In medical practice, liver enlargement is called hepatomegaly. The organ reaches a fairly large size, occupies most of the peritoneum and sometimes weighs more than 10-15 kg. Hepatomegaly is a symptom of any liver pathology and is most often observed in patients with chronic diseases, infections, intoxication of the body and oncological tumors. Some types of oncology of internal organs lead to an enlargement of the right lobe of the liver. The causes of diseases, their symptoms and treatment methods depend on the patient’s age and negative factors affecting the body.
What to do if your liver is enlarged?
In many cases, an enlarged liver causes significant discomfort. Therefore, such a symptom can be detected without using diagnostic methods. Hepatomegaly is not a separate disease. If the liver is enlarged, this is evidence that the organ is damaged.
You can determine what an enlarged liver means using a comprehensive diagnostic examination. The patient needs to undergo blood tests, urine tests, and a stool sample. Instrumental methods are also used: ultrasound, tomography, scintigraphy, puncture biopsy. The listed diagnostic methods are necessary not only to confirm that the liver is enlarged. With their help, I determine the exact cause that provokes the pathology.
What is not recommended to do?
If the liver is enlarged, you cannot ignore the symptoms and neglect the treatment of the pathology. It is important to undergo a full examination as soon as possible and identify the cause of the development of hepatomegaly. It is not worthwhile to carry out therapy only with medicinal herbs or folk recipes. Such treatment may alleviate symptoms, but will not get rid of the underlying disease.
For hepatomegaly it is not recommended:
- self-medicate;
- prematurely interrupt the course of treatment;
- independently select medications for treatment;
- neglect the rules of dietary nutrition;
- eat prohibited foods;
- abuse alcohol;
- ignore signs of exacerbation of the disease.
What is an enlarged liver
Hepatomegaly - as liver enlargement is officially called in the medical field - is not a disease, but is one of the characteristic symptoms indicating problems of the hepatobiliary system. The danger of an enlarged liver is not only in the disruption of its function and the digestion process, but also in the fact that it can be a sign of diseases of organs and systems not related to the gastrointestinal tract - the heart, blood. It is important to stop liver bloating (this is how the patient perceives the problem) at the initial stage, since it has many serious consequences:
- liver failure, resulting in death;
- the development of a disease, the symptom of which is an enlarged liver;
- formation of low-quality tumors;
- cirrhosis of the liver;
- hepatocarcinoma.
The size and location of the liver is normal
The liver is located primarily on the right side of the body, slightly below the level of the heart. Its physical dimensions in a healthy state are 25-30 cm in length, 14-16 cm in height on the left side and 20-22 cm in height on the right side. The thickness is taken to be the thickness of the right lobe. In a healthy organ, it ranges from 12.5 to 14 cm. In those who actively abuse alcohol, these sizes are increased by about 10%.
The boundaries of the liver relative to the abdominal cavity are established by the doctor, who taps the edges of the organ and determines whether they go beyond the nominal values or not. It is impossible to independently understand whether the liver is enlarged or not without proper medical training. The right lobe is increased to a greater extent, since the most active zone responsible for the production of enzymes is concentrated in it.
As the size of the liver increases due to heavy drinking, its location relative to the abdominal cavity does not change, however, the lower edge of the right lobe may extend beyond the boundaries of the lower ribs, which also often happens in children under 7 years of age. In the case of children, such manifestations are not considered deviations, since they are caused by age-related characteristics of the body structure.
What is the treatment?
— One of the most common causes of liver disease is viral hepatitis. In this case, antiviral therapy is prescribed.
If it is toxic, alcoholic hepatitis, then you need abstinence from alcohol, medication support and diet.
In case of fatty hepatosis associated with excess body weight, measures aimed at reducing excess body weight, diet, drug treatment, and surgical intervention if necessary are prescribed.
In the case of cirrhosis, that is, more severe liver damage, treatment is more difficult, but it is possible. First of all, therapy is aimed at eliminating the causes of cirrhosis.
