Feel the liver under the ribs. Colon pathologies

Palpation is a method used in medicine and consists in examining a patient using fingers and palms. It consists in a tactile sensation that appears to the doctor during the pressure of the fingers or the entire palm on the organ being examined. Using this diagnostic method, you can find out:

• location of organs;
• their size and shape;
• density and mobility;
• soreness;
• accumulation of gases in the intestines

Palpation is superficial and deep. The first is carried out with one palm or two at once, which the doctor puts flat on the area of ​​\u200b\u200bthe skin, joints, and heart. The second type is carried out using special techniques (for example, sliding palpation), examining the state of the stomach, spleen, liver and other organs.

Why is liver palpation performed?

When dropped or pathological increase body with the help of palpation, the doctor determines the lower border, the outlines of the edge of the liver, the presence of pain and pathological processes. Palpation of the liver is carried out according to the general rules for palpation of organs located in abdominal cavity. First, superficial palpation of the liver is performed, after which it is deep, sliding.

When performing this procedure, the doctor's attention is focused on the lower anterior part of the liver. According to its condition, the condition of the entire liver is also determined.

How is liver palpation performed?

The palpation procedure is carried out both in the position of the patient lying down and standing. In the supine position, the lower part of the liver is located under the ribs, and in the standing position, the organ is shown 1.5–2 cm from under the ribs, which makes it possible to examine it. The liver is very well palpated in the standing position of the patient, when the pathology of the organ is observed. In this case, the liver has an enlarged and compacted shape. But still the main examination is performed in the supine position. Palpation of the liver is performed with the patient lying on his back, the head should be slightly raised, and the legs should not be fully bent at the knees or straightened. In order to limit the mobility of the chest during inspiration, as well as relax the abdominal muscles, the patient should put his hands on his chest. After that, the doctor begins the procedure.

It should be noted: if in the abdominal cavity accumulates a large number of liquid, then palpation of the liver is either difficult, or the implementation of this procedure becomes completely impossible.

In such a situation, other methods of examination are used to diagnose the disease.

What diseases can be detected?

If the condition of the liver is normal, then it does not protrude from under the ribs and palpation cannot be performed. If the liver protrudes, then pathological processes take place in it or organ prolapse is observed.

Damage to the ligaments of the liver, which appeared due to the fact that a person fell to his feet from a height or performed parachute jumps, is the cause of liver prolapse.

If there were no falls, then the protruding edge of the liver does not indicate the omission of the organ, but its increased size. The causes of this phenomenon may be the following diseases and conditions:

• liver diseases: jaundice, cirrhosis, oncological processes;
• ongoing negative processes, due to which the removal of bile is difficult;
• heart failure;
• various blood diseases;
• acute, as well as chronic infections and other diseases.

If, on palpation of the liver, a sharp, wavy, indurated edge is determined, but completely painless, then these symptoms indicate a possible cirrhosis of the liver. If the edge of the organ is thickened, hard, and the surface is uneven, and pain may also not be observed, then liver cancer is suspected. A very dense consistency of the organ is also found in amyloidosis.

The presence or absence of pain during palpation of the liver is explained by the rapid development of pathological changes in the organ.

Surface roughness, observed in the form of local bulging, is observed with a focal disorder in the organ. Such symptoms are typical for the following diseases:

• echinococcosis;
• abscess.

Finally, if you have any suspicions about liver disease, do not postpone a visit to the doctor. Using not only the method of palpation of the liver, but also other forms of examination, the doctor will make an accurate diagnosis and prescribe treatment.

• Clinical picture
• Diagnostic Measures
• Functional organ tissue
• How are ultrasound results analyzed?

Signs of diffuse changes in the liver can be determined by palpation, examination with ultrasound or computed tomography. These can be any deviations from the norm, not only in the entire organ, but also in a specific part of it. The liver is closely connected with all organs and systems of the body. Since it works almost without interruption, simultaneously storing blood and microelements necessary for the body, it is exposed to various negative influences. These can be stagnation in the ducts of the organ, an increase in size, a violation of the density of liver tissues.

It is worth noting that the organ may increase slightly even with colds, but this is not a cause for concern. However, there are a number of other dangerous diseases in which the liver undergoes significant changes. Among them are cirrhosis, cancer, tuberculosis, syphilis, metastases passing from neighboring organs, adenoma and others. Diffuse liver changes are not a separate disease, but only an alarm signal by which a real irritant can be detected.

Clinical picture

At the beginning of pathological changes, the symptoms are mild. These may be discomfort in the hypochondrium on the right side, which are aggravated after fatty and spicy foods, taking alcoholic beverages. During the period of exacerbation, the signs begin to manifest themselves with particular force, and they depend on the underlying disease that caused the pathological changes. There are a number of basic features common to all changes:

• heartburn;
• loss of appetite;
• nausea turning into vomiting;
• the skin becomes yellowish;
• pain in the right side;
• there may be rashes with itching.

With physical activity, pain in the side intensifies, and subsides at rest. The patient observes turbidity of urine and significant lightening of feces. In some, the disease manifests itself in the form of fainting, hemorrhages on the skin. When palpated, an enlarged liver is felt, which can protrude from under the ribs.

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Diagnostic Measures

Initially, the patient donates blood for biochemical examination and liver tests. An ultrasound examination can show the most accurate picture.

If the examination showed an enlarged liver with increased echogenicity of the structures, then this is a sign of fatty degeneration or lipomatosis; the cause of the changes is chronic alcoholism or diabetes mellitus.

Manifestations of cirrhosis of the liver are in the altered contours of the liver: irregularities and tuberosity of a focal nature. A slight increase in the body, in which the parenchyma condense evenly, is characteristic of hepatitis.

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Functional organ tissue

The presence of diffuse changes, namely its structure, implies a complete modification in the functional tissue of the organ. The degree of changes in this case can be different: insignificant, medium and serious. There are the following types of changes:

• dystrophic;
• sclerotic;
• hypertrophic;
• fibrous;
• swelling.

