cholesterol from the liver occurs via the bile.

After a brief insight into a truly sizable number of liver function, ask yourself how much you are actually good for his liver. If you specify it by entering the daily loads of different drugs, alcohol, food additives and excessive amounts of fat? "Toxic", a modern lifestyle that is characterized by pollution, stress, poor nutrition, indiscriminate use of drugs affects the liver, and is sometimes said that the liver is a mirror of our health. However, most people do not develop during the life of "classical" liver disease like hepatitis, cirrhosis or hepatitis. The modern population is much more common "subclinical" liver dysfunction.
In this situation neither optimal nor flawless food digestion process does not ensure an adequate supply of cell nutrients, due to lower conversion of input of nutrients into usable forms in the liver.

Symptoms of "subclinical" liver dysfunction may include a spectrum of disorders such as chronic fatigue, depression, frequent headaches, insomnia, mood swings, PMS. Already during the early forties of last century, dr. Morton Biskind, in medical journals describing the endocrine premenstrual syndrome as a result of inadequate deactivation of estrogen in the liver that is in short supply B vitamins and protein. Gastrointestinal symptoms include nausea, liver dysfunction, fat intolerance, bloating, and diarrhea episodes in prison and loss of appetite.

Risk factors that should be noted

Frequent consumption of large amounts of fatty and fried foods and / or "junk food-a." Foods like French fries, donuts and chips, the source of lipid peroxides (užeglih fats) that are toxic to the liver. Lipid peroxides have a strong immunosuppressive effect and damage the liver cell membrane. Fats that should give priority to the cold-pressed oils such as olive and pumpkin.

Excessive coffee consumption. Kavi is attributed to a number of positive and nagativna properties. In such a slippery slope it is safe to be moderate in order to ensure the body potential positive effects, and prevent adverse effects. Coffee is often treated during the breeding large quantities of pesticides, and during coffee roasting products formed carcinogens.All these compounds must be converted into harmless compounds in the liver during detoxification. Known is the story of writer Johann Wolfgang Goethe, who admired maker in his youth, and when he is old he endured. Biochemical background stories of JW Goethe lies in the "exhaustion of the liver," or at a reduced level of enzymes needed to break down caffeine. This phenomenon is common in elderly people, and joined her, and decreased kidney function, and the substances that must be expelled from the body retain more than in younger patients.
Excessive alcohol consumption. Alcohol is degraded in the liver and excessive alcohol consumption conditional unconditional damage to the brain, liver, pancreas, duodenum and central nervous system. Alcoholism causes metabolic damage to every cell in the body and reduces immune system function. Frequent consumption of alcohol interferes with the production of digestive enzymes in the liver, causing reduced absorption of fat, protein and vitamins soluble in fats and B vitamins (especially vitamin B1 and folic acid). Toxic effect of alcohol on the liver involves the accumulation of fat in the liver (fatty liver), the possibility of hepatitis (inflammatory changes in liver cells), and the occurrence of liver cirrhosis.

Smoking. The negative effects of cigarette smoke on lung unfair to say much more than the effects of smoking on the liver. Tobacco smoke is rich in toxic compounds - benzapirenom, polycyclic aromatic hydrocarbons, cyanide, tar, acetaldehyde, acrolein, etc.. All these compounds into the bloodstream of smokers, and the task of the liver is the detoxification of each compound. You recognized that the task is not easy.

Toxins. Traces of pesticides in food accumulate in the liver and can cause chronic liver damage.It is very important to thoroughly monitor the food treated with pesticides, to avoid undesirable toxic compounds. Insecticides, and additives should also be avoided.

Oral contraceptives. The liver of a woman who has a deficiency of vitamin B group and / or protein tend to turn into non-toxic form of estrogen - estriol, and remains in the form of liver toxic estradiol. Elevated levels of estradiol is associated with emotional disorders such as unstable mood and obsessive - compulsive behavior.

Drugs. Medication burden the liver, as are foreign and unnatural substances to the organism.These substances are forcing the liver to the "overtime" and recommended a selective approach to drugs.

Foods like our liver
The liver is in constant interplay with organs such as kidneys, gall bladder, thyroid, pancreas, and lower part of the digestive system. It is therefore important to provide nutrition that will act favorably on all the internal organs and the systemic health of man. For liver health is unusually important to the proper function of the kidneys, and it is advisable to include in your diet fruits and vegetables rich in potassium, like bananas, almonds, tomatoes, raisins, plums, and provide daily required amount of water (1-2 liters a day). The traditional approach of "cleaning" the liver is regularly drinking the juices of vegetables like carrots, beetroot, radicchio and dandelion.
Overeating is one of the most common cause of reduced liver function. Intemperance in eating and drinking on the liver also makes "overtime" work, a tired liver is not as effective in detoxification of harmful substances such as liver relieved.