The next step will be treatment with various medications that allow the liver to function more optimally. Well, the last resort treatment for cirrhosis is liver transplantation.
Proper nutrition and prevention
Adjusting the diet during the fight against the disease will help the body quickly overcome the disease, so reviewing the daily menu is an integral part of therapy. When the liver is enlarged, regardless of the cause of the condition, treatment should include diet. All products that have the property of irritating liver cells are prohibited. General recommendations for nutrition during illness:
- fatty, fried, spicy, smoked and salty foods are excluded;
- complete abstinence from alcohol;
- if you want the symptoms of hepatomegaly to go away as quickly as possible, you should only eat boiled or steamed food;
- It is worth monitoring the amount of water you drink. It will also help neutralize acids in the liver faster.
It is necessary to take preventive measures against hepatomegaly seriously. Proper nutrition, complete abstinence from alcohol and regular examinations by a hepatologist will help prevent the disease.
If your liver hurts after drinking alcohol, you should seriously think about your health. Pain in the liver after alcohol, caused by intoxication, will be a bitter reminder of health problems, preventing cells from regenerating, causing, over time, more severe complications.
Hepatomegaly in children
In newborns, the cause of hepatomegaly is jaundice. What to do when diagnosing a disease? There is no need to treat such a physiological change, since after 2-3 months the enlarged liver acquires its natural size. The causes of early hepatomegaly in newborns are changes in the functionality of the endocrine system, trauma during childbirth, and diabetes mellitus in a woman carrying a child.
In children under 7 years of age, liver enlargement is a normal condition. If the organ slightly (up to 2 cm) begins to protrude beyond the ribs, then the problem of how to treat this condition disappears. This process is normal, and as the child ages, everything will return to normal on its own.
If the increase is significant, the doctor determines what to do. Before prescribing therapy, the patient is sent for diagnostics. Hepatomegaly can be caused by:
- intrauterine infection;
- inflammation;
- damage to the gland by pesticides, toxins, honey. drugs;
- exchange changes;
- violation of the structural functionality of the biliary tract;
- blockage of ducts in the bile ducts;
- benign tumors;
- oncology.
Emergency therapeutic measures are required by simultaneous hepatomegaly and:
- increased body temperature;
- the appearance of a “mesh” of blood vessels on the abdomen;
- numerous skin rashes;
- vomit;
- yellowness of mucous membranes;
- lack of appetite;
- sudden loss of body weight.
If it is enlarged in a child
Hepatomegaly in children has slightly different causes than in adults. If parents discover that a child has a very enlarged liver at an early age, then it is necessary to suspect the presence of inborn errors of metabolism. Specific changes indicate that the organ tissue lacks the enzymes necessary for metabolism. Metabolic pathologies are usually accompanied by digestive problems and the development of jaundice.
Another reason why the liver is slightly enlarged in a child may be TORCH infections - diseases that are transmitted to the child during childbirth from an infected mother. This group includes hepatitis, which quickly leads to hepatomegaly.
A more rare factor that can cause liver enlargement is the penetration of parasitic worms into the tissue of the organ. Children are much more likely than adults to suffer from helminthic infestations, which can lead to liver dysfunction.
How is it treated?
Treatment for an enlarged liver depends on what is causing it. Lifestyle changes may help when liver enlargement is the result of fat accumulation in the liver or alcohol consumption. Lifestyle changes include:
- Weight loss, reduction of body fat;
- Reducing or eliminating alcohol intake;
- Eating a healthy diet;
- Increasing physical activity and general physical activity.
Treatment for other causes of liver enlargement depends on the underlying disease that caused it.
Treatment of ailments
Treatment of an enlarged liver necessarily involves getting rid of the disease that caused hepatomegaly.
This can be helped by taking medications or surgery. The decision on how to treat an enlarged liver is made only by a qualified doctor after a complete diagnosis of the body. As a rule, they try to resort to surgical intervention in extreme cases.
