Chronic toxic hepatitis symptoms and treatment. Toxic damage to the liver and the development of hepatitis

Toxic hepatitis is an inflammatory liver disease that occurs as a result of the damaging effect of harmful agents on the cells of this organ. Toxic substances that cause negative changes in the liver tissue can be of a different nature. Most often, these are drugs, alcohol, chemical fertilizers, poisonous substances contained in plants and fungi.

Poisonous substances enter the body different ways: together with food, by inhalation, in the form of injections, etc. Further, in one way or another, they are absorbed into the bloodstream, with which they penetrate the liver. Their toxic effects are also heterogeneous. Damaging agents can directly destroy liver cells, and provoke their destruction through the work of immunity, disrupt the processes of cellular regeneration and protein synthesis, and stimulate oxygen starvation.

Varieties of toxic hepatitis factors

Medications

Basically, liver damage occurs with an overdose or long-term use of hepatotoxic drugs. Also, drug-induced hepatitis can develop with the use of adequate dosages of drugs, against the background of existing disorders of the organ. To prevent this type of hepatitis, it is recommended to refrain from self-treatment, carefully read the instructions for the drug used and carefully monitor your well-being during treatment, reporting all changes to your doctor.

Toxic substances used in production

These substances can enter the body through the lungs, skin, along with food. To prevent this phenomenon, it is necessary to carefully observe safety precautions when working with potentially hazardous chemical compounds.

Alcohol

Ethyl alcohol is a cellular poison, having a variety of negative influence on liver cells, it causes negative changes in the tissues of this organ.

Toxic substances found in plants

To prevent this variant of the development of the disease, you must carefully familiarize yourself with the variety of poisonous flora in your region.

Forms of toxic hepatitis

acute form

It is characterized by high intensity of symptoms and their large number. So, often during acute toxic hepatitis, you can observe a complete picture of the symptoms of hepatitis. The acute form of hepatitis directly affects the life of the patient. During the acute form, a significant deterioration in well-being forces the patient to seek help from a doctor.

Chronic form of toxic hepatitis

It is characterized by a protracted course with a slight severity of the symptomatic picture. Basically, there are a few symptoms that may not be of significant concern. In view of this, it is recommended to consult a doctor for any long-term and persistent changes in your health for the worse. For example, a typical symptomatic picture of chronic hepatitis: a slight increase in body temperature (approximately 36.8 - 37 degrees), slight discomfort in the liver, which occurs periodically, along with a feeling of nausea. This is just an example of the course of the disease. Such symptoms are often ignored by the patient himself, for a long time, which only aggravates the disease itself and increases the risk of complications.

Symptoms of the disease

• . The inflammatory process, which is a consequence of exposure to a poisonous agent, causes an increase in the tissue of this organ. As a result, the enlarged liver begins to affect the adjacent nerve endings, causing pain and discomfort through their stimulation. If the increase is slight, then pain and other discomfort may be absent, since the liver is devoid of its own nerve endings.
• Heat and ache in the joints. With inflammatory processes, the temperature rises, which is why the course of hepatitis often resembles a cold. Body temperature usually rises to 37 - 38 degrees. With toxic hepatitis of a reactive nature, body temperature may rise more strongly.
• Disorders of the stomach and intestines. The inflammation caused in the liver invariably impairs the production of bile, which helps to digest proteins and fats. Often this is accompanied by a feeling of aversion to fatty foods or a lack of appetite in general.
• Symptoms of fatty transformation of the liver;
• icteric symptoms. A characteristic change in the color of the skin and whites of the eyes in hepatitis is the most common symptom for hepatitis of various nature, in particular for toxic hepatitis. The more acute the course of the disease, the stronger the yellow tint becomes tissue.
• Vomiting and feeling of nausea. At the same time, characteristic impurities in the vomit caused by indigestion are noted.
• Enlargement of the liver in size. The more acute the inflammation, the more pronounced this symptom. Also, an increase in the liver takes place as a result of a violation of protein formation, as a result of which water and adipose tissue accumulate more actively in the intercellular space.
• Poor general health, feeling of lethargy, exhaustion, characterized by a decrease in the ability to physical and intellectual work.
• Symptoms characteristic of poisoning by a specific harmful agent. These include symptoms characteristic of poisoning and depending on the typology of the poison and the amount of the penetrating substance.

Toxic hepatitis is dangerous in itself, as it causes a violation of the liver, and together with it negatively affects the functioning of the whole organism, causing concomitant disorders of the organs gastrointestinal tract, worsening the general state of health, thereby causing a violation of the habitual life of the patient. Negative changes in the functioning of the liver can lead to mental disorders that can provoke aggression or depressive disorders, which is an additional negative factor. Correction of mental disorders, if necessary, should be carried out without the use of medications, or with their careful selection so as not to aggravate the patient's condition.

The dangerous consequences of chronic hepatitis resulting from the use of a small dose of a toxic agent for a long time are cirrhosis and fatty transformation of the organ. Therefore, people undergoing treatment, as well as working in hazardous industries, need to carefully monitor their well-being and immediately consult a doctor at the first detection of unwanted symptoms, and also not neglect planned medical measures.

