The liver is the largest gland in the human body; with pathology, its weight can reach 1,5 kilograms. Its function is the utilization of metabolic products for the possibility of subsequent excretion with feces and urine. With a powerful effect on the organ of toxins of various natures, it can increase significantly.
The doctor can determine how much the liver is enlarged by palpating the upper right quadrant of the abdomen. A patient with hepatomegaly syndrome complains of heaviness in the right hypochondrium, indigestion, pain during a medical examination.
This condition (hepatomegaly) is not a separate disease, but just a clear indicator of adverse processes in the body. They are the reason that the gland ceases to fulfill its purpose. The condition requires immediate medical intervention, it can lead to a complete stop of the organ’s work – and irreparable consequences.
Liver enlargement is diagnosed in all ages. Her condition can be affected by diseases of other organs and systems. The reasons will be varied.
A slight enlargement of the gland with minor inflammations is quickly stopped with the help of timely treatment, and the organ quickly returns to its original size. In hepatomegaly, the replacement of hepatocytes with fibrous tissues occurs faster than they can recover.
As a result, only part of the gland tissues regenerates, it acquires a heterogeneous structure and becomes larger in size.
Often the liver is enlarged due to the right, more functional part. If the tail lobe is changed, this means that the closely located pancreas is in danger – an increase provokes compression, which will affect the functions and cause discomfort.
Hepatomegaly will result from the growth of a malignant tumor in the tissues of the organ. When damaged by toxic substances (alcohol, medicines), it can be increased due to the enlargement of hepatocytes, which are capable of doing this to be able to perform their functions while neutralizing poisons.
Moderate organ enlargement is often caused by abnormalities in metabolism and mass accumulation of fat cells within the liver. At the same time, the kidneys and spleen undergo the same process, causing pressure on the gland.
Determining the size of the enlargement of the liver and the probable causes is the main task of the doctor when examining the patient. Most often, hepatomegaly in adults is provoked by:
- alcoholism and cirrhosis caused by it,
- abuse of certain medications, vitamins and dietary supplements,
- toxic damage to the organ by industrial poisons, heavy metals, plant toxins,
- infection with hepatitis viruses, bacterial infections,
- metabolic disorders of some trace elements (copper, iron),
- fatty infiltration,
- changes in the walls of the hepatic veins,
- benign formations (hemangiomas and multiple cysts),
- neoplasms (carcinomas) of the gland, leukemia, non-Hodgkin’s lymphoma,
- systemic diseases of a hereditary nature (amyloidosis, or the accumulation of atypical protein in the liver),
- improper excess nutrition and severe obesity.
The reasons for this condition in children are as follows:
- congenital diseases of the viral type (rubella, cytomegalovirus),
- closure of the internal bile ducts, pathologies that alter the normal outflow of bile,
- viral hepatitis,
- parasitic invasion,
- congenital metabolic pathologies,
- liver damage of various kinds and pathology of hematopoiesis,
- changes in some cells (Kupffer).
It should be noted that in children under 7 years of age, some enlargement of the liver and protrusion from under the costal arch is considered the norm. As the child grows up, the position of the organ is normalized.
The pathology of internal organs can provoke the development of hepatomegaly.
What diseases does this happen?
An excess of the normal size of the gland is noted in heart failure. Stagnation of blood due to poor functioning of the heart in the liver tissues provokes a change in volume due to edema. Viral hepatitis leads to a significant increase in the liver, in this case the organ grows due to inflammation and edema caused by it.
Triggered by a combination of viral damage and excessive alcohol consumption (most often in men), cirrhosis causes liver growth. Hepatomegaly is provoked by the replacement of dead cells with connective and adipose tissues with a simultaneous enlargement of gland cells. Severely deformed lobes, growing, squeeze the internal veins, which is the cause of swelling.
Pancreatitis is often the answer to the question of why the liver is enlarged in adults. Pathology is accompanied by intoxication, which affects the gland, slightly enlarging its size. In severe forms of inflammation of the pancreas, the liver increases significantly.
With emphysema, the formation of false hepatomegaly is possible – hypertrophied organs shift the liver, its lower edge becomes visible from under the costal arch.
Diagnosis and assessment of changes occurring in the gland is possible after a series of instrumental diagnostic studies and analyzes of biological fluids.
Dysfunctions and enlargement of the liver provoke the formation of characteristic symptoms – hepatomegaly syndrome. The manifestations of the disease are determined by the type of organ damage.
Usually the patient complains about:
- discomfort, a feeling of fullness and heaviness in the upper right abdomen,
- digestive disorders – nausea, heartburn, recurrent belching,
- persistent bad breath
- recurrent stool disorders (intermittent constipation and diarrhea),
- the appearance of a yellow tint of the skin, sclera and mucous membranes, which intensifies over time,
- apathy and drowsiness
- severe fatigue,
- dry skin and severe itching.
Behavior changes become noticeable. People with an enlarged liver are characterized by severe irritability, manifested for any reason, excessive anxiety and nervousness.
Slight signs of enlargement of the liver (when the gland protrudes from under the costal arch is not 1-2 centimeters), the patient may not perceive, over time, an increase in symptoms occurs.
