home Auditorium 8 Palpation of the liver: procedure, interpretation and norms. Signs of diffuse liver changes

Palpation of the liver: procedure, interpretation and norms. Signs of diffuse liver changes

Palpation is one of the most informative diagnostic methods, carried out by a doctor at the stage of the initial examination of the patient. We'll talk about it today.

Anatomy of the liver

Before you begin to study the issue of palpation of the liver, you should determine the anatomy and functions of the organ. The liver is located immediately below the diaphragm, on the right side at the very top of the abdominal cavity, and only a small part of the organ in an adult is located on the left (in accordance with the midline). In newborns, the liver occupies a significant part of the abdominal cavity.

Topographically, the liver has two surfaces and two edges. The anterosuperior (upper) surface is adjacent to the surface of the diaphragm and protrudes in accordance with its bend. The lower one is located behind and below, having several impressions from adjacent organs. The lower and upper surfaces are separated by a lower sharp edge, the other edge (posterior superior), on the contrary, is very blunt, and therefore can be attributed to the posterior surface of the organ.

There are two lobes in the liver: the larger right and smaller left, separated by the falciform ligament, in the free part of which lies a dense fibrous cord - the so-called circular ligament, which extends from the navel and is nothing more than an overgrown umbilical vein.

The right lobe is divided by grooves into several secondary lobes. The gallbladder is located in one of these grooves and is separated by a piece of liver tissue called the caudate process.

One of the important parts of the organ is the deep transverse groove, which is called the hilum of the liver. Through this formation, the large hepatic arteries enter the organ, portal vein and nerves, but leave its efferent hepatic duct (evacuation of bile into the gallbladder) and

In the right lobe there is a quadrate lobe, which is bounded by the porta hepatis, round ligament and fossa from the gallbladder, and a caudate lobe, located between the porta hepatis and the portal vein.

Liver functions

Metabolic (control over the exchange of fluid, microelements and vitamins, hormones, amino acids, lipids, proteins, carbohydrates).
Depositing (BJU, vitamins, microelements, hormones accumulate in the organ).
Secretory (production of bile).
Detoxification (carried out thanks to the natural baked filter - hepatic macrophages).
Excretory (due to the binding of toxic substances by glucuronic and sulfuric acids: indole, tyramine, scotol).
Homeostatic (participation of the liver in the control of antigenic and metabolic hemostasis of the body).

Due to morphological and functional features the liver is quite often affected by a variety of non-infectious and infectious diseases. That is why, when a patient first approaches, it is necessary to palpate this organ.

Palpation and percussion of the liver

Before palpating the liver, it is recommended to determine its boundaries using percussion. This will allow you not only to predict the enlargement of the organ, but also to understand where exactly palpation should begin. When percussed, the liver tissue produces a dull (dull) sound, but due to the fact that Bottom part the lung partly covers it, it is possible to determine two boundaries: true and absolute hepatic dullness, but more often only the boundary (lower and upper) of absolute dullness is determined.

Palpation of the organ (technique)

When palpating the liver, certain rules must be followed:

The position of the subject is lying on his back, with his head slightly raised and his legs slightly bent at the knees or straightened. The hands are placed on the chest to limit its mobility when inhaling and to relax the abdominal muscles.
The doctor is positioned on the right, facing the patient.
Slightly bent right palm the doctor places it flat on the patient’s stomach in the area of the right hypochondrium, three to five centimeters lower than the border of the liver, previously determined by percussion. With his left hand, the doctor covers the chest (its lower part on the right), while four fingers must be placed at the back, and one (thumb) finger should be placed on the costal arch. This technique will ensure that the chest remains motionless when inhaling and will increase the downward displacement of the diaphragm.

When the patient exhales, the doctor effortlessly pulls down the skin and, plunging the fingers of his right hand into the abdominal cavity, asks the patient to take a deep breath. At this time, the edge (lower part) of the organ lowers, penetrates the created pocket and slides over the fingers. In this case, the probing hand should remain motionless. If for some reason it was not possible to palpate the liver, the procedure is repeated, but the fingers are moved a few centimeters upward. This manipulation is performed by moving higher and higher until the right hand hits the costal arch, or until the hepatic edge is palpated.

Peculiarities

The liver is usually palpated along the rectus abdominis muscle (its outer edge) or the midclavicular muscle right line. But if such a need arises, palpation is carried out along five lines (from the anterior axillary on the right to the parasternal on the left).
If large volumes of fluid accumulate in the abdomen, palpation becomes difficult. Then they resort to random, jerky palpation of the organ. To do this, use the second, third and fourth fingers of the right hand to perform blows and pushes on the front wall of the abdomen, starting from the bottom and ending with the costal arch until a dense formation is detected - the liver. During a push, the organ first moves deeper, and then returns and bumps into the fingers (the symptom is called “floating ice”).

Interpretation of results (norm)

What results should palpation of the liver show?

Normally, in 88% of patients, the lower edge of the organ is located near the costal arch, in accordance with the midclavicular line on the right.
In a healthy person, the edge of the organ is sharp or slightly rounded. It is soft, painless, easily tucks when touched, and even.

Evaluation of the obtained data (pathology)

If the liver is enlarged, upon palpation it will be located below the costal arch, which may also indicate its displacement. To confirm this or that statement, it is necessary to conduct percussion in order to determine the boundaries of the organ.
If the size of the liver is not changed, but the boundaries of hepatic dullness are shifted downward, this is a sign of organ prolapse.
A displacement of only the lower border indicates an enlarged liver, which occurs with venous congestion, inflammation in the bile ducts and liver, acute infections(malaria, cholera, typhoid fever, dysentery), cirrhosis (on initial stage).
If the lower border moves upward, then a decrease in the size of the organ can be suspected (for example, in the terminal stages of cirrhosis).
A change in the location of the upper hepatic border (down or up) rarely indicates damage to the organ itself (for example, with echinococcosis or liver cancer). More often this is observed due to the high position of the diaphragm during pregnancy, ascites, flatulence, due to the low position of the diaphragm during enteroptosis, pneumothorax, emphysema, as well as in cases of separation of the diaphragm from the liver due to gas accumulation.
wrinkling of its lower part, pneumonia, right-sided pleurisy can also imitate upward displacement of the upper border of the organ.
In some cases, not only palpation of the edge of the liver, but also the entire organ is available. To do this, the fingers are placed directly under the right costal arch. The doctor, applying gentle pressure and sliding movements, examines the liver, assessing its surface (lumpy, smooth, even), consistency (dense, soft), and the presence/absence of pain.

Soft, smooth, smooth surface and a rounded edge that is painful on palpation - signs of inflammatory processes in the organ or a manifestation of acute blood stagnation due to heart failure.
A lumpy, uneven, dense edge is observed with echinococcosis and syphilis. A very dense (“wooden”) liver is determined when the organ is damaged by cancer cells.
A dense edge of the liver indicates hepatitis, and in combination with tuberosity - cirrhosis.
Pain on palpation of the liver can occur due to inflammatory processes or as a result of overstretching of its capsule (with congestive liver).

Palpation of the liver in children

Palpation of the newborn's liver is usually carried out at the level of the midclavicular and anterior axillary lines by sliding palpation. In this case, the hand of the examining pediatrician slides off the edge of the liver, making it possible not only to determine the size of the organ, but also to palpate its edge. The norm for newborns is the protrusion of the liver edge from under the costal arch by two (but not more) centimeters. The assessment is carried out along the midclavicular line. The edge of the organ should be painless, smooth, sharp and soft-elastic.

In healthy children under seven years of age, the edge of the liver, as a rule, protrudes from under the right costal arch and is accessible for palpation. For children up to three years of age, the norm is to determine the edge of the liver 2 or 3 centimeters below the right hypochondrium. After seven years, they correspond to those of adults.

Liver examination using the Kurlov method

To confirm the diagnosis of a particular pathology, which leads to a distortion of the size of the organ, it is necessary to palpate the liver according to Kurlov. To do this, using tapping (percussion), the upper border is determined, and then palpation (or percussion) is used to determine the lower border. Moreover, in accordance with the oblique movement of the lower edge, its boundaries, as well as the distance between the upper and lower boundaries, are determined by three points.

The first corresponds to the midclavicular line, the second to the midclavicular line, and the third to the left costal arch. In the room the dimensions should be 9, 8, 7 cm respectively.

Enlargement of the liver - hepatomegaly - is observed in cases where the size of this the most important body exceeds natural, anatomically determined parameters. As doctors emphasize, this pathology cannot be considered a separate liver disease, since it is a symptom characteristic of many diseases, including those affecting other human organs and systems.

The danger of liver enlargement lies in the complications of liver failure and other pathological conditions, which disrupt the normal functioning of this organ and create many serious health problems.

Therefore, it is worth talking about such a common pathology as liver enlargement in more detail.

ICD-10 code

R16.0 Hepatomegaly, not elsewhere classified

Causes of liver enlargement

Perhaps the list below, including the causes of liver enlargement, is incomplete, but it should make one realize the true scale of its pathogenesis and get an answer to the question - is liver enlargement dangerous?

So, an enlarged liver in an adult can be a consequence of:

excessive alcohol consumption;
liver cirrhosis;
taking large doses of certain medications, vitamin complexes and dietary supplements;
infectious diseases (malaria, tularemia, etc.);
damage by hepatitis A, B, C viruses;
infectious lesion enteroviruses, pathogens of intestinal infections, Leptospira, Epstein-Barr virus (mononucleosis);
toxic damage to the parenchyma by industrial or plant poisons;
fatty hepatosis (fatty degeneration or steatosis of the liver);
disorders of copper metabolism in the liver (hepatolenticular degeneration or Wilson's disease);
disorders of iron metabolism in the liver (hemochromatosis);
inflammation of intrahepatic bile ducts(cholangitis);
genetically determined systemic diseases (amyloidosis, hyperlipoproteinemia, glucosylceramide lipidosis, generalized glycogenosis, etc.);
obliterating endarteritis liver veins;
liver cancer (hepatocarcinoma, epithelioma or metastatic cancer);
leukemia;
diffuse non-Hodgkin's lymphoma;
formation of multiple cysts (polycystic disease).