Hepatic coma is another option for the development of toxic hepatitis. It appears as a result of the extensive influence of a toxic agent on the liver tissue. The characteristic symptoms of its onset are: constant severe fatigue, loss of coordination of movement, slurred speech, confusion, clouding of consciousness, trembling hands. This is an extremely dangerous variant of the development of the disease, since with hepatic coma there is a high probability lethal outcome. Hepatic coma is especially dangerous during the course of hepatitis with a sharp progressive development of the disease.

Identification of toxic hepatitis

In general, it is not possible to distinguish toxic hepatitis by symptoms from other types of hepatitis or other liver disorders and diseases. For this reason, a whole range of diagnostic measures is carried out, which allows you to make an accurate diagnosis:

• general analysis of urine and blood
• blood chemistry
• Puncture of liver tissue

Treatment of toxic hepatitis

First of all, it is necessary to protect the body from the ingress of a poisonous agent, since the time and amount of poison is directly proportional to the degree of dangerous effects on the patient's body. The very first manifestations of toxic hepatitis serve as the basis for transfer to inpatient treatment. Acute severity requires placement in the intensive care unit.

Urgent measures are taken to cleanse the body of a toxic substance: gastric lavage, droppers, taking vitamins and minerals, etc. If there is a special antidote for the substance that has entered the body, then naturally, it must be used. Also used are drugs that promote protection and: hepatoprotectors and phospholipids, as well as drugs to normalize the outflow of bile, since its stagnation negatively affects the liver tissue.

Treatment of toxic hepatitis necessarily involves strict adherence to a special diet. First, to restore the liver, it is necessary to increase the protein content in the diet. So, for example, for a man weighing 90 kg, the amount of protein should be around 100g. per day. It is recommended to use animal protein derived from lean meats ( chicken breast, rabbit, beef), as well as lean fish. Food should be lean, steamed or stewed. It is necessary to use only products of high biological value.

Disease prevention

1. Reasonable application medicines, in adequate dosages and terms. Drug therapy should be prescribed by a qualified specialist. In no case do not self-medicate. particular danger in this case are common drugs such as paracetamol, used to relieve headaches and other symptoms of the common cold, and estrogen-based contraceptives. Often these drugs are used without medical supervision, uncontrolled and symptomatic. Thus, the symptoms of toxic hepatitis develop.
2. Compliance with safety measures and planned medical measures when working with toxic substances. People involved in production using toxic substances (synthetic fertilizers, insecticides, industrial chemicals).
   Drinking alcohol in healthy doses. Since this substance is one of the main toxic agents that contribute to the development of hepatitis. In addition, dependence on alcohol intake is formed and the need to increase the dosage in order to achieve the desired result, which only aggravates the course of the disease.
3. Careful study of poisonous flora. common cause toxic hepatitis is mushroom poisoning. For this reason, it is recommended to engage in mushroom picking only with experienced people, in an ecologically safe region. Poisonous mushrooms, as well as poisonous mushrooms collected in environmentally unsafe regions contain extremely hazardous toxic substances to health. A common outcome of exposure to these substances is death due to complete liver dysfunction.

Please note that the information provided in this article is for informational purposes only. Only a qualified specialist has the right to diagnose and prescribe treatment.

Toxic hepatitis is inflammatory processes occurring in the liver and caused by the toxic effects of chemical or natural toxic substances. Such substances include chemical poisons, poisons of plants and animals, alcohol and medicines. Drug (drug) hepatitis and alcoholic hepatitis are placed in separate groups, because they have some features in the course and treatment. Toxic hepatitis can affect people of any age, but age categories from 20 to 60 years prevail. Women suffer from this disease more often than men. In the absence of timely and correct treatment, this pathology can lead to severe complications, including disability and death.

Causes

The main causes of toxic hepatitis:

• Pesticides - Agriculture(weed control);
• Arsenic - metallurgical plants;
• Insecticides - agriculture (insect control);
• Phosphorus - agriculture (fertilizers), metallurgy (metal processing);
• Phenols - medicine (antiseptics), food industry(preservation);
• Aldehydes - industry (obtaining acetic acid);
• Chlorinated carbohydrates - a component of oil;
• Plant poisons (ragwort, mustard, etc.);
• Mushroom poisons (pale toadstool);
• Animal poisons (snake bites);
• Alcoholic drinks and their substitutes;
• Some medicines.

Poisons and their toxins can enter the human body in several ways: through the gastrointestinal tract, through respiratory system through the skin and through the blood. They can have both a direct effect on the liver (with a direct effect on hepatocytes) and an indirect one (when there is a violation of blood flow in the vessels of the liver, which leads to their death and dysfunction).

There are predisposing factors that increase the risk of developing toxic hepatitis:

• Mental disorders, depression (deliberate intake of poisons);
• Alcoholism;
• Work at industrial enterprises;
• Work in the food industry;
• Reduced immunity;
• Children's age (they taste everything they find on walks, at home, etc.);
• Pregnancy;
• Lack of protein in the diet;
• Any history of liver damage.