In man diffuse changes The liver can be caused by such a number of irritants: alcohol abuse, poor-quality food, exposure to drugs, heredity or metabolic failures, as well as a number of other important reasons.

Due to its density and size, the liver reflects well sound waves, therefore, during examinations using ultrasound, you can get all the necessary echoes. If the patient has problems with the liver or parenchyma, he will be diagnosed with the following manifestations: heterogeneity of the tissue structure with increased echo density, changes in the pattern blood vessels and enlargement of the liver. Sometimes there are cases when different parts of the liver will have a low and increased degree of echogenicity.

Doctors always conduct a joint examination of the liver and pancreas. This is due to the fact that the organs are nearby and very closely related to each other.

And if liver problems can be diagnosed by palpation, then only an ultrasound examination is necessary for the pancreas. When pathologies of the gland are detected, doctors ascertain the presence of uniform changes that have spread throughout the organ, and this is a sign of the absence of tumors or stones. Pancreatitis and fibrosis frequent pathologies pancreas.

So, with a diffuse decrease in the density of pancreatic tissues, acute pancreatitis is diagnosed. The reason for such changes lies in the fact that the digestive juice, in addition to digesting food, also processes the tissue of the organ itself. As a result, the pancreas reacts to this with swelling and enlargement. If this process is not treated, it turns into a chronic form of pancreatitis, and then the patient is diagnosed with tortuosity of the excretory duct of the gland.

There are cases in which the tissues of the gland are replaced by fat. This is called lipomatosis, which occurs in the elderly or in diabetes. If the tissues are replaced by connective tissue, then this is already fibrosis, the cause of which is inflammation of the pancreas.

In some cases, pain may radiate to the right side from the diaphragm or small intestine. Due to the fact that the hypochondrium is permeated with many nerve endings and muscle fibers, pain sensations are intense and sharp. For staging accurate diagnosis it is necessary to describe the symptoms in as much detail as possible and indicate the exact location of the pain.

Localization and nature of pain

At the initial examination, the therapist determines the possible disease with the help of two-handed palpation of the abdomen. Depending on the location and nature of the pain, the doctor may assume which internal organ is damaged and requires additional diagnostics. To do this, the patient must indicate the place of the most intense pain: in front, on the side or behind.

Front and side under the ribs

Liver disease

Liver pathologies are most often the cause of pain in the right side, since this body occupies almost the entire cavity in the right hypochondrium. The liver is a vital organ that acts as a filter that cleanses the body of harmful substances. The most common liver diseases that are characterized by pain in the side on the right include the following diseases:

Hepatitis

Infectious liver disease caused by hepatitis A, B, C, D viruses. Infection occurs parenterally (through the blood), mainly through the use of syringes with infected needles. Also, hepatitis is transmitted during childbirth from mother to child and through sexual contact.

This pathology can occur in both acute and chronic forms. Pain in hepatitis has a dull, aching, pressing character and is localized in front of the right side under the ribs. Amplify when sharp breath, leaning forward or pressing on the stomach.

In addition to pain, hepatitis has a number of characteristic symptoms:

To determine the presence of the hepatitis virus in the body, you can use a blood test. Liver treatment is carried out by hepatologists (in the chronic form) and infectious disease specialists (in the acute course of the disease). Treatment of hepatitis should be aimed at destroying the virus and repairing liver tissue (preventing cirrhosis). Antiviral therapy is carried out using drugs based on nucleosides and interferons. Prolonged ignorance of symptoms and lack of treatment can lead to advanced cirrhosis, and, as a result, the need for a liver transplant.

cirrhosis

Inflammatory liver disease of a chronic nature, in which an irreversible change in the epithelium of the organ occurs, as a result of the replacement of parenchymal tissue with connective fibers (scars). The volume of healthy tissue decreases and the liver stops working normally.

Causes of cirrhosis include:

• viral hepatitis,
• prolonged use of alcohol
• Budd-Chiari Syndrome,
• severe chemical poisoning,
• advanced pathologies bile ducts.

Pain in cirrhosis is severe and has a pulsating, sharp character. They are aggravated by physical exercises, deep inspiration and a change in the position of the body. In addition to pain in the side on the right, cirrhosis is characterized by a feeling of bitterness in the mouth, yellowness of the skin, a sharp decrease in weight, a violation of the stool (diarrhea and flatulence).

Liver cirrhosis can be diagnosed using a comprehensive examination, which includes:

Treatment is prescribed by a hepatologist and consists in eliminating the cause of the disease, following a strict diet and avoiding alcohol. The advanced stages of cirrhosis require an urgent transplantation of a donor organ, otherwise the liver will completely lose its working capacity and a fatal outcome will occur.

Gallbladder diseases

The gallbladder is a small organ of the digestive system located under the liver. The main function of this organ is to accumulate and excrete bile (a fluid that promotes the absorption of fats and the movement of food through the digestive tract). Diseases of the gallbladder, which are characterized by pain in the hypochondrium on the right, include:

Dyskinesia of the gallbladder

Disease of the gallbladder, in which the contractility of the walls of the organ decreases and the processes of excretion of bile are disturbed. As a result, there is an accumulation of bile in the body.

Causes of dyskinesia include:

• not proper nutrition(the predominance of fatty / fried foods, egg yolks),
• chronic diseases of the gastrointestinal tract,
• stress,
• menopause in women
• hormonal disbalance.

There are two forms of this disease:

• hyperkinetic (increased frequency of organ contractions)
• hypokinetic (decrease in the frequency of organ contractions).

Pain in dyskinesia of the gallbladder are short-term and pulsating. aggravated by consumption of fatty or spicy food. In addition to severe pain in the right hypochondrium, dyskinesia is characterized by a bitter taste in the mouth, nausea, loss of strength, diarrhea and flatulence.

You can diagnose gallbladder dyskinesia using:

• biochemical blood test,
• duodenal sounding.

Treatment is prescribed by a gastroenterologist and consists in following a diet, using choleretic drugs, antispasmodics and physiotherapy. If the disease is not treated, then complications may occur, incl. leading to the removal of the organ.