When diagnosing an enlarged liver, the causes and treatment are closely related. In the case of various tumors, chemotherapy and surgical removal of tumors are used.
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Surgical intervention is often required in case of disturbances in the outflow of blood or bile from the enlarged liver.
When diagnosing helminthiasis, it is recommended to take special anthelmintic drugs.
If the cause is various infections, then for an enlarged liver, treatment includes taking antibacterial drugs.
For any diagnosis, the doctor must prescribe medications from the group of hepatoprotectors. These drugs allow you to speed up the process of regeneration of the affected organ, reduce the impact of harmful substances on the liver, and rid it of toxins.
Hepatoprotectors include Gepabene, Essentiale, Galstena, Artihol. In some cases, doctors prescribe the medicine Mezim.
An enzyme-containing drug taken before meals normalizes digestion, improves the production of enzymes and the flow of bile.
If a patient has an enlarged liver and spleen at the same time, then it is necessary to take vitamins, especially group B. The doctor may prescribe both a vitamin complex and the drug Essliver.
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This medicine not only contains all B vitamins, but is also considered a good hepatoprotector.
It should be noted that taking any medications or folk remedies for an enlarged liver should only occur with the consent and under the supervision of the attending physician. Self-treatment can harm the body and worsen the situation.
How to treat
To determine the list of therapeutic measures that will be taken, it is necessary to establish an accurate diagnosis: for this, in addition to the mentioned types of diagnostics - MRI, CT, ultrasound - a biopsy (if there is a suspicion of cancer or steatosis), and detailed blood tests can be prescribed. Additionally, the doctor will compile the patient’s complaints and, in a difficult situation, refer him to several more specialists. The treatment regimen for an enlarged liver is often discussed not only with a gastroenterologist, but with a hepatologist and infectious disease specialist. A few general points:
- Whatever the cause of an enlarged liver, one of the main points of treatment will be diet. The doctor will outline the exact dietary restrictions, but the essence of it is to spare the organ. How long you will have to stick to the diet is also discussed with a specialist, but be prepared that this stage of treatment will last for several months or years.
- The drug treatment regimen necessarily contains drugs from the category of hepatoprotectors, which have not so much a therapeutic quality as a preventive one. They are needed to support the diseased organ, but will not eliminate existing diseases.
- No cure for liver enlargement will work if the problem is advanced hepatitis: in the later stages, the only “treatment” measure is transplantation, and before that, doctors try to prevent the rapid development of complications.
Diagnosis of pathology
By visually observing signs of liver enlargement (yellowness of the skin, “stars” on the abdomen), listening to the patient’s complaints and palpating the organ, a qualified doctor can easily diagnose hepatomegaly.
But this is not enough for a cure; it is necessary to determine which disease caused the pathology. To make an accurate diagnosis, a set of methods is used, including many tests and examinations.
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First of all, general and biochemical blood tests are taken from the patient. Studies can determine the levels of liver enzymes and bilirubin, and identify the presence of hepatitis virus, malaria or typhoid fever.
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In some cases, the patient may be tested for the presence of helminths in their urine or stool. These studies are quite informative, but often an accurate diagnosis can only be made after an ultrasound examination of the liver.
Ultrasound allows you to find out whether the right lobe of the liver is enlarged, since it primarily suffers from all ailments. In rare cases, the organ begins to grow to the left if the corresponding part of it is affected.
During the examination, you can determine what the contours and structure of the liver are. This allows you to clearly diagnose hepatitis, cirrhosis, and various tumors.
During an ultrasound examination, the splenic region is also checked, since quite often the patient has an enlarged liver and spleen at the same time.
For a more detailed diagnosis, the patient may be prescribed a computed tomography or magnetic resonance imaging scan, an X-ray examination, or a radioisotope scan of the liver.