Classification

According to the nature of the course, toxic hepatitis is divided into two types:

• Acute - develops in the first hours or days after exposure to poisons, has a rapid development and severe course;
• Chronic - occurs after a long time after the onset of exposure to poisons, develops slowly, proceeds relatively easily.

According to the etiological factors, toxic hepatitis is divided into 4 groups:

• Toxic drug-induced hepatitis;
• Toxic alcoholic hepatitis;
• Hepatitis caused by industrial poisons;
• Hepatitis caused by naturally occurring poisons.

According to the penetration of poisons into the human body, 3 groups of hepatitis are distinguished:

• Intentional hepatitis;
• occasional hepatitis;
• Occupational hepatitis.

Symptoms of toxic hepatitis

Despite the fact that there are a lot of varieties of toxic poisons, the clinical manifestations of toxic hepatitis are quite similar.

Acute toxic hepatitis

The main symptoms of acute toxic hepatitis are:

• The process begins abruptly, a maximum of 3-5 days after poisoning;
• Pain in the right hypochondrium, severe intensity, associated with an increase in the size of the liver and its capsule;
• Body temperature reaches 38 degrees and above;
• Severe general weakness;
• Aches all over the body;
• Vomiting, possibly with blood impurities;
• Nausea;
• Bleeding from the nose;
• Small punctate hemorrhages under the skin;
• Violation of orientation in space;
• Lethargy or vice versa, mental and nervous activity;
• dark urine;
• Lightening of feces;
• Enlargement of the liver.

Chronic toxic hepatitis

Manifestations of chronic toxic hepatitis are observed:

• The onset of the disease occurs several months or years after the onset of the poison;
• Pain in the right hypochondrium, aching, pressing, periodically disappears on its own, intensifies after each meal;
• Body temperature ranges from 37.0 to 37.5 degrees;
• Reduced ability to work and rapidly emerging weakness throughout the body;
• An increase in the size of the spleen and liver;
• Bloating
• Nausea, occasional vomiting;
• Diarrhea;
• All symptoms may resolve and recur on their own.

Diagnostics

First of all, the doctor collects an anamnesis. Based on the patient's complaints, the alleged causes of the pathology and the presence of predisposing factors, the doctor determines a preliminary diagnosis. This is followed by examination and palpation of the patient. This determines the color of the skin and visible mucous membranes, the size and soreness of the liver.

As laboratory tests, blood and urine tests are used, as well as microscopy of liver tissues:

• Blood biochemistry - liver tests (ALT, AST, total protein, total bilirubin and its fractions, alkaline phosphatase);
• General blood analysis;
• General urine analysis;
• Coagulogram;
• Examination of feces for the presence of toxins;
• Liver biopsy.

Among instrumental studies, ultrasound of the hepatobiliary zone is used.

Treatment of toxic hepatitis

First of all, in the treatment of toxic hepatitis, contact with poisons and toxins should be removed. After that, it is immediately necessary to start removing toxins from the patient's blood and hepatocytes. For this, drip administration of solutions is used - Reopoliglyukin, Gemodez, Reosorbilact, Ringer's solution, 5-10% glucose solution, 0.9% sodium chloride solution (physiological solution), etc. They should be administered 200-400 ml 1-2 times a day. day, depending on the severity of the patient and his weight.

Also quite effective in removing toxins are sorbents - Activated carbon, Enterosgel, Atoxil, etc.

Various hepatoprotectors restore the liver and its functions - Essentiale forte, Heptral, Holosas, Karsil, etc.

In case of poisoning with a pale toadstool, Atropine works well as an antidote.

In case of severe hepatitis, glucocorticosteroids are prescribed - Prednisolone, up to 40 mg per day.

Complications

Complications of toxic hepatitis:

• Hepatic coma;
• Liver failure;
• hepatic encephalopathy;
• Fatal outcome.

Prevention

Among the methods for preventing the development of toxic hepatitis, the main ones are:

• Compliance with safety regulations at work;
• Do not eat unknown mushrooms and plants;
• Do not abuse alcohol;
• Pass annual preventive examinations;
• Monitor children, avoiding the use of medicines, herbs, mushrooms of an unknown nature;
• Take hepatoprotectors for the purpose of prevention;
• At the slightest sign of illness, immediately consult a doctor;
• Increase in the amount of protein in the diet (at least 60-90 g per day).

Toxic hepatitis is one of the varieties of severe liver pathologies. It is a non-viral liver damage that occurs when harmful substances enter the body. There are no exact data on the frequency of its detection in Russia. But the danger of this disease requires its detailed consideration, identification of its causes and features, as well as methods of prevention.

The development of toxic hepatitis begins with the penetration into the body chemical substances. Their harmful effects interfere with the normal functioning of organs and systems and lead to numerous disorders.

Particularly severe harm is done to the liver, since it is involved in cleansing the body and removing pathological substances. If there are too many of them, then the body cannot cope with them, and its cells gradually begin to break down.

In the future, the liver increases in size, the patient develops severe pain and other negative changes. If left untreated, this leads to destruction of the organ and death of the patient. But even the measures taken in time do not guarantee a favorable outcome.

