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  • Liver - The largest inner man of iron, similar to
    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

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