As a rule, an increase in the lobe of the liver is observed, while an increase in the right lobe of the liver (which has a higher functional load in the work of the organ) is diagnosed more often than an increase in the left lobe of the liver. However, this is also not good, since the left lobe is so close to the pancreas that perhaps it is this gland that creates the problem.

Simultaneous enlargement of the liver and pancreas is possible with inflammation of the pancreas (pancreatitis). Inflammation is accompanied by intoxication, and the liver is responsible for removing toxins from the blood. If the course of pancreatitis takes particularly severe forms, the liver may not cope with its task and increases in size.

Diffuse enlargement of the liver is a clearly non-localized change in the size of its lobules, consisting of hepatocytes (liver cells). For one of the above reasons, hepatocytes begin to die, and glandular tissue gives way to fibrous tissue. The latter continues to grow, thereby enlarging (and deforming) individual areas of the organ, squeezing the hepatic veins and creating the preconditions for inflammation and swelling of the parenchyma.

Symptoms of liver enlargement

A person may not feel a slightly pronounced pathology - an enlargement of the liver by 1 cm or an enlargement of the liver by 2 cm. But the process of changing the natural size of the liver sooner or later begins to manifest itself with more obvious clinical symptoms.

The most typical symptoms of liver enlargement are: weakness and fatigue, which patients feel even in the absence of intense exercise; unpleasant sensations (heaviness and discomfort) in the abdominal cavity; attacks of nausea; weight loss. This may be followed by heartburn, halitosis (constant bad breath), itchy skin and dyspepsia.

Liver enlargement due to hepatitis is accompanied not only by general malaise, but also by yellowing of the skin and sclera, increased temperature, aching in all joints, and nagging pain in the right hypochondrium.

Liver enlargement in cirrhosis occurs against the background of the same set of symptoms, which are accompanied by the following signs of this disease: abdominal pain and an increase in its size, a quickly onset feeling of fullness when eating, increased drowsiness during the day and insomnia at night, nosebleeds and bleeding gums, weight loss, hair loss, decreased ability to remember information. In addition to the enlargement of the liver with cirrhosis (first of both lobes, and then more of the left), the size of the spleen in half of the patients also increases, and doctors determine that they have hepatosplenomegaly - an enlargement of the liver and spleen.

In the clinical manifestation of damage to the body by the human immunodeficiency virus, liver enlargement in HIV is diagnosed at stage 2B - in acute HIV infection without secondary diseases. In addition to the enlargement of the liver and spleen, at this stage there is a fever, skin swelling and rashes on the mucous membranes of the mouth and pharynx, enlarged lymph nodes, as well as dyspepsia.

Fatty hepatosis with liver enlargement

Fatty hepatosis (or steatosis), according to the latest WHO data, affects 25% of European adults and up to 10% of children and adolescents. In Europe, “fatty liver” develops in 90% of alcohol abusers and 94% of obese people. Regardless of the underlying cause of the pathology, fatty hepatosis with liver enlargement progresses to cirrhosis within eight years in 10-12% of patients. And with concomitant inflammation of the liver tissue - into hepatocellular carcinoma.

Except alcohol intoxication liver and obesity, this disease is associated with impaired glucose tolerance in type II diabetes mellitus and pathology of the metabolism of cholesterol and other fats (dyslipidemia). From a pathophysiological point of view, fatty liver disease with or without liver enlargement develops due to damage to fatty acid metabolism, which may be caused by an imbalance between energy intake and energy expenditure. As a result, an abnormal accumulation of lipids, in particular triglycerides, occurs in the liver tissue.

Under the pressure of accumulated fat and the resulting fatty infiltrates, parenchyma cells lose viability, the size of the liver grows, and the normal functioning of the organ is disrupted.

In the early stages, fatty hepatosis may not have obvious symptoms, but over time, patients begin to complain of nausea and increased gas formation in the intestines, as well as heaviness or pain in the hypochondrium on the right.

Liver enlargement in heart failure

The functional interaction of all body systems is so close that liver enlargement in heart failure is an indicator of a decrease in blood output from the right ventricle of the heart and a consequence of circulatory disorders.

At the same time, blood circulation in the liver vessels slows down, venous stagnation forms (hemodynamic dysfunction), and the liver swells, increasing in size. Since heart failure is most often chronic, prolonged oxygen deficiency inevitably leads to the death of some liver cells. In their place, connective tissue cells grow, forming entire areas that disrupt the functioning of the liver. These zones enlarge and thicken, and at the same time the liver (most often its left lobe) enlarges.

In clinical hepatology, this is called hepatocellular necrosis and is diagnosed as cardiac cirrhosis or cardiac fibrosis. And cardiologists in such cases make a diagnosis of cardiogenic ischemic hepatitis, which, in essence, is an enlargement of the liver in heart failure.

Enlarged liver in a child

There are many reasons for an enlarged liver in a child. So, it could be syphilis or tuberculosis, generalized cytomegaly or toxoplasmosis, congenital hepatitis or bile duct abnormalities.

With this pathogenesis, not only moderate increase liver, but also a strong enlargement of the liver with significant compaction of the parenchyma can be established by the end of the first year of the child’s life.

Enlargement of the liver and spleen in infants - the so-called hepatolienal syndrome or hepatosplenomegaly - is the result of a congenital elevated level of immunoglobulins in the blood (hypergammaglobulinemia). This pathology, in addition to the enlargement of these organs, manifests itself in a delay in the general development of the child, poor appetite and very pale skin. Enlargement of the liver and spleen (with icteric symptoms) occurs in newborns with congenital aplastic anemia, which occurs due to the destruction of red blood cells, as well as due to extramedullary hematopoiesis - when red blood cells are not formed in bone marrow, but directly in the liver and spleen.

Fatty hepatosis with liver enlargement in children develops in almost half of the cases due to a significant excess of body weight for age. Although this pathology can occur with some chronic gastrointestinal diseases, after long-term use non-steroidal anti-inflammatory drugs, antibacterial or hormonal therapy.

Diagnosis of liver enlargement

Diagnosis of liver enlargement begins with a physical examination of the patient and palpation of the internal organs of the abdominal cavity to the right of the midline of the abdomen - in the epigastric region.

During a medical examination, the doctor may detect severe enlargement of the liver. What does it mean? This means that the liver protrudes from under the edge of the costal arch much more than expected by the anatomical norm (in an adult of average height this is no more than 1.5 cm), and can be felt significantly below the edge of the ribs. Then it is stated that the liver is enlarged by 3 cm, the liver is enlarged by 5 cm, or the liver is enlarged by 6 cm. But the final “verdict” is made only after a comprehensive examination of the patient, primarily using ultrasound.

An enlarged liver on ultrasound confirms that there is, for example, “an enlarged liver of a homogeneous hyperechoic structure with a displacement towards the stomach, the contours are unclear” or that “diffuse hyperechogenicity of the liver and unclear vascular pattern and borders of the liver have been identified.” By the way, in an adult, a healthy liver has the following parameters (on ultrasound): anterior-posterior size right lobe - up to 12.5 cm, left lobe - up to 7 cm.

In addition to ultrasound examination, the following is used in the diagnosis of liver enlargement:

blood test for viral hepatitis (serum virus markers);
biochemical blood test (for amylase and liver enzymes, bilirubin, prothrombin time, etc.);
urine test for bilirubin;
laboratory studies of the functional reserves of the liver (using biochemical and immunological tests);
radiography;
hepatoscintigraphy (radioisotope liver scan);
CT or MRI of the abdominal cavity;
precision puncture biopsy (if necessary, obtain a sample of liver tissue to check for oncology).

Enlarged liver lymph nodes during ultrasound examination are noted by hepatologists in all types of liver cirrhosis, viral hepatitis, tuberculosis lymph nodes, lymphogranulomatosis, sarcoidosis, Gaucher disease, drug-induced lymphadenopathy, HIV infection, pancreatic cancer.

Treatment of liver enlargement

Treatment of liver enlargement is treatment of the symptom, but, by and large, it is necessary complex therapy specific disease which led to pathological change of this body.

Drug therapy for a hypertrophied liver must be supported by proper nutrition, diet and vitamin intake. According to experts, in some diseases accompanied by liver enlargement, damaged parenchyma and normal sizes the organ can be restored.

For the regeneration of liver cells, they normal functioning and protection from negative impact Hepatoprotective drugs are used - special medications for liver enlargement.

The drug Gepabene is a hepatoprotector plant origin(synonyms - Karsil, Levasil, Legalon, Silegon, Silebor, Simepar, Geparsil, Hepatofalk-Planta). The active ingredients of the drug are obtained from extracts of fumaria officinalis (protipin) and milk thistle fruits (silymarin and silibinin). They stimulate the synthesis of proteins and phospholipids in damaged liver cells, inhibit the formation of fibrous tissue and accelerate the process of parenchyma restoration.

This drug is prescribed for toxic hepatitis, chronic inflammatory diseases of the liver, disorders of its metabolism and functions with liver enlargement of various etiologies. It is recommended to take one capsule three times a day (with meals). The minimum course of treatment is three months. Among the contraindications of this drug are: sharp forms inflammation of the liver and bile ducts, age up to 18 years. For hemorrhoids and varicose veins, Gepabene is used with caution. During pregnancy and lactation, the drug is used only as prescribed by a doctor and under his supervision. Possible side effects include laxative and diuretic effects, as well as the appearance skin rash. Taking Gepabene is incompatible with drinking alcohol.

The therapeutic effect of the drug Essentiale (Essentiale Forte) is based on the action of phospholipids (complex fat-containing compounds), which are similar in structure to the natural phospholipids that make up human tissue cells, ensuring their division and restoration in case of damage. Phospholipids block the growth of fibrous tissue cells, due to which this drug reduces the risk of developing liver cirrhosis. Essentiale is prescribed for liver steatosis, hepatitis, liver cirrhosis and its toxic lesions. The standard dose is 1-2 capsules three times a day (with meals). Side effects (in the form of diarrhea) are rare.