Note! The entry of harmful substances into the body can be accidental or intentional. There are also some types of employment in which a person is forced to contact poisons.

These substances can be in the body through Airways through the skin or gastrointestinal tract. From there, they enter the bloodstream, after which they reach the liver.

Toxic hepatitis does not occur with every chemical effect on the body. Very often, the liver and other organs involved in cleansing, as well as the forces of immunity, cope with the pathological influence. But under strong influence, resistance may be useless.

The same happens with a long-term dangerous effect on the body. Gradually, the immune system weakens and the organs wear out, and hepatitis is the result.

This disease can manifest itself in acute or chronic form:

1. The acute form occurs when a large amount of toxic substances of any origin enters the body at the same time. The result is severely symptomatic hepatitis that develops over several days (2-5).
2. The development of the chronic type of this disease is due to a systematic, insignificant effect on the body. In this case, the pathology is formed gradually, at first without even manifesting itself as symptoms. This can take months or even years.

There are several varieties of toxic hepatitis according to the type of the affected substance. These include:

• Alcoholic.
  The liver is pathologically affected by alcohol abuse, due to which pathological processes begin to develop.
• Medical.
  It is caused by the use of medicines unnecessarily and in large quantities. Over time, the body may be poisoned by their active components.
• Food.
  In this case, toxic substances enter the body with food. Most often this happens due to poisonous mushrooms used in food.

Based on what substances can provoke this disease, it is possible to identify the main risk groups. It:

• people employed in hazardous production;
• persons prone to alcohol abuse;
• patients who prefer not to wait for a doctor's prescription to take medication, but start treatment on their own and without following the instructions.

Dosage form

The occurrence of drug-induced hepatitis is due to the intake of drugs in large quantities. This can happen in two ways, due to which two types of such hepatitis are distinguished - chronic and acute.

For the occurrence of an acute form of the disease, it is necessary strong single impact a toxic drug, as a result of which the symptoms of the pathology are manifested very intensely.

Chronic hepatitis develops due to prolonged exposure on the liver with drugs.

Symptoms in this case are less pronounced.

The reasons

The development of hepatitis occurs if the patient has greatly exceeded the dosage of the prescribed drug or has used medicines unnecessarily for a long period of time.

This causes either acute poisoning with active substances, or their gradual accumulation in the body, which also causes poisoning. The result is damage to the liver and the gradual destruction of its cells.

Among the drugs that can have a damaging effect on the liver are:

• antiviral;
• sulfonamides;
• anticonvulsants;
• anti-tuberculosis;
• antipyretic.

Manifestations

With respect to funds from these groups, caution is needed. The development of acute drug-induced hepatitis manifests itself immediately and is quite difficult. When using dangerous drugs, you should pay attention to the following symptoms:

• sudden sharp pain in the right hypochondrium;
• hyperthermia;
• loss of appetite;
• body aches;
• nausea;
• weakness;
• development of jaundice;
• nosebleeds;
• skin hemorrhages;
• excessive irritability;
• unusual lethargy and apathy.

In the chronic type of the disease, the symptoms are different. The patient has:

• a slight increase in temperature over a long time period;
• reduced performance;
• pain in the right hypochondrium, occurring from time to time and characterized by low intensity;
• gastrointestinal disorders;
• enlargement of the spleen.

These signs do not always indicate the development of hepatitis. They can be caused by many other pathologies, therefore, for staging accurate diagnosis you need to contact a specialist. This is especially important for patients who take strong drugs for a long time, since they are the main risk group.

Diagnosis and treatment

Before starting treatment, it is necessary to verify the presence of this pathology. According to the symptoms, this is not easy to do, therefore, an examination using laboratory and instrumental methods is necessary. Among them:

• blood test (biochemical);
• ultrasound of the liver and organs abdominal cavity;
• radiography, etc.

According to the results of the study, treatment is prescribed. First of all, it is necessary to exclude the use of drugs that provoked the development of drug-induced hepatitis.

The remaining measures are as follows:

• gastric lavage;
• neutralization of the action of toxins, for which electrolyte solutions in the form of droppers are used;
• vitamin therapy (consumption of vitamins B and C is especially necessary);
• treatment with hepatoprotectors (Essentiale, etc.);
• taking choleretic agents that help cleanse the liver (Holosas, Cholenzim).

Be sure to carry out treatment in a hospital with bed rest. Also, these patients need to follow a diet.

With its help, you can save the liver and gastrointestinal tract from excessive stress. Its main principles:

Alternative methods of treatment in this case are ineffective. Their use is allowed only after discussion with the doctor and preferably at the recovery stage.

The only thing that is allowed is to use milk or a decoction of flaxseed before the doctor arrives in case of an acute attack in order to reduce the toxic effect of the toxic substance on the stomach.

Note! Preventive measures are to avoid frequent use of drugs. For the use of any drug, a doctor's prescription is necessary, since drug poisoning very often occurs due to self-medication.

If the use of drugs is justified, then the instructions of the specialist regarding dosages and schedules should be followed.

