strongly flattened top of a large bowl. The length of an adult liver
20-30 cm, width - 10-21 cm, height -. 7 to 15 cm weighs
approximately 1400-1800, the liver is located in the right upper quadrant and so
called region of epigastrium. Special cells that comprise the liver,
They called hepatocytes.
On the common pathologies
defined as "fatty liver", or simply - "fat
liver, "says Alexey O. Bueverov, Candidate of Medical
Sciences, a gastroenterologist, hepatologist, a senior fellow at the Clinic
propaedeutics Internal Medicine, Gastroenterology and Hepatology
Moscow Medical Academy. Sechenov.
Question №1. Alex O. what is a "fatty liver"?
"Fatty liver" - a term that is more common in English literature, is a literal translation of the expression «Fatty liver».
In our country the term "fatty liver" refers to a pathological
a condition that in the "strict" medical diagnoses may sound
differently. Usually doctors use three terms: fatty degeneration
liver steatosis, hepatic steatosis. All these names describe
same state, which is characterized by the accumulation of fat in
liver cells - hepatocytes. The reasons for this disease are extremely
In the first place there is the alcoholic defeat
liver. This is approximately 65%, which is about 2/3 of all cases, "fat
Liver. " On the second, third and subsequent places are state
which occur in certain forms of diabetes,
hyperlipidemia (increased levels of fat in the blood) and obesity
(Overweight). Among the rarer causes of this disease
It applies taking certain medications, toxic
exposure operations on the gastrointestinal tract, and others. Besides
of these factors can be combined.
Question №2. And what is dangerous "fatty liver"?
This state faces an increased likelihood of developing complications. how
fat man, and a man with a "fatty liver" lurk most
various diseases. For example, the fat in hepatocytes under the influence of alcohol or
other causes begins to oxidize, and oxidation - the path to inflammation.
Thus, the "fatty liver" is a potential cause of
hepatitis (inflammation of liver cells). With a significant fatty liver
normal activity of hepatocytes can be violated even just because
produced by mechanical interference with fat. With the development of inflammation
special fabric are replaced by hepatocyte "empty", worthless
connective tissue and, in the worst case, this leads to cirrhosis.
I want to emphasize that fatty liver disease is completely reversible in case of liquidation
its causes (especially alcohol intake) and
timely treatment. At the same unfavorable circumstances
possible this progressive pathologic chain: fat
degeneration of the liver ( "fatty liver") - hepatitis - cirrhosis.
Question №3. How does "fatty liver" syndrome and what are the methods of diagnosis?
"Fatty liver" is insidious in that it often does not manifest itself.
Some patients leads to the doctor, for example, a feeling of heaviness in the right
hypochondria, sometimes bursting pain in the same place. about submitting
location yourself organs, patients believe that it is their "hurts
liver". In general, particularly in the liver to hurt nothing, because there is no
nerve endings, they are only in the capsule and bile ducts.
Typically, pain associated with concomitant dyskinesia
biliary tract (violation of their motor activity). other
patients may be concerned about general discomfort, malaise, nausea. but
such cases rarely go to the doctor.
Unfortunately, the "fat
liver ", in spite of its wide distribution, mostly
detected by chance. For example, the patients underwent ultrasound
(USG), the abdominal cavity, or it refers to the doctor
over any other diseases (diabetes mellitus,
coronary heart disease, etc.), and the doctor is already in the survey
reveals the presence of the patient's liver disorders. It is very important to
the patient is turned to a specialist, ie a doctor who deals
namely liver disease. Because not all general practitioners in
sufficiently oriented in the liver. It's not only
our problem, but the problem is more economically developed Western
Why do I need to get it to a specialist? It's not even
that in a specialized clinic practiced those techniques
laboratory and instrumental diagnostics, which do not apply,
for example, in a district clinic. There are well-equipped
clinics, which conduct any survey, but they can not
to interpret due to a lack of relevant experience.
all doctor must examine the patient, because sometimes the patient
"Written" if not all of the diagnosis, it is at least half of it.
Then typically conducted ultrasound, which reveals the very existence
syndrome "fatty liver." To detect the presence of hepatitis B using ultrasound
difficult; signs of cirrhosis is sufficiently far advanced
stages can be detected, and ultrasound. For the final specification of the diagnosis
conducted blood tests: clinical, in which you can
detect features that characterize an inflammatory process, and
biochemical. In particular, the biochemical analysis of a large value
indicators have special enzymes - the so-called transaminases. If
increased level of content, this, with the exclusion of heavy
diseases of the heart or muscles, is a sign of hepatitis.
that almost always appoint an expert study for viruses
hepatitis A. It's not that viral hepatitis - this is the most common in the world
cause of liver disease, and that in some forms of viral
hepatitis, in particular of viral hepatitis C, it is also possible to
As one of syndromes and fatty liver development. More
specialized research methods, such as computer
imaging, study of the immunological status or liver biopsy
(When taken a piece of cloth on microscopic examination)
carried out in the presence of specific indications.
