Non-alcoholic steatohepatitis is a liver lesion that combines fatty degeneration, inflammation and cell damage, fibrosis. Morphological changes in the liver with NASH copy alcoholic hepatitis, however, the disease occurs mainly in individuals who do not drink alcohol in quantities that can cause liver intoxication.
Symptoms of non-alcoholic steatohepatitis
The complexity of determining the disease determines the practical absence of symptoms of non-alcoholic steatohepatitis in 50-100% of patients, the diagnosis in these cases is the accidental detection of the disease in the diagnosis of other pathologies.
If symptoms of non-alcoholic steatohepatitis are observed, they are more expressed by asthenic and hemorrhagic syndromes, there are symptoms of malfunction of the endocrine and cardiovascular systems, pathological changes in the liver and spleen. Signs of pathology are most pronounced with the maximum development of the inflammatory process.
Asthenic syndrome
Manifestations of asthenic syndrome in NASH:
- Increased weakness.
- Fast fatiguability.
- Feeling unwell.
- Decreased performance.
- Loss of appetite.
Asthenia can be accompanied by discomfort in the abdominal cavity, dull pain in the right hypochondrium, unpleasant heaviness in the stomach.
Hemorrhagic syndrome
Non-alcoholic steatohepatitis can manifest itself as hemorrhagic syndrome. This concept includes subcutaneous hemorrhage, bleeding of the mucous membranes, damage to the vascular walls, and bleeding disorders.
Other possible symptoms
NASH has a pathogenic effect on the vascular system, symptoms such as arterial hypotension develop - a significant decrease in pressure by more than 20%, vascular atherosclerosis, and fainting accompany the disease.
The endocrine system responds to liver disorders with hypothyroidism - a condition in which there is a persistent deficiency of thyroid hormones, and in many patients insulin-dependent diabetes mellitus is detected.
Among the possible signs of non-alcoholic steatohepatitis are hepatomegaly - a pathological enlargement of the liver, as well as splenomegaly - a pathological enlargement of the spleen.
Causes
The maximum susceptibility to the disease is female and age 40-60 years.
Metabolic or non-alcoholic steatohepatitis occurs against the background of a supersaturation of liver cells with triglycerides. An excess of fatty acids leads to the development of oxidative and inflammatory processes, as a result of which organ cells die, giving way to rapidly growing connective tissue and scars. The components of NASH fibrosis and cirrhosis are the result of the accumulation of fats and toxins in the liver.
The exact reasons for the development of non-alcoholic steatohepatitis have not been determined by scientists, but medicine highlights some risk factors. First of all, metabolic factors are considered:
- Metabolic disorders
- Diabetes mellitus and obesity.
- Hyperlipidemia is an increased concentration of lipids in the blood.
- Rapid weight loss or fast weight gain.
- Long starvation.
- Nutrition of the body through the introduction of intravenous infusion.
Surgical Risk Factors:
- Superimposed anastomosis.
- Surgical removal of body fat.
- Extensive removal of part of the small intestine.
Non-alcoholic steatohepatitis can provoke some drugs, causing severe intoxication. Relative causes are protrusion of the jejunum wall, regional fatty degeneration, Weber-Christian panniculitis, Wilson-Konovalov’s disease.
Stage non-alcoholic steatohepatitis
Steatohepatitis has two stages of development: primary and secondary.
The primary stage is a manifestation of the metabolic syndrome developed as a result of resistance to insulin. Therefore, in the patient’s blood with primary NASH there is an increased level of glucose, which turns into triglycerides. Triglycerides also accumulate as a result of the breakdown of complex fats into simple ones. Fats accumulate in the liver and provoke the disease.
Secondary steatohepatitis is based on malabsorption syndrome - chronic disorders of the processes of digestion, transportation and absorption of nutrients in the small intestine.
Diagnostics
Diagnosis of non-alcoholic steatohepatitis includes measures:
- Biochemical analyzes.
- Fibromax test.
- Ultrasound procedure.
- CT scan.
- Magnetic resonance imaging, computed tomography.
A puncture biopsy is performed under ultrasound guidance, this is the most appropriate diagnostic measure in the case of non-alcoholic steatohepatitis.
Treatment of non-alcoholic steatohepatitis
Treatment of non-alcoholic steatohepatitis is aimed at eliminating the factors that led to the development of the disease. Specialists of the K + 31 Clinic Medical Center select individual components of therapy for the patient.
Since the primary cause of the disease is the accumulation of fat, the accumulation of lipids in the blood, general obesity, the elimination of hyperglycemia and hyperlipidemia is achieved in the first place.
An important component of complex treatment is rationalization of nutrition and gradual healthy weight loss, which is impossible without physical exercises. Improvement of biochemical parameters is achieved after reducing the patient’s weight; medication is prescribed to strengthen the result.
If a healthy diet and weight loss have not had the desired result, the doctor will prescribe medications:
- Lipotropic drugs - regulate fat metabolism.
- Cytoprotectors - protect hepatocytes.
- Hepatoprotectors - prevent and eliminate intoxication.
- Ursodeoxycholic acid - regulation of bile production.
- Antibacterial drugs - with a wide activity of pathogenic microorganisms in the intestine.
Forecast
The prognosis of non-alcoholic steatohepatitis is favorable. Most patients with NASH do not develop cirrhosis or liver failure, and the disease does not tend to provoke malignant processes.
It should be understood that a positive prognosis has an effect with timely and adequate treatment of the disease. The absence of such entails negative consequences for the body.
Complications
Complications of non-alcoholic steatohepatitis are rare. Possible consequences:
- Cirrhosis of the liver.
- Liver failure.
- Predisposition to the development of infections.
Prevention of non-alcoholic steatohepatitis
Prevention of non-alcoholic steatohepatitis is based on maintaining a healthy lifestyle, primarily on proper nutrition with a reduction in fatty foods consumed. It is important to limit not only the intake of fats, but also carbohydrates, the latter are a source of glucose, which is actively processed into triglycerides.
It is imperative that all diseases be treated promptly, especially endocrine system disorders, the most dangerous of which is diabetes mellitus.
Suspicions of non-alcoholic steatohepatitis require immediate medical attention.
Diet / nutrition for non-alcoholic steatohepatitis
With non-alcoholic steatohepatitis, diet No. 5 is prescribed. The correction of the fifth type of nutrition implies the rejection of fatty foods and animal fats, hot spices.
Table No. 5 allows the use of low-fat meats and poultry, low-fat cheeses, cottage cheese, sour cream, vegetable soups, cereals, hard pasta, eggs, fruits and berries, vegetables, herbs, jam and honey, rye bread, juices and jelly.
The patient will have to give up butter and confectionery, fatty meat, rich broths, marinades and canned goods, sour fruits and berries, coffee, chocolate, alcohol. Diet prohibits the use of sorrel, spinach, radish and radish.