The prognosis for drug-induced hepatitis depends on many factors. With the rapid detection of the disease and proper treatment, the patient has every chance to get rid of the problem. In the absence of treatment, the disease progresses and becomes more complicated.

Among its most frequent complications are mentioned:

• liver failure;
• hepatic coma;
• cirrhosis of the liver.

At an advanced stage, when the liver tissue has been significantly affected and complications have begun to develop, it is much more difficult to overcome the disease.

Alcohol intoxication

This type of hepatitis develops with the frequent use of large amounts of alcohol. When alcohol enters the body, it interacts with liver enzymes, resulting in the formation of a toxic substance.

Under the influence of this substance, disturbances occur in the cellular structure of the liver, which cause tissue death.

Bile also accumulates in the liver.

Alcoholic hepatitis can be acute or chronic. The occurrence of the acute form of the disease is associated with the consumption of alcohol in large quantities for several days. The result is severe intoxication, the liver becomes inflamed, and destructive processes begin.

Usually acute hepatitis occurs in the presence of cirrhosis of the liver. The following factors also contribute to its occurrence:

• smoking;
• viral hepatitis;
• drug abuse;
• malnutrition or malnutrition.

The manifestations of this type of hepatitis include:

• nausea;
• feeling of bitterness in the mouth;
• pain under the ribs on the right side;
• gastrointestinal disorders;
• weakness;
• yellowish skin tone.

This disease develops very quickly. There are several types of acute alcoholic hepatitis. It:

1. Icteric.
   The main feature is the accompaniment of the disease by jaundice.
2. Latent.
   In this case, the symptoms may be absent or weak.
3. cholestatic.
   It is considered the most dangerous, because most of the patients with this form of hepatitis die.
4. Fulminant.
   It is characterized by rapid development and progression.

The development of chronic alcoholic hepatitis occurs at a slow pace and with mild manifestations. It has:

• insomnia;
• nausea;
• poor appetite;
• discomfort in the right hypochondrium;
• slight rise in temperature.

Since it is difficult to determine the correct diagnosis from the symptomatic manifestations of the disease, it is necessary to conduct a study.

Doctors use the following methods:

1. Blood chemistry.
2. Coagulogram.
3. Proteinogram.
4. Ultrasound of the liver.
5. FEGDS.
6. Biopsy.

The main directions of treatment are: drug therapy, avoidance of alcohol and diet.

Due to this, it is possible to restore the functioning of the liver, overcome pathological symptoms, cleanse the body and replenish the missing trace elements. Catering goes according to the usual rules. This is the exclusion of fried, fatty, spicy and smoked, the active consumption of fruits and vegetables.

Among the medications used in the course of treatment, we can mention:

• sorbents (Enterosgel);
• hepatoprotectors (Glutargin);
• antibiotics (Kanamycin);
• preparations containing lactulose (Duphalac), etc.

If necessary, surgical intervention is carried out, with the help of which the patient's condition can be alleviated. The likelihood of recovery depends on how carefully the patient will follow the recommendations of a specialist, as well as on the degree of neglect of the course of hepatitis.

It should be said that most often this disease ends unfavorably, since patients are not able to give up alcohol and do not follow dietary guidelines.

Nutritional type of pathology

The development of food hepatitis occurs due to the penetration of dangerous products into the human body. These include some plants and varieties of fungi. They may contain a large amount of toxic substances, due to which the liver cannot remove them and is exposed to pathological effects.

Note! The symptomatic manifestations of this hepatitis are similar to those of severe food poisoning and viral hepatitis at the same time.

These include:

• temperature rise;
• nausea;
• pain in the right hypochondrium;
• weakness;
• vomiting of bile, etc.

Symptoms alone are not enough to make a diagnosis, so the doctor must conduct a differential diagnosis.

Instrumental and laboratory research methods should also be used. It:

1. CT of the liver.
2. Ultrasound of the abdominal organs.
3. Biochemical analysis of blood, etc.

In the course of treatment, it is very important to eliminate the cause of the pathology. For this, the doctor prescribes specific antidotes (for mushroom poisoning, Atropine is used). The absence of an antidote requires the use of drugs that promote the removal of pathological substances from the body (for example, activated charcoal).

1. Hepatoprotectors (Gepabene).
2. Sorbents (Atoxil).
3. Antibiotics.

Characteristics of the main drugs

Therapy of toxic hepatitis has two main directions:

1. The exclusion of substances that injure the liver from entering the body.
2. Restoration of the organ and elimination of toxins through the intake medicines.

To restore and normalize the functioning of the liver, it is necessary to take drugs aimed at rehabilitating damaged hepatocytes and removing toxins from the body. For this purpose, the following groups of drugs are used:

• Hepatoprotectors. Universal drugs prescribed for any damage to the liver tissue. They are aimed at restoring hepatocytes, as well as protecting them from further damage. The most commonly used drugs:

  
  

• Antidotes. Preparations aimed at neutralizing certain toxic substances in the body:

  
  

• Sorbent drugs.