Question №4. What do you call a doctor who specializes in diseases of the liver?
Hepatologist. Today, this term is not in the register of medical
Ministry of Health specialties. The clinics hepatologists are not welcome, so
there is no approved rates for them, but often such experts
staying in positions of Gastroenterology and even to physicians.
I said, hepatologist - a semi-official name. However, in our
country for the fifth year actions of the Russian Society for the Study of the liver,
which is headed by Vladimir Trofimovich Ivashkin, academician, chief gastroenterologist of Health Ministry of Russia.
Question №5. Who often suffer from "fatty liver"?
The risk group includes people who abuse alcohol, people with
overweight, atherosclerosis different vessels (as
Typically, atherosclerosis - a consequence of elevated levels of lipids in the blood);
suffering from type II diabetes (mostly - people middle
and the elderly); persons applying a large amount of drugs
at the same time (for example, drugs that treat diseases
cardiovascular, hormonal, etc.).; undergone surgery
on the gastrointestinal tract, and patients with rare hereditary
As for the alcohol - it is the most
a common cause of "fatty liver." "Fatty liver" was a frequent
diagnosis of patients from higher social strata. This diagnosis is often
common in artists, politicians, businessmen and diplomats.
They are not "abusing" alcohol, just have a good shot of
cognac - an indispensable attribute of any receptions and presentations, or
a means to relieve stress after work, and sometimes during.
They feel great and just after the wine glasses, and the next morning
after the wine glasses, and a new day begins again with the wine glasses (even
even at eight in the morning and two in the afternoon). When found
pathological changes in the liver, patients are very surprised.
The reaction to alcohol, each of us is individual. The fact that no one
harm could have a very heavy impact on the other.
Furthermore, there is concomitant diseases to which the person can
do not even know that increase the sensitivity of liver cells to alcohol,
such as viral hepatitis. Speaking of the liver, I always
I emphasize that the liver - a very reliable, silent and patient
body of their diseases, it lets you know just when to endure
can not anymore.
Question №6. What preventive measures are needed to
against 'fatty liver'? They differ depending on the stage
the development of the disease?
Any prevention can be divided
primary, secondary and tertiary. Primary - is prevention
the disease to its development, secondary - prevention of
the subsequent stages of the disease and tertiary - prevention of
severe, life-threatening complications. Primary prevention is simple.
It may sound banal, but only need to lead healthy
life. If a man understands that abuse alcohol if
a shot of brandy or beer bottle become an inherent part of
life; if he knows that he has a disease that can
cause of fatty liver; if it takes a lot
drugs that he himself may already include a group
risk and seek medical advice.
As for the development of prevention
more serious violations - hepatitis and cirrhosis, it is necessary to conduct here
We are talking about a mandatory meeting with a specialist. If the "fatty liver"
identified, the patient should be monitored in
hepatologist which firstly must adequately conduct full
examination, secondly, in identifying the causes of fatty liver appoint
appropriate treatment and provide specific recommendations for change
lifestyle of this particular patient. But heavy Prevention
complications must, as you know, take place in a specialized
If we talk about a balanced diet, something special
diet does not exist, but it is recommended not to get involved in fat and carbohydrate
(Especially for people suffering from diabetes and cardiovascular
disease), alcohol. Should eat more plant
food, fish, dairy products. Recommended exercise in
primarily to reduce overweight. When the "fat
liver "is not complicated, contraindications for exercise no.
have any liver problems, in our clinic functions
free school for patients with hepatitis. School Theme. Usually
class consists of the cycles. The story of the general provisions
diagnosis, prevention, treatment of various forms of liver disease
and how to behave ill: what to fear and what not to.
Question №7. How to treat "fatty liver"?
The first step is to either eliminate or minimize
the action of the factors that led to the development of "fatty liver."
For example, if it is based on excessive drinking, then
this patient is recommended to either completely exclude or limit
dose of spirits. When it comes to diabetes, a patient must
observed at the endocrinologist. If elevated levels of lipids in the blood,
it must be reduced because it is the risk of
cardiovascular diseases and liver damage. such a patient
It must be observed both a cardiologist and a hepatologist. are important
dietary recommendations aimed at reducing overweight
body (in their lack of effectiveness prescribed medicines
preparations). In addition, a group of drugs that directly
treatment directed at "fatty liver". The drug is chosen
individually depending on indications and contraindications, that is,
concomitant diseases and individual sensitivity.
about the actual "fatty liver" operations are not carried out.
liver "- a condition potentially reversible. If the causes of disease
eliminated, it is possible either to completely restore the normal structure
liver, or save the stage of development of the pathological condition,
When liver function is not impaired.
Finally, give you my
favorite toast, which I usually pronounce kefir in your hands - for
health, in the interpretation of this concept by the World Organization
Health: "Health - a state of complete physical,
mental and social wellbeing and not merely the absence of
disease or infirmity. " If we take as a basis the WHO definition,
the health of the same happiness, which I would like to wish readers