All these methods make it possible to detect an enlargement of the left lobe of the liver, as well as the right one. Normally, on the right side the organ should measure no more than thirteen centimeters, and on the left – seven centimeters.
If tumors are detected on the liver, a biopsy is taken from the patient. This procedure makes it possible to clearly recognize malignant tumors, thereby quickly identifying oncology in the patient.
Thus, after all the examinations, it becomes clear what kind of disease, by enlarging the liver, threatens human health, why the disease arose and how to further combat it.
Skin rashes
In liver diseases, the skin undergoes a number of changes. The skin becomes atypically pale or dark, sweating increases, and swelling is observed in the face and limbs. Sometimes peeling of the skin occurs. In this case, its surface is covered with scratches and cracks.
Particular attention should be paid to yellowness of the skin. Its moderate degree with an orange tint indicates liver problems. Brown color indicates mechanical damage to the organ. But the lemon-yellow color appears with hemolytic disorders.
Stretch marks on the skin of the abdomen in the form of bluish stripes are not uncommon in liver diseases. The reason for their occurrence is a hormonal imbalance, in which it cannot neutralize steroid hormones. They are characteristic of both the female and male body.
However, not only changes in the nature of the skin indicate diseases in the “laboratory of the body.” A common symptom is a rash.
It may be of the following nature:
Pustular elements. The source is immune imbalance. It appears in the body due to reduced liver function. This means that the organ cannot sufficiently synthesize immunoglobulin. Allergic manifestations. Spots and papules occur as a result of impaired detoxification function.
This is why a person gives an allergic reaction to familiar conditions. Hemorrhagic rash. Expressed in small hemorrhages on the skin. They are an indicator of a decrease in the synthetic function of the liver. The proteins that make up the blood coagulation system are primarily affected. Patients tend to develop hematomas.
Severe redness of the palms. Accompanied by an increase in temperature. May be transmitted to the feet. Spider veins. Localized on the face, neck, back and arms. They are small blood vessels that protrude above the skin. Size - from 1 mm to 2 cm. Yellow plaques.
Formations of yellow color. They appear on the armpits, arms, legs, feet, and eyelids. Parmal erythema is a red rash that disappears when pressed. Then they appear again. Psoriasis. An absolutely painless disease. Forms on the forehead, eyebrows, arms and legs. It appears as pink spots, which are subsequently covered with silvery scales.
Urticaria is an allergic reaction after hepatitis. "Liver palms." The rash has the character of small veins. Localization - thumb and little finger. Any of the skin rashes is accompanied by itching. It is especially pronounced when the rash is combined with yellowing of the skin. This is due to the fact that bilirubin, not neutralized by the liver, is deposited in the epidermis, causing irritation. Other toxic metabolic products accumulate in the skin, further irritating it.
Of course, the appearance of skin rashes does not always signal liver disease. They can be triggered by a number of other reasons. But definitely, this is a reason to think about the condition of the organ. If rashes appear, especially in combination with pain syndromes, you should immediately consult a doctor.
Often, the condition of the skin can reveal the symptoms of certain diseases. Many liver diseases also manifest themselves in the form of skin irritation.
Complications
An enlarged liver, detected by ultrasound, is dangerous not in itself, but because of irreversible consequences: necrosis, cirrhosis, liver failure. In this case, the disease does not respond well to drug treatment. We need transplantation of healthy tissues that can divide. Such operations have restrictions on diseases and age; they are performed on people under 60 years of age without serious pathologies of other internal organs or infectious diseases.
An enlarged liver interferes with the work of neighboring organs, they experience constant pressure, and pathological changes begin to develop in them too. With treatment and diet, it gradually returns to its original size.
It is important to do an ultrasound on time, make an accurate diagnosis, and identify the source of hepatocyte damage. If an organ is inflamed, with treatment it quickly returns to normal. In case of toxic and alcoholic lesions, liver cells are not restored in full, but the pathological process is frozen, and liver failure does not develop.
What are the symptoms?