Cholelithiasis

A disease in which stones form in the gallbladder and bile ducts. The main causes of cholelithiasis include a long-term accumulation of bile in the organ cavity and an increase in the concentration mineral salts in the bile due to a violation metabolic processes in the body. Stones are formed from large particles of bile that cannot leave gallbladder on one's own.

Pain associated with gallstone disease is characterized by periodic attacks colic, which is accompanied by a sharp throbbing pain in the right abdomen. Increased after eating fatty or spicy foods, pressure, bending forward and to the side. In addition to severe pain in front in the right hypochondrium cholelithiasis manifested by nausea, diarrhea, indigestion, flatulence.

• biochemical blood test,
• cholecystocholangiography.

Treatment is prescribed by a gastroenterologist and consists in removing or destroying stones, following a strict diet, and taking anti-inflammatory drugs. Stones can be removed using lithotripsy, dissolution of stones with acids and surgical intervention. Lack of treatment can lead to increased pain and inflammation of the gallbladder, followed by removal of the organ.

Acute cholecystitis

Acute disease of the gallbladder, in which a rapid inflammation of the walls of the organ develops. To the main reasons acute cholecystitis includes blockage of the bile ducts by stones and infection that causes inflammation (streptococcal, intestinal, staphylococcal).

Severe pain in cholecystitis occurs in the right hypochondrium and has a constant, pressing character. Intensify with a sharp breath and after eating fried or fatty foods, egg yolks.

In addition to the characteristic pain, cholecystitis is accompanied by:

• nausea,
• stool disorders (diarrhea or constipation),
• flatulence,
• belching
• bitter taste in the mouth,
• rise in temperature.

This disease can be diagnosed with the help of a biochemical blood test, ultrasound of the gallbladder and ducts. Treatment is prescribed by a gastroenterologist and consists in relieving inflammation, cleansing the stomach and intestines, taking antispasmodics, and following a strict diet. In some cases, a cholecystectomy is performed (a needle is inserted into the gallbladder through which stagnant bile is removed).

Diaphragm diseases

The diaphragm is a muscular septum that separates the abdominal organs from the chest. The diaphragm is located under the ribs (below the lungs) and is involved in the process of breathing, expanding when inhaling. Pain on the right in the hypochondrium can cause the following pathologies of the diaphragm:

diaphragmatic hernia

A disease in which the internal organs penetrate from the chest into the abdominal cavity and vice versa. The causes of a hernia include a congenital or acquired defect of internal organs: a short esophagus, weakness of the muscles of the diaphragm. When the hernia reaches a large size (up to 5 cm), pain occurs in the solar plexus, which is given to the right hypochondrium. The pain has a periodic, pressing character. It increases with a sharp breath, leaning forward and pressing on the area under the ribs.

In addition to pain, in the right hypochondrium may occur:

A diaphragmatic hernia can be diagnosed using ultrasound and MRI. This disease is treated by a surgeon. The defect can only be repaired by surgery.

Diaphragmatitis

A disease in which the outer membrane of the diaphragm, the pleura, becomes inflamed. The source of inflammation is an abdominal abscess, peritonitis or other inflammatory diseases GIT. Pain in diaphragmatitis occurs during breathing (inhalation / exhalation) and has a aching character. It increases with a change in the position of the body (turns to the sides).

In addition to pain, the following symptoms may be present:

• fever,
• pulmonary edema,
• bloating,
• difficulty breathing (unable to take a deep breath).

Treatment is prescribed by the surgeon and consists of anti-inflammatory therapy and the removal of edema. Left untreated, it can lead to suffocation.

Diseases of the duodenum

The duodenum is located between the stomach and small intestine. In the cavity of this intestine, food is broken down into proteins, fats and carbohydrates with the help of enzymes secreted by the pancreas. Pain in the right hypochondrium in front can be caused by the following pathologies of the duodenum:

A disease in which wounds or ulcers form in the walls of the intestine. The culprit for the weakening of the protective functions of the duodenum are the microbes Helicobacter pylori, which destroy the mucous membrane, forming ulcers. This microbe can be found in every second inhabitant of the planet, but peptic ulcer does not affect everyone.

The reasons for the activation of the microbe include:

• malnutrition,
• stress,
• alcohol abuse, fatty / fried foods,
• hereditary predisposition.

Severe pain in peptic ulcer is localized in the hypochondrium and has a constant and aching character. Increases with pressure and after drinking alcohol.

In addition to severe pain in the right hypochondrium, the ulcer causes:

Treatment of an ulcer is prescribed by a gastroenterologist and consists in restoring the intestinal walls, destroying the bacteria, and following a diet. If the ulcer is left untreated, there is a risk of perforation and peritonitis.

Chronic duodenitis

A disease in which inflammation of the duodenum occurs. Duodenitis can occur both in acute and chronic form. The causes of this disease include malnutrition (excess of fried and fatty foods) and alcohol abuse. Pain in duodenitis is localized in the right hypochondrium in front and has a bursting, paroxysmal character. Increases when turning and tilting the torso to the sides.

In addition to the characteristic pain in the hypochondrium, duodenitis causes:

• constant nausea,
• indigestion,
• violation of the stool (diarrhea and flatulence).

Treatment of duodenitis is prescribed by a gastroenterologist and consists in following a strict diet, restoring the intestinal microflora and normalizing the digestive processes. If duodenitis is not treated, an ulcer may occur.

Diseases of the pancreas

The pancreas is an organ of the gastrointestinal tract involved in the production of digestive enzymes that help food to be absorbed by the body. In addition to active participation in the processes of digestion, this body produces the hormone insulin, on which the level of sugar in the blood depends.

Pancreatitis

A disease in which inflammation of the pancreas occurs. The disease can occur in both acute and chronic forms.

Causes of pancreatitis include:

The pain is excruciating and sharp. Pancreatitis is also accompanied by:

Diagnosis is carried out using ultrasound, two-handed palpation, blood and stool tests. Treatment of pancreatitis is prescribed by a gastroenterologist and consists in eliminating primary disease diet, restoration of intestinal microflora and normalization of digestion.