  • Activated charcoal is the most affordable drug, a natural adsorbent that allows you to effectively cleanse the body of toxins, interrupting their absorption in the digestive tract;
  • Synthetic adsorbents can be considered analogues of coal: Enterosgel, Atoxil, Smecta.
• Corticosteroids. In severe cases of the disease, hormonal preparations can reduce the activity of the body's immune system, relieve inflammation, and improve the general condition of the patient. Used, in particular, Prednisolone, Dexamethasone, Methylprednisolone.
• 
  Cytostatics. Non-hormonal immunosuppressants are primarily indicated for malignant processes, but can also be used for hepatitis, in particular, for autoimmune ones to stabilize the patient's condition and reduce the intensity of the body's immune response. So, Azathioprine, Cyclosporine A are prescribed.
• Vitamins. The liver is an organ in which metabolism, synthesis and production of many vital vitamins take place: E, A, B, C, etc. With hepatitis, this process is disrupted, therefore, additional vitamins are required from the outside. For this, both monopreparations (Tocopherol, Folic acid, Orotic acid, Pyridoxine, Retinol, Ascorbic acid) and special vitamin complexes(Aevit, Neurorubin, Vitrum, Liver active Nutrilite, Hepatrin, Heparosis forte, Hepaton-2).

• Antibiotics. In liver diseases, antibiotics are contraindicated, since they have an extremely negative effect on the affected organ. First of all, this concerns tetracyclines and anti-tuberculosis antibiotics. However, in some cases, their use cannot be avoided, for example, with the development of other acute pathologies of a bacterial nature or with the development of complications of hepatitis (ascites, peritonitis, sepsis, hepatic encephalopathy). In these cases, the following may apply:

  
  

The scheme of reception in each case is selected individually. Alternative methods of treatment for such a disease are rarely used - due to low efficiency. Cleansing and strengthening procedures using medicinal plants are allowed, but only after consulting a doctor.

Principles of therapeutic nutrition

For the return of health and the normalization of liver function, diet is of great, and in many cases decisive importance. It allows you to reduce negative impact on the body, as well as to compensate for the lack of nutrients in the body.

In hepatitis, as a rule, a diet developed by Pevzner is used. There are two options for this diet:

• sparing - No. 5;
• more rigid - No. 5a.

The main principles of the treatment table are:

Toxic hepatitis is a dangerous pathology that, if left untreated, can lead to severe complications and even death of the patient. Even timely treatment does not guarantee a favorable outcome. Therefore, if you suspect its development, you should immediately consult a specialist.

Toxic hepatitis is an inflammatory liver disease that develops as a result of the pathological effect of toxic substances on the body. Most often, people with alcohol addiction or chemical workers. Tends to progress to cirrhosis of the liver.

The route of entry of toxic substances into the human body is different. This may be a long-term effect of chemical or toxic factors of production due to professional activity, accidental or intentional poisoning, prolonged or uncontrolled use of hepatotoxic drugs. Such substances can enter the body through the digestive tract, respiratory system and skin.

The most common hepatotoxic substances that provoke toxic hepatitis are different types. The clinic and the course of the disease depend on the nature of the poisonous substance.

Long-term use of alcoholic beverages promotes increased absorption of iron in the gastrointestinal tract, which leads to its excessive deposition in hepatocytes. Due to some chemical processes, iron forms free radicals in the liver cells, which leads to the destruction of the hepatocyte membrane. The use of alcoholic beverages outside of meals greatly increases the risk of developing.

Medications

Toxic hepatitis against the background of taking medications occurs in cases where the patient suffers from any chronic diseases and is forced to take prescribed drugs for a long time. The second common cause is self-administration of uncontrolled drugs without control or without medical indications. These drugs include almost all antibacterial drugs: sulfonamides, beta-lactam antibiotics, tetracyclines, nitrofurans, etc.

industrial poisons

Toxic hepatitis against the background of exposure to poisons can be acute and chronic. Acute occurs when a large amount of poison is exposed to the body, severely affects the liver and other organs, and in many cases is fatal. It is diagnosed mainly in employees of enterprises who have had constant contact with small doses of toxins for many years.

Natural (vegetable) poisons

These include the poisons of weeds and fungi. They act directly on the liver and lead to acute toxic hepatitis. Even a small dose of such a poison can cause severe coma and death. The sooner assistance is provided to the patient, the more favorable the prognosis for recovery.

Narcotic drugs

Such a causative factor is rare, mainly diagnosed in people with severe drug addiction who take several types of drugs at once (for example, cocaine and phenobarbital).

Symptoms

The manifestations of the disease depend on the type of toxic effect on the body and the severity of the course of hepatitis. The acute form is characterized by vivid symptoms of the disease and a severe course. Most often, in the acute form of toxic hepatitis, the following manifestations are observed:

• hepatosplenomegaly (enlargement of the liver and spleen);
• sharp or dull pain in the right hypochondrium;
• nausea, vomiting, disturbances in the work of the gastrointestinal tract;
• fever, general weakness, dizziness;
• bleeding from the nose or gums, hemorrhages (subcutaneous hemorrhages), the appearance of spider veins;
• signs of mental agitation or lethargy, clouding of consciousness, hallucinations;
• jaundice, urine becomes dark, and feces - light;
• loss of consciousness, stupor, stunning, coma.