Artichoke
Artichoke is a vegetable that belongs to the family of composite, along with herbs milk thistle and burdock. Their common feature is the high proportion of substance silymarin and inulin with zaštitan effect on the liver. Regular consumption of artichoke stimulates liver function and reduces blood fat and cholesterol in the blood, and this effect may be to thank the high percentage of substance cinarina.
Cinarin and caffeic acid, a substance which is rich artichoke, in experiments on animals have proven to be effective hepatoprotective compounds. Inulin, neprobaljivi carbohydrates, has a mild laxative effect and helps with constipation. Liver health is dependent on regular bowel movement, and in periods of imprisonment greater burden on the liver. Inulin is also food for the "good" bacteria in the colon, and encouraging their growth and activity suppresses the growth of pathogenic bacteria in the colon. Thereby reducing the level of toxins that reach the liver, and is held and the health of the whole organism.

Garlic
The medicinal properties of garlic have been known since ancient times. The ancient Roman writer Pliny described the garlic as a cure for 61 medical conditions. With a well-known antibacterial and antiviral activity, the active substances in garlic reduce levels of "bad" cholesterol and raise levels of "good" cholesterol. Garlic contains sulfur compounds that help in detoxification of harmful metals such as mercury, and it is this effect indirectly responsible for the beneficial effects on the liver.

Apples and Pears
This fruit is rich in pectin, dietary fiber soluble in water, which proved to be a means of slightly lowering blood cholesterol levels in several controlled trials. Pectin binds to bile acids, which helps in lowering cholesterol. It is useful to include in your diet and other foods rich in soluble dietary fiber, like oats, rice, plums, citrus, beans, and brussels sprouts.

Pulses
Foods like beans, soy beans are rich in amino acid arginine, which helps in the detoxification of ammonia, toxic by-product generated during protein breakdown. Just place the liver in which this process of detoxification of ammonia.

And bitter greens
Radicchio, arugula, collards, and all dark green leafy vegetables are an excellent source of chlorophyll and other phytochemicals that possess a number of positive impacts on health.
Chlorophyll acts as a "cleaner" blood and liver, and numerous antioxidants protect against the destructive effects of free radicals.
Diet that actually likes our liver is the diet that you should follow everyone who wants to take best of the best. In situations where the liver is damaged and in chronic liver disease with all the tips listed should be careful to enter a sequence of nutrients, like vitamins B, C and E, and some amino acids.

The best-known medicinal herb that is used in diseases of the liver or the sikavica osljebad (Sylibum marianum), and the active substance that is responsible for the positive effects of this plant is silymarin. Silymarin is a flavonoid that is being investigated as a potential aid in all forms of liver disease. The standard daily dose that was used in most experiments was 420 mg. In studies of viral hepatitis in the silymarin used in combination with phosphatidyl - choline.Controlled studies have yielded different results, but the looming effectiveness of this substance in reducing liver damage. It is necessary to conduct more studies on larger number of participants, which will confirm the effectiveness of these agents in the treatment of chronic liver disease.

Save your liver

Increased fatigue, accompanied by headache or reduced concentration, in addition to plenty of sleep, may have a cause of hepatic failure.

Often problems or liver disease associated with alcohol immediately, even though liver problems may also have people who do not drink a drop of alcohol.

In addition to alcohol, the liver burden and chemical agents, dirt from the air, heavy metals in food, fillings, cosmetics, stress, anger, poor diet full of fat, meat, sugar, and too little water movement.

A healthy liver is able to man the normal processing 1l ½ l of beer or wine a day, but only if it is the only alcohol that is consumed on that day.

The amount of alcohol that the liver can be easily processed in women depends on body weight.For instance, a woman with 50 kg can only handle half the amount submitted by the man with 80 kg.

If you have less alcohol in trouble, it could mean that the liver but has problems.

To be able to digest fat, liver to bile acids. Problems in the digestion of fats have the following symptoms: light stools, gas in the intestines, a feeling of pressure in the right abdomen, diarrhea or constipation.

When bile duct obstruction (stones, inflammation, or spasm) which may be the cause and the mental level, not only through the pain of the liver, but also to change chairs.