Pain due to worms

Ascariasis

A disease in which the intestines are affected by the largest roundworm worms. The maximum length of these worms can reach 15 cm. They live in the small intestine, do not cause symptoms in the anus. Infection occurs when larvae or eggs of Ascaris enter the body.

The main causes of ascariasis include eating unwashed vegetables and fruits that have come into contact with animal feces.

Pain in this disease is localized in the right hypochondrium in front, and has a constant, aching character.

In addition to pain, ascariasis is characterized by:

Diagnosed by fecal analysis and biochemical blood tests. Treatment is with medications. If ascariasis is not treated, helminths will penetrate into the organs and disrupt their work.

Giardiasis

Pain in giardiasis is localized in the upper abdomen, giving to the right hypochondrium. The pain syndrome increases with inflammation and acute giardiasis.

Also, this disease is accompanied by:

Giardiasis is diagnosed by fecal analysis. Treatment consists in following a diet, using medications, and restoring the intestinal microflora. Why Giardia settled in the small intestine, only a doctor can answer after the examination.

below the ribs

Diseases of the small intestine

Digestion takes place in the small intestine complex substances to simpler ones and their subsequent absorption into the blood. The walls of the small intestine absorb useful minerals, vitamins and salts from food, which are the main building material for the human body.

Chronic enteritis

Inflammatory disease of the small intestine, in which there is a violation of the functions of digestion. The main cause of inflammation are pathogens of infectious diseases of the intestine (rotaviruses, dysentery, yersinia, salmonella).

The chronic process develops after an acute infection, when the pathogen is defeated. Pain in chronic enteritis occurs in the area of ​​the right side below the ribs and has a pulsating, pressing character. Increased with inhalation and after eating fatty / fried foods.

In addition to the characteristic pain, enteritis is accompanied by:

• bloating,
• stool problems (diarrhea, constipation, flatulence),
• drastic weight loss
• deterioration of potency in men.

Chronic enteritis can be diagnosed with:

• coprograms,
• absorption tests,
• bacteriological analysis of feces,
• biochemical blood test,
• endoscopic examination.

Treatment is prescribed by a gastroenterologist and consists in eliminating the infection, restoring bowel function (treatment of dysbacteriosis), and following a diet.

Celiac disease (celiac disease)

congenital disease in which underproduction peptidase enzyme, which is involved in the breakdown of gluten. As a result of this disease, the walls of the small intestine are toxic from unsplit enzymes, the intestinal lining becomes thinner and damaged, disrupting the digestive processes.

Pain in celiac disease occurs in the right side below the ribs and is aching, permanent. They increase with a sharp breath, bending forward and after eating foods containing gluten (pasta, bakery and other products containing cereal crops). In addition to the characteristic pain, enteropathy is accompanied by constant nausea and severe diarrhea.

This disease can be diagnosed with:

Treatment is prescribed by a gastroenterologist and consists in restoring bowel function and following a strict diet that excludes gluten. If the disease is not treated, peritonitis will develop.

Appendicitis

Chronic appendicitis

A disease in which it periodically becomes inflamed appendix under the influence of external or internal factors.

Causes of chronic appendicitis include:

The pain has an aching, pressing character and is localized in the region of the right side below the ribs, radiating to the hypochondrium. Pain worsens after physical exercise, tilt left/right.

Diagnosis is carried out using radiography, ultrasound, blood tests. Treatment is carried out by a gastroenterologist and a surgeon. As a rule, with a long chronic process, the appendix is ​​​​removed.

Acute appendicitis

The disease in which acute inflammation appendix. The pain has a cutting, paroxysmal character and is localized in the lower abdomen on the right, giving to the hypochondrium. In addition to pain in the hypochondrium, acute appendicitis is accompanied by:

Diagnosis is carried out using two-handed palpation, blood tests and ultrasound. Acute appendicitis is treated only by removing the inflamed appendix. Why the appendix is ​​inflamed, only a doctor can say after the examination.

Women's and men's diseases

Pain in the right hypochondrium may occur due to gynecological problems in women and urological in men. Diseases of the female genital area that cause this symptom include an ovarian cyst, an ectopic pregnancy, tumors of the appendages. Diseases of the male genital area include prostate adenoma, prostatitis, inflammation or rupture of the testicle. As a rule, pain in these diseases is localized in the lower abdomen, but can spread throughout the abdomen, extending to the right hypochondrium.

Behind

Pain in the right side from behind also appears is a fairly frequent visitor and can be caused by diseases of the lungs, musculoskeletal system, kidneys and urinary system. Pain in the area of ​​the right hypochondrium in case of lung pathology (tuberculosis, bronchitis, inflammation) differs in return to the chest area. And increased pain can be seen with bouts of coughing and deep breathing. Pain in osteochondrosis occurs when bending and turning the torso. An increase in pain can be seen when a vertebra or nerve ending is pinched in the region of the right rib. In the pathology of the kidneys (pyelonephritis), the pain has a girdle character and radiates to the coccyx.

This article discusses only a small part of the diseases in which pain appears in the right side under the rib, but even this small list shows that you should not joke with these signals from the body. In case of any similar symptoms, it is necessary to urgently consult a doctor, since delay can lead to irreversible consequences, for example, the need to remove an organ, and, as a result, a sharp deterioration in the quality of life, disability, and the obligatory use of drugs for the rest of your life.

• pain in right side under ribs
• smell from the mouth
• heartburn
• constipation
• diarrhea
• belching
• heaviness after eating
• increased gas production (flatulence)

If you have at least 2 of these symptoms, then this indicates a developing gastritis or ulcer. These diseases are dangerous for the development of serious complications (penetration, gastric bleeding, etc.), many of which can lead to FATAL outcome. Treatment needs to start now. Read an article about how a woman got rid of these symptoms by defeating their root cause. natural method. Read material.