Since chronic poisoning with toxic substances occurs over a long period of time, the symptoms of hepatitis are not clearly expressed.

Such manifestations of the disease are not always specific and can sometimes be disguised as other pathologies of the gastrointestinal tract and liver.

The main symptoms of chronic toxic hepatitis:

• recurrent pain in the right hypochondrium, which mainly occurs after eating heavy food or alcohol;
• slight increase in body temperature (up to 37.5);
• yellowness of the skin;
• skin itching, small point subcutaneous hemorrhages;
• periodic nausea, bloating, digestive disorders;
• bitterness in the mouth or belching bitter;
• fatigue, loss of strength, decreased performance;
• stagnation of bile, dyskinesia;
• dark urine and light feces;
• cytolysis (destruction) of hepatocytes;
• neutrophilic leukocytosis (an increase in the number of leukocytes in the blood);
• weight loss up to anorexia.

Cases of toxic hepatitis in children

The toxic form of hepatitis in children is relatively less common than in adults. Such hepatitis occurs when poison enters the body due to parental negligence (for example, household chemicals), against the background of long-term drug therapy or after mushroom poisoning.

In children, toxic forms of hepatitis are very difficult. In many cases, they can be fatal due to untimely provision of specialized medical care.

Children mostly suffer from the acute form of the disease and the symptoms will be almost the same as in adults. The main task is to prevent severe irreparable consequences both for the liver and for the whole organism, which can occur against the background of poisoning. The prognosis is predominantly unfavorable.

Toxic hepatitis during pregnancy

Cases of hepatitis during pregnancy caused by toxic substances are quite common and, as a rule, there is chronic form illness. Gradually, signs of severe liver failure develop, pregnant women feel satisfactory, but the prognosis is rarely favorable.

The main symptoms of the disease will be the following manifestations:

• the occurrence of jaundice (skin and sclera);
• discoloration of urine and feces;
• pain in the right hypochondrium;
• nausea, vomiting.

Complications of the normal course of pregnancy in this case will be intrauterine fetal death, postpartum hemorrhage in early period, the development of cholestatic hepatitis with impaired blood clotting. Treatment of toxic hepatitis during pregnancy is carried out through active drug therapy.

Diagnostics

To confirm the diagnosis of a toxic form of hepatitis, the patient must undergo a complete medical examination, which includes examination of the patient, palpation of the liver and internal organs, percussion and auscultation. An important point in the diagnosis is the collection of information about the patient's lifestyle: alcohol abuse, place and working conditions, the presence of chronic and past diseases, complaints at the moment.

Diagnosis of acute toxic hepatitis can be difficult in some cases because the patient may be unconscious. In this case, it is difficult to determine the cause of poisoning and the patient's complaints.

Such patients receive emergency medical care in order to prevent the development of a terminal condition. After stabilization of the patient's condition, other laboratory and instrumental studies are carried out.

Laboratory diagnostic methods include: general blood and urine analysis, fecal analysis, as well as liver tests (ALT, AST, bilirubin, thymol test, total protein, protein fractions). Instrumental methods include ultrasound of the abdominal organs, radiography and, if necessary, a liver biopsy.

Treatment

Treatment of hepatitis resulting from the toxic effects of toxic substances depends on the form of the disease (acute or chronic) and the type of poison.

In acute form, all medical measures must be carried out in a hospital setting. First of all, the patient is given a gastric lavage to clean waters, active infusion therapy, plasmapheresis (blood purification), antidotes are administered (with a known toxic substance), provide parenteral nutrition (if the patient is unconscious). Hepatoprotectors and choleretic drugs are also prescribed, symptomatic therapy is carried out. During the rehabilitation period, the patient must regularly take the drugs prescribed by the doctor, undergo preventive examinations in a timely manner, follow a diet and proper nutrition, and treat any associated complications.

Treatment of the chronic form of toxic hepatitis is carried out in courses and includes:

• vitamin therapy;
• detoxification therapy (glucose and Rieger solutions, physiological saline);
• regular intake of hepatoprotectors and choleretic drugs;
• taking membrane-stabilizing drugs, glucocorticoids;
• diet
• in severe conditions is shown.

Diet and Nutrition

It is very important to follow a diet and proper nutrition in the toxic form of hepatitis, since the intake of heavy foods can greatly complicate the course of the disease. An approximate list of products and dishes is given in the table:

Compliance with the diet and proper nutrition significantly reduce the load on the liver and contribute to the fastest recovery and easier course of the disease. Any errors in diet and nutrition can provoke an acute attack of pain and disrupt normal digestion.

The disease occurs in a chronic or acute form. Acute toxic hepatitis occurs when a large concentration of toxic substances enters the body at the same time. Clinical manifestations in this case, they appear literally on the second or third day and are distinctly pronounced. Chronic toxic hepatitis is a consequence of long-term poisoning of the liver with toxic substances that enter the human body in small quantities. Symptoms of such a disease can appear months, and even years after the onset of toxic agents entering the body.