The drug Essliver differs from Essentiale by the presence in its composition - along with phospholipids - of vitamins B1, B2, B5, B6 and B12. And the combined hepatoprotective medicine Phosphogliv (in capsules), in addition to phospholipids, contains glycyrrhizic acid, which has anti-inflammatory and antioxidant properties. It helps reduce damage to hepatocyte membranes during inflammation and liver enlargement, as well as normalize metabolic processes. The method of administration and dosage of the last two drugs are similar to Essentiale.

Medicines for liver enlargement include a drug based on the artichoke plant - Artichol (synonyms - Hofitol, Cynarix, Artichoke extract). This medicine helps improve the condition of liver cells and normalize their functioning. Doctors recommend taking this drug 1-2 tablets three times a day (before meals). The course of treatment lasts from two weeks to a month, depending on the severity of the disease. Side effects may include heartburn, diarrhea, and stomach pain. Contraindications to its use are obstruction of the urinary tract and bile ducts, gallstones, as well as severe forms of renal and liver failure.

Besides that medicinal plants are the basis of many hepatoprotective drugs; herbs for liver enlargement are widely used in the form of infusions and decoctions prepared at home. For this pathology, herbalists advise using dandelion, corn silk, calendula, sandy immortelle, yarrow, peppermint. Standard recipe for water infusion: take a tablespoon of dry herbs or flowers for 200-250 ml of boiling water, brew with boiling water, infuse until cool, strain and take 50 ml 3-4 times a day (25-30 minutes before meals).

Diet for liver enlargement

A strictly followed diet for liver enlargement is the key to successful treatment. With a hypertrophied liver, you need to completely avoid eating fatty, fried, smoked and spicy foods, since such foods overload the liver and the entire digestive system.

In addition, the diet for liver enlargement is incompatible with foods such as legumes, radishes, radishes, spinach and sorrel; sausage and spicy cheeses; margarine and spreads; White bread and baked goods; vinegar, mustard and pepper; cream confectionery, chocolate and ice cream; carbonated drinks and alcohol.

Everything else (especially vegetables and fruits) can be eaten, at least five times a day, but little by little. It is not recommended to eat after 19 hours even if the liver is healthy, and even if the liver is enlarged, it is absolutely forbidden. But a glass of water with a spoonful of natural honey is possible and necessary.

The daily diet should contain 100 g of animal proteins, approximately the same amount of vegetable proteins and 50 g of vegetable fats. The volume of carbohydrate food is 450-500 g, while sugar consumption should be reduced to 50-60 g per day, and salt to 10-12 g. The daily volume of liquid (excluding liquid food) is at least 1.5 liters.

Prevention of liver enlargement

The best prevention of liver enlargement caused by excess weight or addiction to strong drinks, you know what it is. Nothing will work here without following the principles of a healthy lifestyle...

Unfortunately, it is impossible to predict how the liver will behave and how much it may enlarge, for example, with hepatitis, mononucleosis, Wilson's disease, hemochromatosis or cholangitis. But even in such cases, rational nutrition, consumption of vitamins, physical exercise, hardening and giving up bad habits will help the liver cope with cleansing the blood of toxins, producing bile and enzymes, regulating protein, carbohydrate and fat metabolism in the body. Also, to help the liver when there is a threat of hepatomegaly, B vitamins, vitamin E, zinc (to restore liver tissue) and selenium (to increase overall immunity and reduce the risk of inflammatory liver diseases) are especially needed.

Forecast for liver enlargement

The prognosis for liver enlargement is quite alarming. Since the pronounced signs of this pathology do not appear immediately, treatment in a third of cases begins when the process reaches the “point of no return.” And the most likely consequences of liver enlargement are partial or complete loss of its functionality.

An increase in the size of the liver is called hepatomegaly. This is not a disease, but a syndrome. Often the spleen is involved in the process. In this case we are talking about hepatosplenomegaly. These organs grow at a certain rate. With this pathology, the liver is palpated in the epigastric zone, which is not normally observed. In a healthy person, the diameter of the organ is about 20 cm, the left lobe does not exceed 6-8 cm. The size of the right lobe is no more than 12.5 cm. Normally, the width of the liver is 23-27 cm.

The distance from the blunt posterior edge to the sharp anterior edge ranges from 14 to 20 cm. Experienced doctors must know the size of the common liver duct. Normally, its diameter varies from 3 to 5 mm. In healthy people, this organ has a soft consistency. It can be easily felt in the hypochondrium. At various diseases the organ becomes denser and enlarges by 5 cm or more. An enlarged liver is detected during ultrasound.

Etiological factors

Experienced attending physicians know the causes of hepatomegaly. The following etiological factors are distinguished:

viral hepatitis;
fatty hepatosis;
violation of the outflow of bile;
bacterial infections;
cirrhosis;
thrombosis of the hepatic and portal veins;
Budd-Chiari syndrome;
amoebiasis;
Infectious mononucleosis;
thrombophlebitis;
cholangitis;
benign tumors;
cysts;
alcoholism;
drug intoxication;
amyloidosis;
autoimmune diseases;
injuries;
hemochromatosis;
acute and chronic heart failure;
malaria;
leishmaniasis
leukemia;
lymphogranulomatosis;
hemolytic disease;
lipid metabolism disorder;
helminths;
gallstone disease.

This is facilitated by congenital diseases (TORCH infection), inflammatory pathology and poisoning. In children under 7 years of age, signs of liver enlargement may be normal. It is allowed for the organ to protrude from under the edge of the costal arch by 1-2 cm. With age, the liver acquires a normal size. If hepatomegaly is combined with other symptoms, this indicates pathology.

Hepatomegaly during inflammation

Causes of liver enlargement in adults and children include hepatitis. It can be acute, chronic, drug-induced, alcohol-induced, viral and autoimmune. This disease is characterized by diffuse inflammation of the organ parenchyma. The chronic form of hepatitis lasts more than six months. Acute hepatitis develops quickly and is characterized by severe symptoms.

The liver becomes inflamed during hepatitis for several reasons. The following factors are of greatest importance:

alcoholism;
non-compliance with the sanitary and hygienic regime in preschool and school institutions;
consumption of contaminated vegetables, fruits, berries and herbs;
drinking unboiled water;
blood transfusion of an infected person;
sharing the same utensils with a patient with hepatitis B and C;
unprotected sexual intercourse;
use of non-sterile instruments;
injection drug use.

Not everyone knows what symptoms are characteristic of hepatitis. In this disease, hepatomegaly is combined with jaundice of the skin and sclera, pain in the right hypochondrium, heaviness, petechial rash, itching, dark urine, bradycardia, weakness and fever. Symptoms of liver enlargement are nonspecific. You can find out about the condition of the liver from the results of ultrasound, tomography and biochemical analysis.

With echinococcosis, the liver can become significantly enlarged. There are few symptoms for this pathology. Along with hepatomegaly, low-grade fever, minor rash, weight loss, decreased appetite, heaviness in the hypochondrium, diarrhea and nausea with vomiting are observed. A person’s first complaints appear several months or years after infection.

An enlargement of the liver by 2 cm or more is possible if a person has heart failure of the right ventricular type. Its consequences can be very dangerous. The following are involved in the development of this pathology:

You can understand that the liver is enlarged by a number of symptoms. They include swelling of the legs, pain in the right hypochondrium, bulging veins in the neck, shortness of breath, cyanosis of the skin, increased venous pressure and pain in the heart. In chronic heart failure, a decrease in diuresis and an enlargement of the abdomen are possible. Palpation determines the expansion of the boundaries of the liver and cardiac dullness. The legs of such patients swell. Why the liver is enlarged with right ventricular failure, what this means, is not known to everyone. It is based on stagnation of blood in the pulmonary circulation.

Hepatomegaly due to alcohol consumption

If the liver is enlarged, the cause may be alcohol abuse. Alcohol causes hepatosis (fatty degeneration of the organ) and hepatitis. Diffuse inflammation develops 5-7 years after the start of regular ethanol consumption. The disease threatens dangerous consequences up to cirrhosis.

The prognosis is not always favorable. Hepatomegaly is most often detected in the icteric form alcoholic hepatitis. It is associated with diarrhea, nausea, pain, exhaustion, jaundice, fever and tenderness of the abdomen on the right. On palpation, the liver is greatly enlarged. In the absence of cirrhosis, it is smooth.

When the liver is enlarged against the background of fatty hepatosis, the person looks healthy. Symptoms are scant. Very often the disease is discovered by chance. Severe damage rarely occurs. Hepatomegaly can be detected by ultrasound. Symptoms include aching pain in the right hypochondrium, discomfort and asthenia.

Patient examination plan

For an enlarged liver, treatment is carried out after a comprehensive examination. Hepatomegaly can only be determined by instrumental methods or by palpation of the abdomen. The following studies are required:

An experienced doctor understands how to place correct diagnosis. Low concentrations of prothrombin and albumin, increased alkaline phosphatase and gamma globulins, an indication of alcoholism, heterogeneity of the parenchyma, an increase in the width of the portal vein - all these are signs of cirrhosis. The detection of circulating immune complexes in the patient's body indicates an autoimmune origin of hepatomegaly.

How to heal the sick

Treatment for liver enlargement is determined by the underlying disease. The drugs are selected by the doctor. The main aspects of therapy are:

diet;
use of antiviral drugs;
increasing the resistance of hepatocytes to the effects of adverse factors.

Treatment of viral hepatitis A in an adult involves bed rest, proper nutrition, drinking plenty of fluids, avoiding alcohol, using antispasmodics and lactulose preparations. Sometimes choleretic drugs are prescribed. Patients are prescribed diet No. 5. The causes and treatment of hepatomegaly are directly related.

If the enlargement of the organ is due to hepatitis B, then detoxification therapy is carried out. Sorbents are used. Appointed antiviral drugs and alpha interferon. IN terminal stage It is impossible to shrink the liver. An organ transplant operation is required.