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Pain in the liver - causes

We all know that the liver is one of the most important organs of the human body. Everyone can show with confidence where it is located. Due to its size, the liver occupies a fairly large space on the right under the ribs. And we are accustomed to associate all unpleasant or painful sensations in this area with violations of the work of this irreplaceable organ.

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

What is a liver?

The liver is the largest gland in our body. It is responsible for maintaining the same chemical composition of the human body:

• participates in the processes of digestion, 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 have entered the body from the outside;
• processes and utilizes excess hormones and vitamins;
• is a place of storage of energy reserves in the form of a depot of glycogen, some vitamins (such as vitamins A, D, B12) and trace elements;
• serves as a depot for a significant reserve volume of blood required in conditions associated with disorders in the general vascular bed.

The liver is closely connected with the extrahepatic system of the bile ducts and the gallbladder. The gallbladder is an organ located on the underside 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 get sick on its own.

And we judge the deterioration of its work by many other symptoms, experiencing pain only with an increase in the size of the liver and a significant stretching of the capsule enveloping it. Most often, pain in the right hypochondrium is caused by certain disorders of the gallbladder.

What affects liver and gallbladder disease?

At various stages of our life, the liver carries increased loads. This is the period of pregnancy for women. Childhood and youth, 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 detoxifying functions for two organisms at once. During pregnancy, pre-existing chronic diseases are often exacerbated due to increased stress. And because of the increased synthesis of steroids, the processes of bile production and bile secretion can be disturbed.

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

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

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

As a rule, physiological changes in the work of the digestive organs during pregnancy are not pronounced and do not require any treatment. It is enough to adhere to a healthy diet and a work and rest regime suitable for a pregnant woman. All past or existing diseases must be told to the therapist when registering with women's consultation. The doctor will help adjust the diet, and, if necessary, prescribe maintenance drugs, taking into account the duration of pregnancy.

growing up

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

The child refuses to eat due to frequent nausea or pain in the hypochondrium. He is concerned about increased gas formation and bloating due to a violation of the proper secretion of bile during digestion.

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

Old age

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

Stones or polyps may form in the gallbladder. Any pain in the liver is a reason to see a doctor. It must be remembered that a timely appeal to a therapist or gastroenterologist will save you from a lot of trouble. And this must be done with the development of hepatic colic.

hepatic colic

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

With hepatic colic, severe soreness of the entire right lateral region is characteristic, sometimes with a transition to the back and high in the ribs, a significant deterioration in the general condition of the patient. The only thing that can be done to make him feel better is to give an antispasmodic (no-shpa, spazmalgon, baralgin) and call an ambulance.

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

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Feeling of fullness and pain under the ribs on the right - causes and treatment

Discomfort, pain and heaviness in the right side make you think about the source of these sensations. Most often, such manifestations make themselves felt some gastroenterological diseases.

Causes and symptoms

Regularly occurring discomfort heaviness and pain on the right side of the body can occur for several reasons. The nature of such manifestations depends on their origin.

Physiological

Symptoms usually appear during strenuous sports or during strenuous work. In these cases, the severity and pain are short-lived.

They occur due to the fact that a high load activates blood flow. The hepatic veins overflow, provoking bursting and heaviness in the liver. Its fibrous membrane has many nerve endings and pain receptors. Stretching causes pain.

ADVICE! After the blood flow returns to normal, the symptoms stop immediately.

Nutrition

Pain after eating, belching and bloating can occur when you consume a large amount of alcoholic beverages or fatty foods heavily saturated with spices. The causes of such symptoms are a malfunction in the liver, gallbladder, gastrointestinal tract, which occur as a result of overeating and drinking alcohol.

Development of diseases

If the right side regularly hurts, the reason most likely lies in the pathological changes in the internal organs. The manifestation of unpleasant painful sensations, in this case, is of two types - constant sluggish or periodic acute. There are many diseases that can cause heaviness in the right side or hypochondrium.

Liver pathologies

The resulting feeling of fullness, heaviness and pain in the liver and right hypochondrium may be signs of serious problems in the liver and related organs. Such symptoms can be caused by:

1. Problems with the gallbladder and bile ducts:

Such pathologies are characterized by nausea and spasmodic pain.

Basically, liver diseases are of a viral or physiological nature. As a result of their development, stagnation of bile is formed, the functional activity of the organ is disrupted. Its complete failure leads to death.

All negative processes in the liver have similar symptoms. These include pain under the ribs, which is most often localized in front, bitterness in the mouth. If the cause of discomfort lies in liver disease, this can be found out by palpation. The affected organ is usually enlarged.

Pathological changes in the liver tissues may be asymptomatic. Pronounced signs appear more often in chronic forms or in the acute course of the disease.

Gastrointestinal organs

Some diseases gastrointestinal tract may have a course that causes unpleasant symptoms in the right side. They can be expressed as a feeling of bloating, heaviness under the right rib, girdle pain around the entire hypochondrium (characteristic of inflammation of the pancreas).

These diseases include:

Diseases of the gastrointestinal tract have symptoms similar to those of liver pathologies. To determine exactly what causes heaviness and pain, you need a special diagnosis.

kidneys

In cases where prolonged discomfort, heaviness in the right side and pain syndrome are localized behind, one can suspect the presence of pathologies in the kidneys.

Such symptoms occur in the following diseases:

• Urolithiasis disease;
• Pyelonephritis;
• Acute upper paranephritis;
• Cancer of the kidney and right adrenal gland.

The most common symptoms in renal negative processes are acute pain and a feeling of swelling in the right side.

Neurological disorders

Various neurological dysfunctions can cause symptoms similar to signs of liver disease. Sterno-lumbar degenerative changes are characterized by the presence of pulling or spasmodic pains. There may also be a feeling of tightness, heaviness and burning on the right, often from the back. Usually, heaviness in the right side of the body provokes intercostal neuralgia, the symptoms of which are similar to cholecystitis.

One of the causes of heaviness on the right side of the body can be stress and increased nervous activity, which give impetus to the development of various diseases.