An enlarged liver often does not cause any symptoms. Doctors often discover it when treating a patient for another, unrelated condition.
An enlarged liver may occur along with other symptoms, especially if the underlying cause is a primary liver disease. These symptoms may include:
- Fatigue;
- Jaundice (yellowing of the whites of the eyes and skin);
- Nausea and vomiting;
- Pain in the upper middle or upper right abdomen;
- Fills up quickly after eating.
If you have any of these symptoms, especially if they persist, contact your doctor.
Causes of disease development
All causes leading to the development of liver hepatomegaly can be divided into three groups:
- Liver diseases. In this case, damage to hepatocytes (liver cells) is observed, which triggers the mechanism of either tissue swelling or its regeneration. Enlargement of the liver due to edema goes away after inflammation is relieved. With enhanced regeneration of hepatocytes, everything is somewhat more complicated. During this process, only part of the liver cells is restored, and the rest are replaced by connective (scar) tissue. As a result, the liver gradually increases in size and becomes lumpy and dense. The causes of hepatomegaly can be various liver diseases: autoimmune and viral hepatitis, echinococcosis, polycystic disease, cirrhosis and fibrosis, malignant neoplasms, etc.
- Storage diseases. As a result of metabolic disorders, glycogen, iron, carbohydrates, fats and other substances begin to accumulate in the liver, leading to an increase in the size of the organ. Such diseases include hepatolenticular degeneration, amyloidosis, fatty hepatosis, and hemochromatosis. Many of them are hereditary. But some, such as fatty hepatosis, can occur as a result of general obesity, alcohol abuse, and long-term use of certain medications.
- Cardiovascular diseases, accompanied by circulatory failure and leading to oxygen starvation of hepatocytes and stagnation of blood in the liver. The cause of hepatomegaly in this case is the death of liver cells and the development of connective tissue in their place.
Diet for hepatomegaly
You need to exclude everything spicy, fried, pickled, floury from your diet, and also make sure that the body receives the proper amount of nutrients. The diet allows the consumption of cereals, vegetables and fruits, dairy products, sauerkraut, and sweets - jam, marmalade, honey.
The diet prohibits the consumption of alcohol, meat - goose, pork, lamb, liver, as well as legumes and nuts. Without abuse, you are allowed to eat eggs, cheese, butter, tomatoes and boiled sausage without fat.
Enlarged liver - how to treat?
Treatment is prescribed taking into account the underlying cause that led to liver enlargement. Complex therapy includes drugs to cure the disease or condition that led to the change in size, as well as medications that inhibit its growth and support its function. The first depends on the reason:
- For infections, viral diseases: antibiotics, antiviral drugs;
- In case of improper metabolism: vitamins and drugs that replenish the deficiency of a specific hormone;
- In case of poisoning, incl. alcoholic: drugs that support organ function and enzymes that replenish it;
- When replacing normal cells with fat cells: corticosteroids.
The doctor decides what to take to reduce the size of the liver and stimulate its work. There are many drugs:
- Ovesol: cleanses, improves the condition of the bile ducts;
- Essentiale: supports cardiac function, lowers cholesterol;
- Hepatamine: restores the functioning of the organ, performs a protective function;
- Liv-52: protects against poisons;
- Essliver: accelerates the recovery of hepatocytes;
- Legalon, Karsil: protective drugs;
Galstena is indicated for gallstones and hepatitis. To treat the latter, bile duct stimulants – Ursofalk – are also used.
Treatment with medications is effective for viral and infectious diseases to bring the filtering organ to a normal state. In case of cirrhosis, they only contain liver damage, but do not cure. For hepatitis, medications alone are also not enough. Sometimes treatment includes surgery:
- Removal of affected parts in case of oncology and cyst formation.
- Vascular embolization for tumors. This cuts off oxygen supply to the tumor, causing it to die.
- Transplanting part of the liver instead of the damaged one, since the organ is capable of regeneration.