Not everyone knows what to do if the liver is enlarged due to cirrhosis. In this situation, a strict diet is prescribed. If complications develop, you need to reduce your protein intake. Many drugs are contraindicated. According to indications, Duphalac or Normaze is prescribed. Hepatoprotectors are used (Heptral, Essentiale Forte, Gepamerz). Herbal remedies (Liv-52) and homeopathic remedies (Galstena) are often prescribed. If the liver and spleen are enlarged due to mononucleosis, antiviral drugs (Arbidol, Valtrex, Acyclovir Forte), as well as immunomodulators, are prescribed.

Isoprinosine is often used. If the liver is swollen and there are signs of a secondary infection, then antibiotics are prescribed. Treatment methods for alcoholic hepatitis include diet, abstinence from alcohol, taking choleretic drugs, tissue proteinase inhibitors and hepatoprotectors. If the organ has increased by 3 cm, then surgery may be required. It is necessary for the formation of cysts and abscesses.

How to prevent hepatomegaly

You need to know not only why a person has an enlarged liver, what to do with hepatomegaly, but also how to prevent this condition. To do this you need:

do not drink alcohol;
drink only boiled water;
wash your hands before eating;
wash vegetables and fruits;
refuse to visit tattoo parlors;
use sterile instruments during medical procedures;
eat well;
lead healthy image life;
treat chronic diseases;
Avoid contact with chemicals.

If the underlying disease is not cured, complications such as liver failure are possible.

hepatitis.care

Causes

Factors that lead to hepatomegaly can be divided into several groups:

Inflammatory diseases:

viral hepatitis;
infectious diseases.

Volumetric formations:

cyst;
benign tumors;
hemangiomas;
carcinomas.

Metabolic disorders

hemochromatosis;
pathology of fat metabolism (steatosis);

Toxic damage:

alcohol;
medications, including Reye's syndrome;
hepatotropic poisons;

Bile outflow disorders:

cholestatic hepatosis;
cholelithiasis;
cholecystitis.

Hereditary metabolic diseases:

Wilson's disease;
Nimman-Pick disease.

Helminthiases.

Diseases of cardio-vascular system:

heart failure;
hepatic vein thrombosis.

Sarcoidosis.

Mechanism of liver enlargement

Pathological processes in the liver are associated with the death of hepatocytes. Hepatitis viruses have a direct cytolytic effect (complete destruction of the cell) or cytopathic (damage to intracellular organelles). The immune system reacts by activating macrophages, leukocytes and specific antibodies. Their actions aimed at viruses cause damage to their own cells.

Damage from toxic substances develops either from their direct effect on cells with the development of necrosis, or after undergoing biotransformation, when more toxic substances are formed. For example, in the case of ethanol, acetaldehyde is formed.

Any damage is accompanied by an inflammatory reaction and swelling develops. The liver increases in size. In areas of necrosis, macrophages begin their work, and fibrous tissue is synthesized. Gradually, areas of fibrosis increase. Cirrhosis develops.

When fat metabolism is impaired, droplets of fat accumulate in liver cells. Gradually, the number of damaged hepatocytes increases. And this leads to an increase in the size of the liver.

Liver enlargement in young children

In children under one year of age, the liver is abundantly supplied with blood. Therefore, any impact on it causes an increase in size. These may include infectious effects, blood flow disorders, exposure to toxins, tumors, and trauma. In children under one year of age, the severity of other symptoms is insignificant, so it is not always possible to suspect hepatomegaly. A small child cannot always explain his complaints of pain in the hypochondrium. Therefore, hepatomegaly is either an accidental finding or is detected after the addition of symptoms such as vomiting and the appearance of jaundice.

Hepatomegaly is typical for children with 2 and 3 degrees of rickets. Liver enlargement is triggered by a complex mechanism of calcium malabsorption, as a result of which alkaline phosphatase is activated.

Fatty hepatosis

A disease that develops due to alcohol abuse or diabetes mellitus, obesity. Violation of lipid metabolism leads to retention of fats in liver cells, their accumulation in the form of droplets gradually leads to a breakthrough of the membrane and the release of fatty contents. Liver function is impaired, which manifests itself typical symptoms– fatigue, dyspepsia, stool disorders.

Heart failure

The appearance of disturbances in the functioning of the heart leads to the development of heart failure, which means that blood output decreases and blood flow decreases. In the vessels of the liver, blood flow slows down, it stagnates in the veins. The plasma sweats into the liver tissue, swelling develops and the organ increases in size.

Chronic heart failure leads to hypoxia of the liver tissue, and foci of cell death - necrosis - appear in it. Dead hepatocytes are replaced by fibrous tissue. Cirrhosis develops over time

Enlarged lymph nodes

Sometimes there is a primary enlargement not of the liver itself, but of the lymph nodes located at the porta hepatis. Initially, hepatomegaly becomes noticeable, but upon examination it turns out that main reason– enlarged lymph nodes.

This may be accompanied by additional symptoms - sweating, weight loss, pain in the corresponding area, and a slight rise in temperature. The reason for this increase is infectious viral, bacterial, fungal lesions, tumor metastases.

Hepatomegaly after exercise

Prolonged exposure to an inadequate load leads to the development of pain. The mechanism of pain is associated with impaired blood outflow and excessive stretching of the liver capsule, which causes pain. All athletes are susceptible to this condition.

Symptoms

A slight enlargement of the liver is not accompanied by overstretching of its capsule. Therefore, subjective sensations do not arise. Gradually, the process of changing sizes will manifest itself in other symptoms.

Weakness and increased fatigue appear. Discomfort in the hypochondrium is replaced by a feeling of fullness, and then a distinct dull pain. Some are concerned about dyspeptic symptoms - nausea, vomiting, bad breath, heartburn. Impaired digestion of food indicates serious liver pathology, which is manifested by bloating, flatulence, constipation and diarrhea. Symptoms of intoxication are added - fever, malaise, headache.

In some cases, skin itching appears, which is caused by the deposition and free circulation of bile acids in the blood. If this is accompanied by a violation of bilirubin metabolism, then jaundice develops. The cause may be increased hemolysis of red blood cells, damage to the liver itself, or impaired bile outflow.

Consequences

Enlargement of the liver associated with the inflammatory response to infection goes away without a trace, unless gross damage occurs and there is no degeneration into fibrosis and cirrhosis. Severe diseases accompanied by hepatomegaly can provoke the development of liver failure.

Diagnostics

Establishing the fact of an enlarged liver does not provide insight into the cause of this condition. To do this, you need to conduct in-depth diagnostics.

At the first visit to the patient, a thorough history is taken and all complaints are clarified. Pay attention to the following issues:

how long ago did the malaise or pain appear?
are there any dyspeptic disorders;
connection between the appearance of symptoms and food intake, consumption of certain foods;
what digestive disorders have appeared recently;
worries about skin itching;
whether the color of feces, urine, skin has changed;

Next they proceed to inspection. You can determine fat metabolism disorders by your overall physique. Veins anterior abdominal wall can bulge, forming a bizarre plexus - the “head of a jellyfish”. This condition develops when portal hypertension. This condition is also characterized by the development of ascites and edema of the whole body.

Pay attention to hemorrhages in the skin. Their presence indicates disturbances in the coagulation system. Skin color is important for identifying bilirubin metabolism disorders. The patient is asked to show his tongue - it is often coated with a yellow coating.

After the examination, the doctor performs palpation. In the supine position, the liver is probed through the anterior abdominal wall. Normally, its edge is hidden behind the costal arch. But when enlarged, it will protrude from under them. By palpation, the consistency, tenderness, edge of the liver, and the presence of individual large formations are determined.

Laboratory diagnostics

Blood and urine tests help suggest the cause of hepatomegaly. IN general analysis blood may be a sign of inflammation - an increase in the number of leukocytes, a shift leukocyte formula to the left. Some conditions are characterized by a decrease in platelets. If the cause of hepatomegaly was hemolysis, then in the blood this will manifest itself as anemia and a decrease in the number of red blood cells.

A general urine test will reflect the condition of the kidneys. A change in its color to a darker one indicates a violation of bilirubin metabolism.

A biochemical blood test reflects the degree of liver damage. The development of cytolysis syndrome is possible - the destruction of hepatocytes under the influence of a damaging factor. It is characterized by an increase in ALT, AST, GGTP, LDH, and bilirubin due to two fractions. Cholestasis in tests is characterized by an increase in alkaline phosphatase, GGTP, 5-nucleotidase, and a decrease in the content of fat-soluble vitamins.

Hepatocellular failure is manifested by a decrease in the content of albumin, proteins, and an increase in bilirubin. Portal hypertension is accompanied by thrombocytopenia, anemia and leukopenia.

Ultrasound of the liver

This is a painless, publicly available method that allows you to determine the size of the liver, the condition of its parenchyma, the presence of space-occupying formations, and blood flow. A big plus is the lack of radiation exposure, so it can be used in small children and pregnant women.

To obtain the most reliable result, it is necessary to undergo special training, the purpose of which is to reduce the amount of gases in the intestines. 2-3 days before the test, you must avoid foods that cause increased gas formation. These are legumes, bread and milk, sweets. If there is constipation, it is recommended to take mild laxatives, such as lactulose syrup.

Ultrasound is performed on an empty stomach, 8-10 hours after eating. But for emergency indications, the study can be carried out at any time.

During the study, the size of the liver and its deviation from the norm are determined. Heterogeneity of the parenchyma, decreased echogenicity, depleted vascular pattern, together with an enlarged liver, indicate an inflammatory process. Regeneration nodes, tuberosity, changes in the vascular pattern and signs of portal hypertension are signs of cirrhosis.

X-ray of the liver

X-ray examination methods are very diverse. Survey radiography allows you to determine the size of the organ, its location relative to neighboring ones, the presence of various inclusions, cysts, and calcifications.

The use of contrasting vessels reveals a picture of changes in the blood flow of an organ, allows you to see places of narrowing or thrombosis, and disturbances in the vascular pattern.