Circulatory disorders

Chronic venous congestion in fibrosis, and collateral venous plethora with cirrhosis of the liver, arising from heart failure. Since the vessels are squeezed by the nodular formations of the affected liver, blood accumulates in the organ. It expands, causing an unpleasant feeling of heaviness and swelling.

Pregnancy

AT III trimester During pregnancy, the size of the uterus increases so much that the rest of the organs are under constant pressure. Because of this, constant aching pain and heaviness can occur.

Diabetes mellitus, which affects many organs, is one of the causes of heaviness and pain in the liver and kidneys.

For all diseases of the liver, kidneys and gastrointestinal tract, nausea, vomiting, and stool disorders are characteristic. In the acute stage, the temperature may rise, profuse sweating may appear. As a local reaction, a rash may appear.

Diagnostics

The affected liver most often increases in size and presses on adjacent tissues, causing a feeling of heaviness. Constant heaviness in the right side is the basis for urgent medical attention. If there is discomfort in the right hypochondrium, the causes and treatment should be evaluated and prescribed by a specialist.

With the help of a comprehensive examination, the doctor will determine which organ damage causes symptoms and make a diagnosis, revealing the pathology. The diagnosis includes laboratory tests of blood, urine, tissue samples taken with a biopsy. Instrumental and hardware diagnostic methods are also needed. Ultrasound, CT, MRI allow not only to make a diagnosis, but also to accurately localize the place of development of the negative process.

The sooner you see a doctor, the less likely the disease will develop into a chronic form.

Treatment

Complex curative measures appointed only after establishing the source of pathology. Depending on the type and severity, it can be:

• Medicamentous, with the use of drugs;
• Physiotherapy;
• operational.

In no case should you self-medicate. Taking drugs without a doctor's prescription can aggravate the condition or cause a toxic complication, especially with liver pathologies.

To maintain the body during the rehabilitation period, preventive or maintenance treatment is prescribed. Folk remedies and herbal medicine, used in parallel with other types of therapy, increase the effectiveness of treatment. You can independently prepare decoctions and teas, observing all the requirements and recipes. There are also ready herbal preparations and balms, which can be purchased at the pharmacy. Traditional medicine should not contain alcohol.

Prevention

During the period of examination and treatment, as well as after them, it is necessary to adhere to proper nutrition. Some diseases involve the use special diets(table number 5, 9). The use of pickled, spicy and fried foods during the course of the disease is unacceptable. Preventive measures include the periodic use of vitamin-mineral complexes and hepatoprotectors.

In liver disease, drinking alcohol is strictly not recommended. Alcoholic beverages exacerbate pathologies and can lead to the development of incurable cirrhosis, which is an irreversible and fatal disease.

Heaviness in the right side is rarely spontaneous. It appears as the first symptom of some diseases and is a signal of violations in the body. When it appears, even if this symptom is painless, it is worth contacting a specialist and preventing possible complications.

Symptoms: pain right side under the ribs

Dull or aching pain in the right side under the ribs is a fairly common symptom that every person has experienced at least once in his life. This is due to the dense structure of the organs that cover the right ribs. This area contains the liver and right kidney. Both of these organs have a dense structure and are quite closely in contact with the ribs inside. In the normal state, the kidney and liver are reliably protected by the ribs on the right and are not injured by them when moving.

Dull or sharp pain in the right side under the ribs can occur when the right kidney or liver becomes “cramped” in its natural bed. This can be caused not only by an increase in size due to the inflammatory process. There are also possible reasons such as displacement of organs during impacts and squeezing them by other organs that are located nearby.

In order to understand the etiology of pain in the right side under the ribs and understand what diseases can provoke it, we suggest that you familiarize yourself with this material.

How does pain occur under the right rib

As mentioned above, several factors can provoke pain under the right rib. But in any case, it should be understood that pain under the right rib must be differentiated from acute conditions. It is important to know that acute pain in the right lower rib can threaten a person's life.

Therefore, we immediately stipulate that:

• aching pain under the right rib, which lasts more than an hour, requires an ambulance call;
• sharp sharp pain under the right rib requires an immediate call for an ambulance;
• nausea pain under the right rib requires you to see a doctor on the same day that these symptoms occur;
• stabbing pain under the right rib that occurs during movement and does not go away within 30 minutes may indicate organ infringement and requires immediate medical attention.

In normal physiological state right kidney and liver pain under the right lower rib does not occur. The exception is injuries. In this case, pain in the right lower rib may indicate a bruise, both of the rib itself and of the internal organs. If there is a bruise or abrasion on the surface of the lower right edge of the chest, then most likely the pain in the right rib is caused by an injury.

What can cause pain in the right ribs

In addition to injury, pain in the right ribs can be associated with inflammatory processes in such organs as:

In women during pregnancy, pain in the right ribs may be associated with the growth of the fetus and compression of the internal organs. With inflammation, for example, of the gallbladder, there is a thickening of the walls of this organ. Slowing down the outflow of bile causes the expansion of the gallbladder. He starts to put pressure on the liver. That, in turn, presses on the ribs on the right. There is a dull aching pain in the right ribs, which increases with movement and subsides in the supine position.

Sharp cutting pain in the right ribs may indicate that some internal organ is seriously damaged. If this symptom occurs, seek immediate medical attention medical care.

How to Diagnose Right Rib Pain

In order to correctly diagnose pain in the right rib, it is necessary not only to carefully collect an anamnesis, but also to make a series of examinations. The doctor can make a primary diagnosis by interviewing the patient. For collecting anamnesis, not only existing chronic diseases are important, but also past hepatitis or other acute inflammatory processes. During the survey, it is important to identify the facts of injuries and the possibility of a blow in the recent past. It is also important to establish the relationship between the occurrence of pain in the right ribs and food intake. An important factor is physical exertion, in which there is pain in the right ribs.