The liver participates in the deconstruction of the hormone. Its weakness may lead to additional symptoms such as reduced need for sex, problems with impotence, breast enlargement in men or migraine.

By changing diet and taking herbal preparations that clean and strengthen the liver can help this important organ.

The best plants for the regeneration of the liver; gujina grass (osljebad white stičak) lat: Silybum marianum and artichoke. If products with these plants are taken regularly for a while (preferably several months), there is a liver-cleansing, regeneration of damaged and creating new liver cells.

In addition to these herbal remedies, and recommended taking the amino acid L-carnitine and coenzyme Q10.

Food for the sick liver

Nutrition in acute inflammation of the liver

Patients return to normal given, usually liquid or mechanically pulverized diet, but without any sharp spices and less animal and more vegetable fats. Especially note the Podhranjen patients to ensure they are eating the required amounts of all nutrients, especially essential. When liquid diet or soft diet must avoid foods that cause bloating. Acutely inflamed liver is particularly sensitive to alcohol, and it is strictly prohibited and not recommended either by smoking status of patients particularly difficult.

Food patients with chronic liver disease / hepatitis B and C /

In chronic liver disease, until normal function was held, did not need a special diet other than the avoidance of alcohol along with a healthy balanced diet. Upon the occurrence of liver damage normal light diet and avoid alcohol is required.
The diet of patients with chronic liver disease is recommended lean chicken, beef, veal, lamb and fish, and you should avoid the consumption of cured meats, pork, sausage, fattened geese and ducks, and fatty fish. The food should boil, simmer or bake, avoid frying, frying. As a side dish can be served all kinds of pasta and rice, and white, black or corn bread. Not recommended fried noodles and it is rich yeast.
Since vegetables are recommended: potatoes, spinach, lettuce, carrots, beets, chard, kohlrabi, cauliflower, asparagus and cooked, braised and served as a salad. It is recommended to avoid beans, cabbage, pickled and fresh herbs, onions, cucumbers, garlic and paprika.
Since priority is given to fat vegetable oil, margarine, low-fat cream, and definitely avoid butter and other fats.
In preparing food are permitted spices: parsley, lemon, dill, basil, white vinegar, a strictly forbidden pepper, mustard, cayenne pepper and other strong spices.
Since milk and milk products should be selected cottage cheese, and nonfat yogurt, and avoid fatty and dry cheeses.
Fruit is the healthiest fresh take, but it could be boiled or mashed. What you should definitely avoid the greasy pastries, rich walnuts, almonds and chocolate, and give preference to  biscuits.
The drink is recommended to take a mild tea / mint and camomile / other teas are not allowed, prepared natural juices. Avoid fizzy drinks and alcohol and spirits.

The advantage of light normal diet is that it does not cause unpleasant symptoms such as fullness, pain, nausea, bloating, diarrhea, which may occur after a meal.

FEEDING OF PATIENTS WITH LIVER WHO

In patients at risk of occurrence of liver where / encephalopathy / diet is necessary to prevent the accumulation of ammonia in the body.
Therefore, reducing the intake of proteins, which are brought food.
However, it is necessary to bring small amounts of protein, while the preferred protein contained in the low-fat milk and dairy products and proteins of plant origin. It is also important to ensure a sufficient amount of UH patients, to ensure sufficient amount of energy the body.
Therefore, the recommended diet foods such as rice, noodles and other low-fat pasta, potatoes boiled and mashed potatoes, wheat and corn grits, cereal, sweet milk dishes and puddings, low fat cookies, pureed vegetables and fruit (without peel and seeds ), and the Stale bread and toast.
Patients who have already developed hepatic coma is usually treated in a hospital, a diet is done by direct infusion into the bloodstream of special preparations / parenteral nutrition /

DIET OF HEPATITIS
Nutrition in patients icteric stage of the disease is normal calorie which totals 3,000 Kcal.
Representation of carbohydrates is 350 - 500 g, 70-75 g of fat, protein, 120-150 g., vitamin B complex in optimal amounts, 150g of vitamin C and vitamin A, mineral salts (increase intake of Ca and K).
Grain - white bread or toast, yeast, milk and dairy products (acidic dairy beverages), tender cooked lean meat, fish, boiled eggs.
Since fats are allowed a small amount of butter or oil
Vegetables - with a little more starch with cellulose in the form of puree.
Fruit - Fruit juices of fresh fruits, cooked dried fruit (stewed, etc.).
Sugar-concentrates only moderate amounts of sugar and sweets D
drinks - mineral water, tea is prohibited except mint and chamomile
Daily meals should be divided into 5 parts.