Computed tomography is a series of layer-by-layer X-ray images. They clearly show the size of the organ, changes in its outline, the condition of the bile ducts, the presence of space-occupying formations - cysts, abscesses, tumors.

Liver biopsy

Examination of liver tissue is necessary in the presence of a tumor (except hemangioma) or cirrhosis. This method allows you to determine the histological structure of the tissue and the characteristics of the cells. For a biopsy for cirrhosis, it is important to determine the inflammatory process and the degree of fibrosis in order to determine treatment tactics or monitor the effectiveness of the therapy.

A biopsy of cysts is also carried out for therapeutic purposes - a drainage is installed through which medication can be administered and the cyst cavity can be washed.

Treatment

The choice of treatment method depends on the cause of the liver enlargement.

Infectious viral hepatitis requires etiological treatment. Botkin's disease has no specific treatment; supportive therapy and diet are used. Viruses of other types are treated with the use of special interferon preparations. Hepatoprotectors and vitamins are also used.

Patients with severe toxic liver damage are treated in toxicology or intensive care departments. Detoxification methods using drip solutions and hepatoprotectors are used. Poisoning with some hepatropic poisons requires the administration of an antidote.

Hepatomegaly caused by impaired bile flow is treated depending on the condition. Calculous cholecystitis, which has led to blockage of the duct with a stone and is accompanied by an attack of hepatic colic, requires emergency surgical treatment. Acalculous cholecystitis is an infectious inflammation that requires antibiotics to treat.

If the cause of liver enlargement is heart pathology, then treatment is aimed at eliminating the underlying cause. Treatment of heart pathology is carried out by a therapist together with a cardiologist; it is possible that consultation with a vascular surgeon and further surgical elimination of heart pathology will be required.

Liver tumors and metastases are treated depending on the extent of spread. Surgically remove the affected lobe of the liver if there is a limited formation, adjacent lymph nodes. Surgical treatment is supported by chemotherapy and radiation treatment. Efficiency depends on the stage at which the tumor was detected and its sensitivity to treatment drugs.

It is possible to use a method such as embolization of the vessels feeding the tumor. To do this, the blockage of the vessel, which has the main function of maintaining it, is performed endoscopically. As a result, necrosis of the pathological tissue and healing develops.

Some severe toxic or diffuse liver damage can only be cured by organ transplantation. The liver has good regenerative abilities and can recover from a small fragment. Part of an organ can be used for transplantation close relative, which is compatible in several parameters, for example, blood type, antigenic structure.

Hepatomegaly resulting from cirrhosis requires lifelong treatment. It is aimed at slowing the progression of the disease and improving the patient’s quality of life. Cirrhosis can only be radically cured with a liver transplant. Other methods are aimed at maintaining organ function. Use various groups heptoprotectors – essential phospholipids, ursodeoxycholic acid, plant extracts. They have the properties to restore cell membranes, have a protective effect, and regulate metabolism in liver cells. For antioxidant protection and regulation of metabolic processes, vitamin complexes and amino acids are prescribed.

The development of ascites is an unfavorable symptom, for the treatment of which diuretics are used. It is imperative to adhere to a daily routine and special nutrition.

Diet

For patients with liver pathology, diet No. 5 according to Pevzner is prescribed. Its main principles are gentle food and fractional nutrition, sufficient in calorie content and nutrient content. Alcohol, fried foods, fatty foods, and high-salt foods are strictly prohibited. Industrial and home-made marinades and canned food, sauces (mayonnaise, ketchup) contain a lot of sugar and salt, vinegar, which irritates the digestive system.

Smoked meats and sausages contain a lot of preservatives and hidden fats, so they are also prohibited. Legumes, vegetables with coarse fiber during periods of exacerbation of the disease are also not recommended. Mushrooms and nuts are rough and heavy foods. You should not eat very hot or cold foods. This also applies to ice cream. Give preference to cooking methods such as boiling, stewing, baking.

Allowed products include cereals, vegetables in any form, and fruits. You can cook lean meat - beef, chicken, turkey, rabbit. Also choose low-fat varieties of fish. Milk and dairy products should be low in fat. Limit sweets and yeast baked goods made from white flour as much as possible.

hepatologist.com

What does an enlarged liver mean?

An enlarged liver is not a disease, but a symptom of some problem related to the functioning of the liver. In medicine, this phenomenon is called hepatomegaly and means that the liver ceases to perform its functions. Hepatomegaly, if left untreated, can lead to the development of a fatal disease - liver failure. A routine medical examination is sufficient to detect liver enlargement.

To identify the causes, more thorough research and analysis will be required:

Ultrasound or tomography to accurately determine the size of the liver and assess the general condition.

MRI will accurately show the condition of the bile ducts.

Blood tests. Necessary for examining liver enzymes, the presence viral infections and other violations.

Biopsy. This test is prescribed if cancer or fatty disease is suspected.

Causes of liver enlargement

Liver diseases:

Fatty hepatosis ( a large number of fat cells in the liver).

Cholestatic hepatosis (impaired bile outflow)

Hepatitis

Viral or bacterial infections

Hereditary diseases associated with metabolic disorders

Diseases associated with circulatory disorders:

Heart failure

Blockage of the hepatic veins

Exchange disorders:

Hemochromatosis

Fat metabolism disorders

The appearance of neoplasms:

Benign tumors

Cancerous tumors

Exposure to toxins:

Alcohol damage

Drug damage

Cholelithiasis

Helminth damage

Liver enlargement can be determined independently when the following symptoms appear:

Feeling of discomfort in the right hypochondrium, feeling of heaviness

Dyspeptic disorders - nausea, heartburn, changes in stool, belching, accompanied by an unpleasant odor.

Change in skin color - yellowness, characteristic of hepatomegaly.

Changes in behavior – nervousness, irritability, drowsiness or insomnia.

Since the above signs may indicate other disorders in the functioning of the body, for an accurate diagnosis it is necessary to consult a specialist. There is no need to delay your visit to the doctor - timely measures will help avoid serious consequences.

Enlarged liver in a child

In infants, liver enlargement may be associated with neonatal jaundice. It does not require treatment as it goes away within a month. The causes of this condition may be birth injuries, diabetes and other disorders of the endocrine system in the mother.

In a child under 7 years of age, hepatomegaly is a completely normal physiological phenomenon. It is considered normal if the baby’s liver protrudes slightly beyond the edges of the ribs (by 1–2 cm). As the child grows, the liver becomes normal in size. In any case, the doctor will most accurately determine whether the child needs treatment.

In children, liver enlargement may indicate the following diseases:

Inflammatory processes in the body.

Congenital TORCH infections

Liver damage from toxins or drugs.

Metabolic pathology

Disorders of the biliary tract, blockage of the bile ducts

Metastases or tumors

A cause for concern is an enlarged liver in children in combination with other “danger signals”: fever, venous network in the abdomen, vomiting, skin rashes, weight loss, loss of appetite, yellowness of the mucous membranes. When these signs appear, the pediatrician prescribes a consultation with a hepatologist, infectious disease specialist, or gastroenterologist. To identify the exact cause of liver enlargement, a number of tests and ultrasound examination are necessary.

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Diet for liver enlargement

Right organized regime nutrition will help the liver cope with hepatomegaly. The diet for liver enlargement excludes spicy, salty, fatty foods. The diet must contain proteins, vitamins, minerals and fiber. Food should enter the body in small portions so as not to overload the diseased liver. Small meals are recommended (6–7 times a day) for better digestion. Read more about what you can and cannot eat if you have liver disease.

Sample menu for liver enlargement for a week

Monday.

Meal 1 – Milk rice porridge without adding butter and sugar, green tea with honey or rosehip decoction.

Meal 2 – A glass of freshly squeezed apple juice, oatmeal cookies

Meal 3 – Boiled river fish

Meal 4 – Boiled carrots, grated

Meal 5 – Steamed vegetable dish (without salt and spices)

Meal 6 – Fresh fruit

Tuesday

Meal 1 – Omelet from one egg (without yolk), rosehip decoction or green tea, dietary biscuits

Meal 2 – Dried fruits (dried apricots, prunes, raisins), previously poured with boiling water.

4th reception – Freshly squeezed carrot juice, oat cookies

Meal 5 – Low-fat cottage cheese

Meal 6 – Greens and cucumber salad

Wednesday

1st appointment – Low-fat kefir or cottage cheese

Meal 2 – Rosehip decoction with honey, oatmeal cookies

Method 3 – Steamed meatballs

Meal 4 – Pumpkin puree, herbal tea

Meal 5 – Baked cheesecakes with dried fruits

Meal 6 – Freshly squeezed fruit juice, oatmeal cookies

Thursday

1st appointment – Oatmeal with milk, green tea with honey and lemon

Meal 2 – Compote with dried fruits, dietary biscuits

Meal 3 – Steamed river fish, bran bread

Meal 4 – Fresh fruit juice, oatmeal cookies

Meal 5 – Vegetable casserole, bran bread

Meal 6 – Herbal tea

Friday

Meal 1 – Boiled pasta in small quantities

Meal 2 – A glass of freshly squeezed apple juice, biscuits

Meal 3 – Dietary buckwheat soup, bran bread

Meal 4 – Dried fruits soaked in boiling water

Meal 5 – Milk porridge, dietary biscuits

Meal 6 – Green tea with honey, oatmeal cookies

Saturday

1st appointment – Buckwheat, brewed in water without salt and sugar, herbal tea

Meal 2 – Fruit platter

Meal 3 – Veal or chicken broth, bran bread

Meal 4 – Sauerkraut salad

Meal 5 – Pastila or fruit marmalade

Sunday

Meal 1 – Cheese pancakes with dried fruits, cooked in the oven, green tea with honey and lemon

Meal 2 – Fruit or vegetable juice, biscuits

Meal 3 – Veal or turkey, boiled and pureed with the addition of boiled carrots or pumpkin

Meal 4 – Rosehip decoction, bran bread

Meal 5 – Kefir or cottage cheese, oatmeal cookies

Meal 6 – Fruit or vegetable salad

It is also necessary to maintain equal periods of time between meals. Any diet must be discussed with a doctor, who will give all the necessary recommendations. With an enlarged liver, nutrition should be optimally balanced. Therefore, it is periodically necessary to adjust and diversify the diet. With severe enlargement of the liver, fruit and vegetable juices It is advisable to dilute with boiled water in a 1:1 ratio. Alcohol, coffee, chocolate, confectionery, salt, pepper, vinegar are the main enemies of the liver. For any liver disease, legumes in any form, nuts, and carbonated drinks are contraindicated.