After questioning and collecting facts that accompany pain on the right side under the ribs, the patient is examined. The integrity of the skin is revealed. After that, you can proceed to palpation of the abdominal wall. The inflamed right kidney can be palpated along the anterior abdominal wall. The liver, if inflamed, will protrude beyond the edge of the right rib. If the gallbladder hurts, then palpation will be painful just below the right ribs. It is important to know that sometimes pain in the right ribs can be associated with helminthic invasion. In this case, palpation will be painful around the navel.

Further important for the diagnosis of pain in the right rib is the examination of the sclera of the eyes, tongue and skin. With an inflammatory process in the liver or gallbladder, the surface of the tongue will be lined with a yellowish coating. With inflammation of the pancreas or kidney, plaque on the tongue is also possible, but white color. With liver diseases and a violation of the outflow of bile, yellowing of the skin and proteins of the eyeballs can be observed. This is due to the fact that bilirubin from bile enters the bloodstream and decomposes into bile pigments. They color the skin and sclera of the eyes in a saffron shade.

After establishing a preliminary diagnosis, an additional laboratory examination should be performed.

Severe pain in the right side under the ribs - a reason to urgently consult a doctor

If you have severe pain in your right side under the ribs, this is a signal from your body that it is in catastrophe. In this place there are three important internal organs at once, the defeat of which can lead to death. Most often, severe pain on the right side under the ribs begins to bother if:

• there is a rupture of the gallbladder with cholelithiasis;
• liver injury;
• prolapse of the kidney, rupture of the kidney, or strangulation of the renal cyst.

All of these conditions require immediate surgical intervention. Therefore, if you are worried about severe pain in your right rib, do not hesitate a second, urgently call an ambulance. Every minute can count.

What diseases give pain under the right rib in front

Dumb and aching pain under the right edge in front can give a variety of diseases. Among them are:

• acute and chronic hepatitis;
• fatty degeneration of cellular structures of the liver;
• cholecystitis;
• pyelonephritis;
• glomerulonephritis;
• polycystic kidney on the right;
• inflammation of the appendages in women;
• acute attack of appendicitis;
• inflammation of the small intestine;
• helminthic invasions;
• inflammation of the pancreas;
• pneumonia;
• peptic ulcer of the duodenum;
• oncological processes in the lung, liver, gallbladder or kidney.

Do not engage in self-diagnosis and treatment without medical supervision. Install correct diagnosis and only a specialist who has the possibilities of laboratory research, including ultrasound of the internal organs of the abdominal cavity, can start high-quality treatment in a timely manner. To identify, for example, chronic hepatitis, is possible only if there is a blood test.

How to relieve pain on the right under the ribs

Dull and aching pain on the right side under the ribs, which is associated with chronic diseases, can be treated with antispasmodics such as noshpa. But you should not take painkillers if you do not know your diagnosis. An erased picture in the future will complicate the diagnosis of the disease.

If acute pain occurs in the right rib, ensure rest, static position of the body in a supine position and put cold on the site of pain. Nothing should be accepted. Call a doctor urgently. If the pain in the right ribs is associated with stagnation of bile, and you know this for sure, that tubage, or liver cleansing, will help relieve pain. Read about it in a special article.

What does the pain under the right rib at the back mean?

Very often, people are worried about pain under the right rib at the back. This is a symptom of an inflammatory process in the kidney or pancreas. It is quite easy to distinguish between these two states.

If the pain under the right rib at the back is associated with kidney problems, then, as a rule, a positive symptom of Pasternatsky appears. To identify it, it is enough to stand up straight and lightly hit the edge of the palm on the surface of the lower rib from behind. If this causes pain, then Pasternatsky's syndrome is positive.

In the event that pain under the right rib at the back is associated with inflammation of the pancreas, then the factor that pancreatitis is most often accompanied by girdle pain will help to distinguish it. That is, with inflammation of the pancreas, it will hurt not only under the right rib from behind, but also from the front and left.

Pain under right lower rib on movement

Sometimes pain under the right lower rib can occur in perfectly healthy people when moving. If you are experiencing unusual physical exercise, then there is an expansion of the internal organs due to the release of adrenaline and an increase in blood flow. This provokes pain in the right ribs, since this is where the vena cava passes, which can swell.

Also, pain under the right lower rib during movement can occur due to sharp turns and tilts. In this case, the internal organs come into contact with the rib structures. This pain usually goes away within a few minutes.

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Find out the causes of pain under the ribs on the right

A common symptom is pain on the right under the ribs. This could be the reason various diseases or problems. Even perfectly healthy people can experience soreness in this area.

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

Pain varies

In adolescents, pain on the right side is considered normal, as it speaks of the development of the body, its growth. Also, such manifestations occur with:

Duration less than 30 minutes is considered short. Anxiety should cause soreness, which does not pass for more than an hour, increases with movement, 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, gallbladder, kidney. Acute pain, which increases when walking, suggests the presence of a hematoma in the internal organs.

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

Sometimes the pain is mixed. It is pulling, blunt, but sometimes sharp. Wandering, short-term under the rib on the right or spills so that it is difficult to determine its location. Such manifestations have psychosomatic causes, it is necessary to contact a neurologist.

Be sure to watch the following video

Hepatitis

This is a liver disease. You can get infected through blood transfusion, through a sexual partner, when applying a tattoo with non-sterile needles, as well as with acupuncture.

• heat;
• pain on the right under the ribs;
• dark urine;
• aches all over the body;
• discolored feces;
• skin rashes are possible.

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

Diagnosis of pathology is carried out by a specialist - an infectious disease specialist. Treatment is provided 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, a diagnostic examination is carried out, tests are taken:

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

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

To facilitate digestion, liver function, it is forbidden to consume such products:

For hepatitis, the following products are useful:

• slightly dried bread;
• fish - pike perch, cod;
• dairy products;
• butter;
• natural homemade juices (not acidic);
• jam (but not strawberry);
• marshmallow;
• fruit pastille;
• green apples;
• persimmon;
• watermelons;
• bananas.