Acute and chronic forms of pathology are dangerous for human life. Firstly, because such a disease can lead to, and also because it can develop, followed by liver failure. That is, in any case, without treatment, the prognosis of the course of the disease is unfavorable, and the likelihood of a fatal outcome is very high. Especially dangerous for humans is drug toxic hepatitis caused by long-term use of drugs, in particular antibiotics.

The reasons

As mentioned above, the disease occurs due to the action of toxic agents on liver cells. At the same time, the entry of poison into the body can be caused by the professional activity of a person - that is, the body is poisoned when a person works in adverse conditions. Also, poisons can enter the human body intentionally - when he himself uses them for the purpose of suicide, or when someone offers him to use them intentionally, for the purpose of murder. By the way, the use of liver poisons in order to commit a criminal act is an extremely common way to take a person's life, therefore, when autopsy of dead people, the doctor carefully examines the liver cells, trying to detect traces of poison in them.

Another way that toxic substances enter the body is by accident. That is, when a person does not understand that the use of a particular substance can harm his health. This is how drug-induced hepatitis usually appears - a person uses various medical preparations for a long time, not knowing that they were doing irreparable damage to his liver cells.

For liver cells, poisons are:

• many medicines;
• alcohol;
• poisons contained in plants and fungi;
• components on industrial productions, in particular insecticides, arsenic, phosphorus, pesticides and others.

Note that drug-induced hepatitis occurs due to various reasons. One of them is the above - long-term use of drugs, leading to chronic poisoning. However, acute toxic hepatitis can also occur with a single administration of drugs, especially intramuscularly or intravenously. In addition, inhalation of toxic drugs is considered very dangerous, as it causes acute drug-induced hepatitis very quickly.

Toxic hepatitis is not contagious, although under certain conditions it can infect other people. In particular, during oral caress, infection can occur if the toxic agent is in fragments of fecal matter transmitted from a sick person to a healthy person during oral sex. But in fairness, it should be noted that this method of infection is quite rare, so we can assume that toxic hepatitis cannot be transmitted from person to person.

Symptoms

If we are talking about a chronic pathology, then it can be asymptomatic for a long time. Therefore, when signs of the disease appear, it already affects a large number of liver cells, which is fraught with serious conditions. In the acute form, the signs usually appear quickly, so diagnosing the pathology in this case is much easier.

The characteristic symptoms of toxic hepatitis are as follows:

• the appearance of small hemorrhages on the skin (petechiae);
• dark urine;
• discoloration of feces;
• yellowing of mucous membranes and skin;
• frequent nosebleeds and hemorrhages.

A person with such a diagnosis may experience skin itching, he loses weight, up to, complains of bitterness in the mouth and belching, and other symptoms of indigestion. With the progression of the process, more severe symptoms appear, such as vomiting, fever with a violation of the general condition, acute or dull pain in the right hypochondrium, as well as signs of a psycho-emotional disorder (clouding of consciousness, hallucinations, loss of consciousness and even coma).

Extremely serious conditions can cause death of a person, so it is so important to diagnose the disease in a timely manner and prescribe treatment.

Diagnosis and treatment

It is impossible to make a diagnosis of toxic hepatitis with only one examination of the patient and the collection of his anamnesis, although given the specifics of his professional activity, the disease can still be suspected. Therefore, diagnostics uses methods such as ultrasound, CT and MRI. But the most revealing are laboratory methods that allow you to determine the level of bilirubin, alkaline phosphatase, AST and ALT, as well as gamma-glutamyl transpeptidase.

Treatment of toxic hepatitis is to remove toxic substances from the body. Therefore, patients with this diagnosis are shown bed rest and gastric lavage. In addition, they are prescribed enterosorbents to remove poisons from the intestines, and the introduction of intravenous drugs that also remove toxins. It is mandatory to take hepatoprotectors that protect liver cells and restore them - Heptral, Essentiale and others.

In addition, the treatment of toxic hepatitis involves taking vitamins that increase overall immunity, and choleretic drugs that can speed up the process of removing poisons. If the patient has drug-induced toxic hepatitis, or if it is known which poisons caused the disease, it is urgent to stop the intake of medicines or other substances into the body, since without this the treatment will not have an effect. In some cases, antidotes are shown to neutralize certain toxic substances. And of course, the patient is shown a certain diet - protein-free.

Some people treat toxic hepatitis folk remedies. However, all the methods that can be used to treat this disease at home are effective only in the initial stages of the disease. In particular, one can artificially induce vomiting to rid the stomach of poisons, or apply a cold compress to the forehead in order to relieve the temperature.

But folk treatment can in no way replace medical therapy, and therefore such methods can only be undertaken with the aim of supporting the body until the moment when a person can see a doctor. Moreover, usually such methods are effective only in acute poisoning - in chronic poisoning, a person does not understand what caused his poor health.

If a person has developed drug-induced hepatitis, he will also need artificial induction of vomiting, but due to the fact that such a pathology occurs only with prolonged exposure to poisons on the liver, other alternative methods of treatment will be useless and only in a hospital can save a person's life.