Liver enlargement in clinical practice is usually called hepatomegaly. This pathological condition can be a manifestation of various diseases not only of this organ, but also of others. important systems body. Normally, the edge of the liver in an adult, as a rule, is at the level of the right costal arch, but when it protrudes from under it, we are talking about its enlargement.

Classification

There are different classifications of this disease. The degree of liver enlargement is initially determined during a routine examination of the patient and his percussion (tapping the anterior abdominal wall) and palpation (palpation of internal organs). Moreover, depending on how many centimeters the lower edge of this organ protrudes, the following are distinguished:

small degree (1 cm);
moderate degree (2 cm);
pronounced degree (3 cm or more).

With hepatomegaly, this organ can increase in size as a whole (diffuse process), or each lobe individually. In the latter case, we are talking about a local pathological process, for example, echinococcosis of the left lobe.

Causes

All the reasons why the liver can become enlarged are divided into three groups:

Liver diseases.
Storage diseases.
Diseases of the cardiovascular system.

Liver diseases

Almost any pathology of the liver tissue leads to an increase in the size of the organ. The most common causes are the following conditions:

Since the liver is the central organ responsible for the metabolism of various substances in the body, if any breakdown processes are disrupted, its tissue can increase in size. Storage diseases include:

hepatolenticular degeneration;
amyloidosis.

At the same time, a large amount of unbroken substances (iron, fats, glycogen) accumulates in the liver cells.

Diseases of the cardiovascular system

Almost any pathology of the cardiovascular system leading to the development of congestive failure can cause an enlarged liver. This occurs due to the accumulation of a large amount of venous blood in the hepatic sinuses and further secondary tissue restructuring. Most often, the development of hepatomegaly is accompanied by:

post-infarction cardiosclerosis;
permanent form of atrial fibrillation;
heart defects (acquired and congenital);
postmyocardial syndrome;
hypertensive heart.

Symptoms

At the initial stages, the enlarged liver does not manifest itself in any way. However, since the capsule covering the outside of this organ is not extensible and contains a large number of pain receptors, even with a slight increase in tissue volume, discomfort or a feeling of heaviness may occur in the epigastrium and right hypochondrium. Subsequently, a rather pronounced pain syndrome occurs. In addition, there will be signs of that primary disease, as well as symptoms of liver failure:

(digestion, stool problems);
yellowness of the skin;
enlargement of the veins of the esophagus, as well as the anterior abdominal wall (head of the medusa) due to portal hypertension;
a violation of the blood coagulation system, which causes the appearance of a petechial rash and frequent bleeding, including uterine and nasal bleeding;
and swelling.

Course of the disease

Since liver enlargement is only a manifestation of various diseases, its course is primarily determined by the primary pathology. However, there are risk factors that can aggravate the course of the disease. These include:

consumption of alcohol and other toxic substances;
taking excessive amounts of dietary supplements and medications;
herbal medicine using some active plant components;
any infectious diseases that reduce immunity and make liver cells more susceptible;
excess body weight;
eating excess amounts of preservatives, animal fats and processed foods.

Diagnostics

In some cases, it is possible to diagnose liver enlargement with a standard examination of the patient and manual examination. However, to clarify the condition of this organ, instrumental and laboratory diagnostic methods are used.

Among instrumental methods usually do:

If the doctor suspects a cardiac pathology, the patient is examined for diseases of the cardiovascular system (ECG, ECHO-cardiography).

Treatment

With hepatomegaly, it is very important to find out the reason for the enlargement of this organ, since treatment for various diseases will be quite different.

Drug treatment

Medicines can be used to relieve symptoms of the disease. In this case, drugs called hepatoprotectors are prescribed. They improve the condition of liver cells and normalize the function of the organ. However, special attention must be paid to the treatment of primary pathology:

for viral hepatitis, interferon is prescribed;
autoimmune processes can be slowed down by taking glucocorticosteroid hormones;
for congestive heart failure, cardiac medications (diuretics, ACE inhibitors) are prescribed.

Surgery

At malignant formations, echinococcosis and cysts, the most effective method of treatment is surgical treatment. In this case it is possible to carry out open surgery with removal of a segment or lobe of an organ. The amount of intervention depends on the extent of the process.

Recently, so-called embolization of vessels that supply blood to the tumor is increasingly used. In this case, the blood flow in it stops, and the neoplasm itself is gradually destroyed due to lack of oxygen. This manipulation is performed through a puncture of the vessel under X-ray control.

In advanced cases of diffuse damage to the liver tissue, the only option is transplantation. Since this organ is capable of regeneration, that is, growth, it is enough to transplant part of the liver. Therefore, any relative who meets a number of criteria can be a donor.

Diet

All patients with liver enlargement, regardless of the underlying disease, must adhere to a special diet. At the same time, it is necessary to exclude from the diet foods that have a toxic effect on the liver tissue (alcohol, spicy foods), as well as difficult-to-digest and fatty foods.

For storage diseases, it is necessary to limit as much as possible the consumption of foods that the liver is not able to metabolize. For example, with hemochromatosis, it is necessary to exclude foods containing iron (meat, fish, eggs).

ethnoscience

Traditional methods of treatment can be used only after consulting a therapist or gastroenterologist. Moreover, their use is most effective in the initial stages of the disease. Taking an infusion made from equal parts of motherwort and sage herbs, dandelion roots, chicory and peony is very effective. You need to drink 450 ml per day for two weeks. Eating beet and pumpkin salad seasoned with vegetable oil may also be useful for cleansing the liver.

Consequences and prognosis

The consequences and prognosis of liver enlargement are entirely determined by the primary pathology, as well as the stage of the process and the severity of liver failure.

And we are accustomed to associate all unpleasant or painful sensations in this area with disruptions in the functioning of this irreplaceable organ.

“The liver is being naughty,” we say, pressing our palm to the sore spot. Is this always true? And what to do if it’s the liver that’s pressing? We will try to figure this out.

What is the liver?

The liver is the largest gland in our body. She is responsible for maintaining constant chemical composition human body:

participates in digestive processes, synthesizing and secreting bile, as well as hormones and enzymes necessary for the transformation of food in the small intestine;
neutralizes intermediate metabolic products and toxins that enter the body from the outside;
processes and utilizes excess hormones and vitamins;
is a storage site for energy reserves in the form of glycogen depots, some vitamins (such as vitamins A, D, B12) and microelements;
serves as a depot for a significant reserve volume of blood necessary for conditions associated with disorders in the general vascular bed.

The liver is closely connected with the extrahepatic bile duct system and the gallbladder. The gallbladder is an organ located on the lower surface of the liver. It has an oblong sac shape, filled with greenish bile. The function of the gallbladder is to regulate the flow of bile into the small intestine under the influence of digestive hormones.

The liver does not have pain receptors, so it cannot hurt on its own.

And we judge the deterioration of its functioning by many other symptoms, experiencing pain only when the size of the liver increases and the capsule enveloping it is significantly stretched. Most often, pain in the right hypochondrium is caused by certain disorders of the gallbladder.

What affects liver and gallbladder diseases?

At various stages of our lives, the liver bears increased stress. This is the period of pregnancy for women. Childhood and adolescence, when the body is being built and the activity of all processes is increased. And the time of maturity, the fight against approaching diseases and old age.

Each stage has its own characteristics and problems.

Pregnancy

During this period, the woman’s liver performs catabolic and detoxification functions for two organisms at once. During pregnancy, due to increased stress, pre-existing chronic diseases often worsen. And due to increased synthesis of steroids, the processes of bile formation and bile secretion may be disrupted.

In the first trimester of pregnancy, pain in the right hypochondrium is often associated with impaired motility of the gallbladder. This condition occurs during early gestosis, when the usual diet is disrupted due to nausea and selectivity in food. From this time on, symptoms of cholestasis may appear.

In the second trimester, a woman’s body usually adapts to the changes taking place and the pregnant woman’s well-being improves.

In the last trimester of pregnancy, the liver bears its maximum load. The volume of blood passing through it increases by an average of 30–40%. The location of internal organs changes. The uterus, increasing in size according to the growth of the fetus, reaches the region of the ribs and puts pressure on the liver and gall bladder. A pregnant woman feels heaviness and fullness and may complain of constant dull pain in the area of the right lower ribs and other dyspeptic symptoms.

Usually, physiological changes the functioning of the digestive organs during pregnancy is not clearly expressed and does not require any treatment. It is enough to adhere to a healthy diet and work and rest regime suitable for a pregnant woman. All past or existing illnesses must be reported to the therapist when registering with the antenatal clinic. The doctor will help you adjust your diet and, if necessary, prescribe maintenance medications taking into account the duration of your pregnancy.

Growing up

In children, in early age due to the immaturity of all organs and systems, and in adolescence due to rapid growth, functional diseases most often occur biliary tract. They develop as a result of a violation of motor-tonic dysfunction of the gallbladder, bile ducts and their sphincters.

The child refuses to eat for a reason frequent nausea or pain in the subcostal area. He is concerned about increased gas formation and bloating due to a violation correct selection bile during digestion.

The situation is most unpleasant character in infancy, when the only manifestation of complaints is the child’s loud cry. Therefore, at this age, regular examination by a pediatrician is necessary. A competent doctor will tell you what to do to ease the adaptation period and not miss initial manifestations congenital diseases and developmental defects.