A sharp rise in temperature and an enlarged liver indicate viral lesions. Distinctive signs of viral inflammation against the background of a general complex of manifestations of hepatomegaly syndrome will be:
- yellowing of mucous membranes and skin at certain stages of pathology,
- aches and soreness in the joints,
- bloating, discomfort, dull pain in the area of the liver.
Symptoms of an enlarged liver from exposure to alcohol (with cirrhosis) complement the main complex of symptoms:
- large belly size,
- hair loss on the abdominal wall in the liver area,
- sleep disorders with a desire to sleep during the day and insomnia at night,
- fast saturation with a small amount of food,
- frequent nosebleeds and irritable gums,
- a sharp decrease in body weight,
- decreased intelligence.
The size of the organ with alcoholic lesion changes unevenly – the pathology is more manifested as an increase in the left lobe of the liver together with hypertrophy of the spleen (hepatosplenomegaly is diagnosed).
Typical signs of HIV liver damage are:
- enlargement of the spleen,
- fever, fever,
- soreness of the lymph nodes.
The manifestations of hepatomegaly in children are similar to those in adults, and are supplemented by:
- the manifestation of vascular capillary asterisks on the skin of the abdomen,
- refusal to eat,
- complaints about the taste of bitterness,
- apathy and inactivity,
- changes in blood clotting,
- protrusion of the navel.
Quite often, an enlarged liver appears in the last months of pregnancy. This is due to surges in hormonal levels and displacement of the liver due to an increase in the volume of the uterus. Symptoms of pathology are manifested:
- changes in blood composition,
- the appearance of spider veins,
- changes in the structure and functions of the intrahepatic bile ducts. symptoms of liver damage.
Prolonged manifestation of several symptoms of gland damage is a reason to see a doctor. The first stage of treatment is a thorough diagnosis of the condition and the search for the causes that caused it.
The doctor begins the diagnosis of the liver with an external examination of the patient, assessment of the color of the sclera and skin. Primary liver enlargement, organ density are determined by palpation and percussion of the abdominal cavity along the midclavicular line.
The doctor asks the patient about the manifested symptoms of malaise, digestive disorders, vomiting and nausea, changes in stool. Collecting a detailed history allows you to establish the true causes of the disease. Information about recent illnesses, injuries, hereditary pathologies is important.
The patient can determine:
- small (up to 2 cm) enlargement of the organ, which does not cause discomfort when probing,
- moderate hepatomegaly, the main cause of which is unhealthy diet and drug and alcohol abuse,
- pronounced enlargement of the organ (sometimes several times).
Most accurately, the size of the liver can be determined by ultrasound (ultrasound). The doctor notes:
- position and size of the gland,
- determines how much it protrudes from under the costal arch,
- the ratio of parts of the organ, a change in the ratio of segments,
- an increase in the right lobe of the liver (at a physiological norm of 125 mm)
- location in relation to other organs of the abdominal cavity,
- condition of the gallbladder,
- an increase in the left lobe of the liver (at a physiological norm of 70 mm),
- dense organ or regular structure,
- the condition of the lymph nodes and intrahepatic veins,
- the size and condition of the bile ducts.
In parallel, the spleen and pancreas are examined (the density, size of the body, head and caudate lobe (part) are determined, a photo is taken.
Additionally, the patient is assigned:
- general and biochemical blood test for bilirubin, enzymes, proteins, prothrombin index, etc.),
- blood test for markers of viral hepatitis,
- urinalysis to determine if bilirubin is elevated,
- biopsy for suspected neoplasms,
- immunological tests,
- analyzes of feces for eggs of worms.
Apparatus studies can be assigned:
- scintigraphy (research using radioisotopes),
- carrying out computed and magnetic resonance imaging.
- additional studies of the stomach and intestines.
Independently determine at home whether the liver is enlarged and how much impossible. Determining the degree of damage, identifying the causes and treatment is the sole competence of the doctor.
What to do if the liver is enlarged
The diagnosis and treatment of an enlarged liver must be performed by a specialist. Which doctor should I see?
Diagnosis and treatment is carried out by a family doctor, gastroenerologist or hepatologist. The patient is required to carefully fulfill the appointments, if the child is sick – the responsibility for this lies with the parents.
What should the patient do if the liver is enlarged, but no pathologies have been identified? To restore it to its normal size, you must:
- change your lifestyle, establish a normal daily routine with good sleep, set aside time for walks and exercise,
- completely give up alcohol and cigarettes,
- change the diet in accordance with the doctor’s recommendations, eliminating fatty, fried and spicy, excess salt from the diet,
- adjust the drinking regime,
- eliminate hard work and nervous overload.
What should be done if the gland is enlarged? Treatment of hepatomegaly in this case is symptomatic, the focus is on the primary disease, which is the true cause of the pathology. To reduce the size of the organ, use:
- drug treatment,
- folk recipes and homeopathy,
- regulation of physical and nervous stress.
The same approach is used for hepatomegaly in children – the main treatment should be aimed at eliminating the primary pathology or containing it. The basis for prescriptions is a thorough initial diagnosis.