Old age

In adulthood, pain in the right hypochondrium is most common. Over time, chronic diseases and metabolic disorders accumulate. Here, diseases of the liver itself, such as chronic hepatitis, fibrosis and cirrhosis, come to the fore. As well as cardiovascular failure with the development of portal hypertension.

Gallstones or polyps may form in the gallbladder. Any pain in the liver area is a reason to see a doctor. It must be remembered that a timely visit to a therapist or gastroenterologist will save you from many troubles. And this must be done if hepatic colic develops.

Hepatic colic

Colic is a condition characterized by sharp pain in the right hypochondrium, accompanied, as a rule, by other dyspeptic manifestations: nausea, vomiting, stool retention and urination. The cause of hepatic colic is most often gall bladder and duct stones. But there are more rare cases, for example, phlegmon of the gallbladder, suppuration of a liver cyst, acute thrombosis of the hepatic veins.

Hepatic colic is characterized by severe pain in the entire right lateral region, sometimes extending to the back and high in the ribs, significant deterioration general condition sick. The only thing that can be done to make him feel better is to give an antispasmodic (no-spa, spasmalgon, baralgin) and call an ambulance.

Attention! Information about drugs and folk remedies is presented for informational purposes only. Under no circumstances should you use the medicine or give it to your loved ones without medical advice! Self-medication and uncontrolled use of drugs are dangerous for the development of complications and side effects! At the first signs of liver disease, you should consult a doctor.

The use of site materials is permitted only with prior approval from the editor.

Let's find out the causes of pain under the ribs on the right

A common symptom is pain on the right side under the ribs. This can be caused by various diseases or problems. Even completely healthy people may experience soreness in this area.

There are many internal organs located on the right under the ribs, so the list of diseases will be large. First of all, you need to figure out what kind of pain should cause a person’s anxiety.

Pain varies

In adolescents, pain on the right side is considered normal occurrence, as it speaks about the development of the body, its growth. Such manifestations also occur when:

taking certain hormonal medications;

pregnancy;

premenstrual syndrome.

Duration less than 30 minutes is considered short. The concern should be caused by pain that does not go away for more than an hour, intensifies with movement, and has a stabbing, sharp character.

It is the acute nature of the pain that is often associated with inflammation of the appendix. Stitching unbearable pain is a sign of rupture of the liver, gall bladder, or kidney. Acute pain, which intensifies when walking, gives reason to assume the presence of a hematoma in the internal organs.

A dull pain, similar to the heaviness of a bag hanging on its side, signals chronic pathologies of the internal organs (pancreatitis, malignant neoplasm, cirrhosis of the liver).

Sometimes the pain is of a mixed nature. It is tugging, dull, but at times sharp. Wandering, short-term under the rib on the right or spreads so that it is difficult to determine its location. Such manifestations have psychosomatic reasons, you need to contact a neurologist.

Be sure to watch the next video

Hepatitis

This is a liver disease. You can become infected through a blood transfusion, through a sexual partner, when applying a tattoo with unsterile needles, or through acupuncture.

The pain under the ribs has a bursting, aching character, because the liver has enlarged and puts pressure on other internal organs and ribs.

Diagnosis of pathology is carried out by an infectious disease specialist. Treatment is carried out by a hepatologist (a specialist in liver diseases) and a gastroenterologist (a doctor who specializes in diseases of the digestive tract and liver).

To make an accurate diagnosis, it is carried out diagnostic examination, tests are taken:

blood chemistry;
specific blood tests (ALAT, AST);
bilirubin test;
test for antibodies to the hepatitis C virus;
analysis to determine the RNA of the virus (PCR);
virus biopsy.

This disease can only be treated with medications. Immunomodulators and interferons are used. They are designed to reduce the inflammatory process in the liver, prevent the transition of hepatitis to a chronic form, then to cirrhosis and cancer. Also, medications should help eliminate the hepatitis virus from the liver.

To facilitate digestion and liver function, it is prohibited to consume the following foods:

The following products are useful for hepatitis:

If an infected person follows doctors’ recommendations, undergoes examinations, and follows a diet, then the main complications in his life will occur in about 30 years. Hepatitis has no cure yet. The liver will gradually lose its ability to filter blood. The main enemies of the liver are alcohol and fatty foods. An infected person will help themselves by not using it.

Cirrhosis

This is a liver disease where the organ's normal cells are replaced connective tissue. The liver can no longer do its job normally, for example, cleanse the blood, and the whole body suffers.

complication after viral hepatitis;
immunity disorders;
hereditary pathologies;
chemical poisoning;

Signs of pathology are weak. On initial stage They are completely unnoticeable and short-lived.

periodic pain in the right side under the ribs in front;
in the morning bitterness, dry mouth;
weight loss;
irritability, short temper;
fast fatiguability;
upset stool, increased gas formation;
jaundice.

The disease is complex, and treatment is strictly individualized. Physiotherapy procedures are not recommended; the use of traditional medicine recipes is agreed with the attending physician; they are not used at the stage of primary treatment. Perhaps only at the recovery stage to maintain the body’s strength. A positive result largely depends on the coordination of the actions of the doctor and the patient.

Pathology has a different prognosis. It all depends on the stage of liver destruction. Modern science has many tools, capabilities, and techniques. But the patient must reconsider his lifestyle, listen to doctors, follow their instructions, and not hope for a magic pill.

Cholecystitis

This is an inflammatory disease of the gallbladder.

sedentary lifestyle;
poor nutrition;
use of certain contraceptives;
heredity;
allergic reaction.

The disease begins gradually, the onset is greatly influenced by stressful situations, emotional stress, overeating. The main manifestation is pain in the right side, and the pain is constant and severe, and can spread to the shoulder blade and reach the shoulder. IN special cases the pain shifts to the left side, covers the entire upper area belly.

An experienced doctor will already identify this disease based on the symptoms. Additional examinations will confirm the diagnosis:

Ultrasound of the abdomen;
X-ray;
cholecystocholangiography ( special examination to identify stones in the biliary tract);
blood sugar test;
general, biochemical blood test
bacteriological, microscopic analysis of bile.

A gastroenterologist treats this disease. Inflammation in the gallbladder is eliminated with the help of antibiotics. To normalize the functioning of the organ, they are prescribed antispasmodics, analgesics, choleretic agents.

Traditional methods are of great help. Medicinal herbs increase the secretion of bile, reduce its viscosity, and reduce inflammation. It is necessary to take infusions of medicinal herbs during recovery periods, and not during exacerbation stages. The duration of treatment is approximately a month.

Pour 5 g of tansy flowers into a glass of boiling water and leave for half an hour. Take 1 tablespoon 3 times a day before meals.

Pour 10 g of corn silk into a glass of water and boil for 5 minutes. Drink a quarter glass 3 times before meals.

If you consult a doctor in a timely manner, the development of the disease can be stopped. The danger lies in complications.

Right kidney - Urolithiasis

A disease that leads to the formation of peculiar stones (calculi) in the urinary system.

unbalanced diet;
frequent infectious diseases;
lack of fluid;
hereditary diseases;
passive lifestyle;
chronic diseases of the digestive system;
long-term use of certain medications;
poor composition of drinking water;
hot climate.

Urolithiasis usually does not manifest itself for a long time; it is discovered unexpectedly when scheduled inspection. But some patients sometimes feel pain on the right side in the area of the kidney under the ribs.

blood in urine;
increased blood pressure;
high body temperature;
renal colic.

During a conversation with the patient, the doctor selects a lot of important information - when the pain began, whether there were cases of stone passage, whether there were cases of such diseases in the family, what chronic diseases the patient suffers from, what operations he underwent. Examinations are carried out and tests are collected:

blood analysis;
Analysis of urine;
cytoscopy (special examination Bladder);
Ultrasound of the kidneys, bladder;
abdominal x-ray;
CT scan.

A kidney specialist is called a nephrologist. The most difficult period in urolithiasis– this is the passage of stones. At such a moment, it is better to stay in a medical institution under the supervision of doctors. Severe pain should be relieved with non-seroid anti-inflammatory drugs, for example Ibuprofen, Naproxen. Doses are indicated in the instructions.

But only small stones come off on their own; large ones need to be crushed. For this, there are several methods that use ultrasound and other technologies. Special physical training, physiotherapy, and sanatorium and resort treatment help well in treatment.

If urolithiasis is detected, you need to change your lifestyle. This does not mean that you need to give up all joys and pleasures. Life should be filled with movement, sports, natural food, and regular medical examinations.

Pyelonephritis

This is a kidney infection that is caused by bacteria. A pathogenic microorganism that is located in the human body has somehow reached the kidneys. This can be due to inflammation of the external genitalia in girls. The urinary tract infection travels up to the kidneys. Also, with the blood flow after viral infections of the throat or nose, pathological microorganisms reach the kidneys.

Favorable conditions for the development of pyelonephritis:

immunity;
hypothermia of the body;
incomplete emptying of the bladder when urinating;
chronic infection in the body - caries, tonsillitis;
scalatina;
diabetes.

Manifestations of pyelonephritis can be confused with another disease, since pain in the right hypochondrium is a sign of many pathologies.

constant weakness ;
anxiety, insomnia;
poor appetite;
thirst, increased sweating;
heat;
frequent urination;
nagging, aching pain in the right hypochondrium, which becomes stronger when moving;
cloudy urine.

Examination of the patient by a doctor is an important part of the diagnosis. The doctor feels the kidneys, finds out the location of the pain, asks about the nature of the pain and the duration of this condition. Instrumental methods include:

computed tomography;
kidney biopsy;
X-ray;
Ultrasound of the urinary system.

An important condition for recovery is getting rid of the causative agent of the disease. Antibiotics help with this, but they need to be changed every 10 days to avoid resistance of pathogenic microorganisms. IN difficult situations a combination of several drugs is used.

Also prescribed are drugs to improve blood supply to the kidneys, antioxidants, diuretics, and vitamins. To suppress the inflammatory process, nonsteroidal medications are prescribed for a course of up to 10 days. During exacerbation of pyelonephritis, it is recommended to limit salt intake.

The body is especially vulnerable to pyelonephritis in children, adolescence. In adults, this disease can be caused by blockage of stones in the urinary tract. Delayed treatment will lead to complications that will be associated with the accumulation of pus in the kidneys and disruption of their normal functioning.

Negative consequences of pyelonephritis

constant increase in blood pressure;
blood poisoning;
death from renal failure.

Diaphragm diseases

The diaphragm is a muscular plate that separates the thoracic and abdominal regions. It also plays an active role in breathing. Pathologies of the diaphragm can occur due to:

When relaxing, the diaphragm muscle becomes thinner, which leads to negative consequences.

When the diaphragm is damaged during an injury, internal organs usually also suffer. I have to urgently undergo surgery. This often happens in the event of an accident or fall from a great height.

With pathologies of the diaphragm, the internal organs of the chest suffer. They are compressed, bent, their normal functioning is disrupted, and the patient’s condition sharply worsens.

increased pain under the ribs;
constant feeling of heaviness;
shortness of breath, rapid heartbeat after eating;
rumbling in the chest;

The general practitioner is the first to assume that a person has diaphragm disease based on a survey and examination. Confirmation of the diagnosis can be obtained from the results of an x-ray with contrast agent, also EGDS. Such methods allow you to decide on a treatment plan.

Some types of hernias are not strangulated, so for their treatment a certain diet with fractional meals and a special set of medications are prescribed to reduce the acidity of gastric juice. Such patients should not carry heavy weights or tightly tighten the abdomen with tight belts.

During the operation, all organs are reduced and the enlarged hole is sutured. When relaxing the hernia, the thinned area is strengthened with special material.

Proper treatment carried out on time surgery relieves a person from these problems.

Lung cancer

This is a malignant epithelial tumor that has spread to the lung. The reason is this terrible disease is a DNA disorder that occurs under the influence of factors external environment. This includes smoking, working in hazardous industries where you have to inhale various chemicals.

The disease does not immediately manifest itself. The signs are similar to other pathologies, people waste time turning to other specialists.

Symptoms of right lung cancer

cough streaked with blood;
labored breathing;
pain in the right hypochondrium;
shortness of breath even without exertion;
weight loss.

Diagnosis of such a disease is at a high-tech level and has several stages. To finally approve this terrible diagnosis, it is rechecked several times.

If the patient applied at the initial stage, the presence of the disease will be determined by analysis, because the tumor is not yet visible on the pictures. At later stages, photographs will serve as evidence.

The standard cancer treatment includes several methods. Doctors choose the appropriate one based on the individual situation for each patient separately. ethnoscience focuses more on cancer prevention and health promotion. For example, licorice root softens the mucous membrane of the lungs, especially if it is damaged after a cold, inflammation, bronchitis, or smoking.

Make plans, make forecasts in such a situation serious illness very hard. Early application for medical care, following doctors’ recommendations helps to cope with the disease.

Pneumonia

Infectious lung disease. It is often a complication after colds.

Manifestations can be similar to the flu or a cold.

temperature;
acute pain in the chest, under the ribs;
constant sweating;
cough with thick sputum;
rapid pulse;
possible shortness of breath;
blue lips, nails;
muscle pain, headache;
overwork.

After the examination, the doctor conducts diagnostic tests :

blood tests (general, biochemical);
sputum analysis;
chest x-ray;
fibrobronchoscopy (examination of the lungs);
blood culture to identify the pathogen.

A lung specialist is called a pulmonologist. He is invited to the patient in difficult cases. For treatment, expectorants are prescribed to better separate sputum. Antipyretics only at high temperatures. Cardiac medications for severe shortness of breath. At the recovery stage, immunomodulators and vitamins are recommended to strengthen the body's defenses.

Among the folk remedies, a compress of honey and vodka helps a lot. The skin on the affected side is smeared with honey, a napkin is moistened with vodka, applied to the honey, covered with a warm towel, and left overnight. Such compresses are made 3–4 times, but only if there is no pus in the lungs.

Pneumonia is a serious pathology, has many complications, it cannot be ignored, it must be treated. Negative consequences include:

Duodenal ulcer

This is a pathology in which defects – ulcers – form on the wall of the duodenum.

They can manifest themselves clearly, but are perceived as other diseases.

pain in the upper abdomen under the ribs;
pain at night, stops after eating;
heartburn;
belching with a sour taste;
constipation

The doctor must find out what the patient associates his painful sensations with, which helps to get rid of it.

urine, blood, stool tests;
analysis of gastric juice;
FGDS;
Ultrasound of the abdominal cavity.

Treatment is prescribed by a gastroenterologist. These will be means to reduce stomach acidity and reduce its amount. Antibiotics are required to destroy pathological microorganisms. For severe pain, use antispasmodics, for example, but spa.

Traditional medicine recommends natural honey as a healing agent. It should be eaten every day for 2 weeks 30 minutes before meals. But it is better to mix in equal proportions with olive oil, keep this mixture in the refrigerator.

With patient treatment, the prognosis is favorable. The ulcer can be brought to the stage of scarring. But if treatment is not carried out, perforation (rupture of the intestinal walls), narrowing of the intestine, and other complications may occur.

Crack, broken ribs

Damage to the integrity of the rib. If the injury is minor, then this may manifest itself as slight soreness, which will not bother you much.

The appearance of cracks and fractures of ribs is influenced by a person’s age and existing diseases.

Signs appear immediately, sharply, and then may subside

periodic pain;
pain when inhaling, exhaling, coughing;
feeling of lack of air;
hemorrhage in the area of injury;
swelling at the site of injury.

The therapist conducts initial examination, an area of pain is visible along it. To confirm the diagnosis, X-rays and computed tomography are performed.

The treatment is carried out by a traumatologist. Hospitalization is carried out if damage to internal organs is detected. If only the ribs are injured, treatment at home is allowed. Painkillers are prescribed, and cold compresses should be applied to the site of the bruise.

If all the doctor’s instructions are followed, complete recovery occurs.

Osteocondritis of the spine

A chronic disease that damages cartilage and intervertebral discs.

Causes of pathology:

hereditary predisposition;
injuries;
impaired metabolism;
obesity;
overload of the spine during sports activities;
poor posture;
flat feet.

It appears gradually, the symptoms depend on the department in which the pathology develops.

constant aching pain in the lower back, radiating to the ribs;
dizziness when turning the head suddenly;
blurred vision;
pain between the ribs when moving;
loss of sensation in the limbs.

Osteochondrosis is determined using MRI, ultrasound, and laboratory examinations.

Therapy must be comprehensive to obtain the desired positive result. Good effect They provide acupuncture, vacuum therapy, and laser treatment. Many doctors recommend dry traction, electrical stimulation, and magnetic puncture.

Without quality treatment, a person is doomed to severe consequences which subsequently lead to paralysis of the limbs. It is necessary to receive treatment in a timely manner, conscientiously, and follow the recommendations of doctors.

Shingles

A skin disease of viral origin that affects nervous system and skin. Once it enters the human body, the virus manifests itself under favorable conditions, subsiding under the influence of treatment or the immune system.

Factors influencing the manifestations of lichen:

Shingles is contagious. When in contact with a sick person for several weeks, characteristic rashes are observed along the nerves.

Weakness;
The temperature is low-grade, rarely high;
Headache;
Disruption of the digestive system;
Pain along the skin rash, most often in the right hypochondrium;

The pain associated with this pathology is special. Ringworm disrupts the functioning of nerve cells. At the site of the rash, the nerve endings become very sensitive, even a slight touch to them causes a burning sensation.

Initially, the disease is treated by a therapist. If necessary, a dermatologist and an infectious disease specialist join. If the pathology is severe or advanced, you may need to consult a neurologist.

To relieve pain, doctors prescribe painkillers, for example, Ibuprofen, Paracetamol. Specific drugs against herpes are Acyclovir, Zovirax. They promote healing of ulcers and normalization of general condition.

Ringworm can cause damage to internal organs. During pregnancy, it can harm the baby. We must remember that under favorable conditions it will appear again. Its appearance is always unpleasant, reduces immunity, and takes away strength. Hardening and a healthy lifestyle will prevent the appearance of herpes.

Pain when breathing

Particular attention should be paid to pain on the right under the ribs when inhaling or breathing. It can't just happen. The reasons may be:

Usually accompanied by a dry cough. Even several years after suffering pleurisy, pain may remain with deep breath as a complication. When breathing, pain occurs when there is a tumor of the pleura.

Inflammation of the outer lining of the heart (pericarditis) also causes pain when breathing. People with this condition usually try not to take deep breaths.

Inflammation of intercostal nerve endings worsens with deep inspiration. Soreness is localized at the site of greatest nerve damage. The pain may also intensify from movements, bending, and unsuccessful turns in the painful direction. Inflammation in the muscles (myositis) also causes pain when breathing.

Pain on the right side under the ribs occurs with renal colic, when the stone is in the right kidney or ureter. In this case, the pain will increase when you inhale and radiate under the shoulder blade.

If you have such symptoms, you should seek help from a doctor. There are many diseases, they are treated in different ways. Only a professional can make a diagnosis.

See a doctor urgently!

You should rush to seek medical help:

if it hurts on the right under the ribs for a long time, more than an hour;
with acute, sudden pain;
with bursting pain;
if a sharp pain in the right hypochondrium intensifies when walking or any movement.

It’s better not to take painkillers, they will only blur clinical picture diseases. If the pain is difficult to bear, it is better to apply a cold compress, it will relieve the pain a little.

Conclusion

When pain occurs, you need to concentrate and understand what is happening to the body. It is necessary to remember what happened before this moment, what foods and drinks you consumed, what you did. You need to be a good master of your body, remember where which organs are located, what can happen to them. Now a little more is known about the right hypochondrium. Let's hope that this knowledge is useful only theoretically.

Editor and expert of the site zdorovya-spine.ru. Specialization: general practitioner. More than 10 years of experience. City clinic, Smolensk. Graduated from Smolensk State medical academy specialty: general medicine. I really love my profession.

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