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If the liver is enlarged and the process is known, it provoked, appropriate medications are prescribed. Medicines that stabilize the enlarged gland are prescribed in combination with vitamins and immunostimulating drugs:
- for viral or infectious infections – antibiotics or antiviral drugs,
- for pathologies caused by metabolic disorders – drugs that replace or restore the production of the desired hormone,
- with toxic or irreversible alcoholic lesions – means that support the function of the liver and compensate for the lack of enzymes that it produces,
- in the autoimmune process, corticosteroids are used,
- when diagnosing conditions with ascites, diuretics are prescribed.
In all cases, drugs are prescribed that protect hepatocytes and restrain organ proliferation. The drugs taken for liver enlargement are as follows:
- Liv 52, used for viral and toxic liver damage, created with the use of herbal extracts of yarrow and chicory,
- Essliver, accelerating the recovery of hepatocytes,
- Hepatamine – a protective drug based on an extract from the gland of bulls,
- Legalon protective tablets, which are used in all cases of an enlarged liver, are based on milk thistle extract. Analogs are Karsil, Silibor,
- Tsikvalone, synthetic with anti-inflammatory action,
- Ursofalk, which contains a specific ursodeoxycholic acid, which stimulates the activity of the bile ducts in viral and toxic hepatitis,
- Oatsol, which normalizes the condition of the gland, is created on the basis of many plant components.
The choice of how to treat an enlarged liver belongs exclusively to a specialized specialist who:
- selects medicines
- prescribes how to take them,
- prescribes the terms of treatment,
- monitor the effectiveness of the drug,
- replaces when ineffective.
- effective in the treatment of viral and bacterial liver damage, the condition in most cases returns to normal,
- has a deterrent effect in toxic lesions (alcoholic cirrhosis), but cannot prevent the constant aggravation of the patient’s condition,
- not effective enough for hepatitis B, C and D in the active phase to curb cell degeneration and the emergence of neoplasms.
An organ transplant can be a possible option for hepatomegaly (one of the conditions is the patient’s age up to 60 years).
Traditionally in folk medicine there are many recipes for how to shrink the liver. They are based on the healing effects of herbs and bee products, most of the recipes are recognized and used by official medicine.
Moderate and medium enlargement of the gland lends itself to therapeutic effects; in case of irreversible lesions, phytopreparations can only maintain the condition.
A proven effect in liver enlargement is possessed by:
- herbal decoction from a mixture of dandelion root, sage, motherwort, peony root and chicory in equal proportions. 2 tablespoons of the mixture are poured with a liter of water and kept in a water bath for up to half an hour. The mixture is infused and filtered. You need to drink between meals during the day,
- a mixture of a glass of warm water, a tablespoon of honey and lemon juice throughout the day, on an empty stomach in the morning and before bed,
- pulp and juice of pumpkin, carrots, beets,
- berries and juice of wild strawberries, green apples,
- fresh cabbage pickle mixed with any vegetable juice,
- fresh juniper berries.
Treatment with folk remedies must be agreed with a doctor. An improperly selected recipe or cooking irregularities can cause irreparable harm to the liver and the body.
Prevention and diet
Enlargement of the liver requires special nutrition, which would transfer the organ to a sparing mode of functioning. Diet is an integral part of the treatment; without it, the use of medications will not have the desired effect.
For hepatomegaly, table No. 5 is used, which is prescribed for diseases of the liver and gallbladder. The principle of building a diet is the division of products into permitted and prohibited. At the same time, food should be complete and balanced, not exceeding the level of 2500 Kcal per day. Meals should be frequent, portions small, and the last meal should not be later than 3 hours before bedtime.
Sufficient sugar on the menu is important. It is desirable that it comes from fruits and vegetables, honey.
Correct selection of products, a special thermal mode of cooking inhibits an increase in the size of the liver, allows you to restore its functionality. Allowed for use:
- low-fat fish,
- milk and products from it,
- dietary poultry meat,
- natural sweets – honey, dry jam, marmalade,
- fresh fruits, vegetables and herbs,
- dried fruits,
- various cereals,
- a variety of soups with vegetable broths,
- vegetable oil.
Some foods allowed by table 5 may be excluded from the list by the attending physician based on the patient’s condition. A patient with hepatomegaly needs to adhere to a diet that is tougher during an exacerbation, more extended during remission.
Prognosis and complications
An enlarged liver indicates the existence of a serious pathology in the body that requires medical intervention. The consequences of ignoring this problem in 1/3 of the cases will lead to serious complications up to the refusal of the organ to work.
What threatens an enlarged liver and how dangerous is it?
Viral and infectious hepatitis is reversible, early treatment usually ends with recovery and the return of organ size back to normal. Damage caused by toxic substances, in particular alcohol, is usually irreversible. There will not be a positive prognosis for fatty hepatosis and transient forms of hepatitis.
The transition to proper nutrition, the rejection of bad habits, the regulation of sexual activity, a timely visit to the doctor at the first symptoms of the disease will help prevent liver disease.