If an infected person follows the recommendations of doctors, undergoes examinations, and follows a diet, then the main complications in his life will come in about 30 years. Hepatitis has not yet been cured. The liver will gradually lose its ability to filter the blood. The main enemies of the liver are alcohol, fatty foods. An infected person will help himself by not using it.

cirrhosis

This is a disease of the liver when the normal cells of the organ are replaced by connective tissue. The liver can no longer do its job normally, for example, purify the blood, the whole body suffers.

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

Signs of pathology are mild. At the initial stage, they are completely invisible, short-lived.

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

The disease is complex, strictly individual treatment is selected. Physiotherapy is not recommended, the use of traditional medicine recipes is agreed with the attending physician, they are not used at the main treatment stage. Perhaps only at the stage of recovery to maintain the strength of the body. 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 destruction of the liver. Modern science has many means, opportunities, methods. But the patient must reconsider his lifestyle, listen to the doctors, follow their instructions, and not rely on a magic pill.

Cholecystitis

This is an inflammatory disease of the gallbladder.

• sedentary lifestyle;
• irrational nutrition;
• the use of certain contraceptives;
• heredity;
• allergic reaction.

The disease begins gradually big influence stressful situations, emotional overstrain, overeating have a beginning. The main manifestation is a pain in the side on the right side, and the pain is constant and strong, it can spread to the shoulder blade, reach the shoulder. In special cases, the pain shifts to the left side, covering the entire upper region belly.

• vomiting with bile;
• bloating;
• bitterness in the mouth;
• weakness;
• increased sweating;
• increased heart rate
• body temperature increases.

An experienced doctor will determine this disease by the symptoms. Additional examinations will confirm the diagnosis:

• abdominal ultrasound;
• x-ray;
• cholecystocholangiography (a special examination to detect stones in the biliary tract);
• blood sugar test;
• general, biochemical blood test
• bacteriological, microscopic analysis of bile.

A gastroenterologist deals with the treatment of this disease. Inflammation in the gallbladder is eliminated with antibiotics. To normalize the work of the body, antispasmodic drugs, analgesics, choleretic agents are prescribed.

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

5 g of tansy flowers pour a glass of boiling water, leave for half an hour. 3 times a day before meals, take 1 tablespoon.

Pour 10 g of corn stigmas with a glass of water, boil for 5 minutes. Drink a quarter cup 3 times before meals.

With timely access to doctors, the development of the disease can be stopped. The danger lies in the 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 drugs;
• 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 region of the kidney under the ribs.

• blood in the urine;
• increase in pressure;
• high body temperature;
• renal colic.

During the conversation with the patient, the doctor selects a lot of important information - when the pains appeared, whether there were cases of stone discharge, there were cases of such diseases in the family, what chronic diseases the patient suffers from, what operations he underwent. Examinations are being carried out, analyzes are being collected:

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

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

But only small stones leave on their own, large ones need to be crushed. To do this, there are several methods that use ultrasound and other technologies. Well helps in the treatment of special physical education, physiotherapy, spa treatment.

When urolithiasis is detected, it is necessary to change the way of life. This does not mean that you need to give up all the joys and pleasures. Life should be filled with movement, sports, natural food and regular medical examinations.

Pyelonephritis

This is an infectious disease of the kidneys, which is caused by bacteria. A pathogen that is in the human body has somehow reached the kidneys. This can be with inflammation in girls of the external genitalia. The urinary tract infection travels up to the kidneys. Also, with the blood flow after viral infections of the throat or nose, pathological microorganisms reached the kidneys.

Favorable conditions for the development of pyelonephritis:

• immunity;
• hypothermia of the body;
• incomplete emptying of the bladder during urination;
• chronic infection in the body - caries, tonsillitis;
• scalatin;
• 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;
• pulling, aching pain in the right hypochondrium, with movement becomes stronger;
• cloudy urine.

Examination of the patient by a doctor is an important part of the diagnosis. The doctor feels the kidneys, finds out the place of pain, asks about the nature of the pain, the duration of such a condition. Among the instrumental methods perform:

• 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 pathogen resistance. In difficult situations, a combination of several drugs is used.

They also prescribe funds to improve blood supply to the kidneys, antioxidants, diuretics, vitamins. To suppress the inflammatory process, nonsteroidal drugs are prescribed for a course of up to 10 days. With exacerbation of pyelonephritis, it is recommended to limit salt intake.

The body is especially vulnerable to pyelonephritis in childhood and 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, disruption of their normal functioning.

Negative consequences of pyelonephritis

• persistent increase in blood pressure;
• blood poisoning;
• death from renal failure.

Diaphragm disease

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

• congenital pathologies of development;
• mechanical damage;
• Changes with age.

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

When the diaphragm is damaged during an injury, internal organs are usually also affected. We have to urgently do the operation. Often this happens in the event of an accident or a fall from a great height.

With pathologies of the diaphragm, the internal organs of the chest suffer. They are squeezed, bent, broken normal work, the patient's condition is rapidly deteriorating.

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

A general practitioner may be the first to assume that a person has a diaphragm disease based on a survey, examination. Diagnosis can be confirmed by X-ray contrast agent, also EGDS. Such methods allow you to decide on a treatment plan.

Some types of hernias are not infringed, therefore, for their treatment, a certain diet with fractional nutrition is prescribed, a special complex of drugs to reduce the acidity of gastric juice. Such patients should not wear weights, strongly tighten the stomach with tight belts.

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

Proper treatment, timely surgical operation saves a person from these problems.

Lung cancer

This is a malignant epithelial tumor that has spread to the lung. The cause of such a terrible disease is a violation of DNA, which occurs under the influence of factors external environment. This is smoking, work in a hazardous industry, 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 with streaks of blood;
• labored breathing;
• pain in the right hypochondrium;
• shortness of breath even without exertion;
• weight loss.

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

If the patient applied for initial stage, will determine the presence of the disease by analysis, because the tumor is not yet visible in the pictures. In the later stages, pictures will serve as proof.

The standard complex of cancer treatment includes several methods. Doctors choose an acceptable one based on the individual situation for each patient separately. Traditional medicine 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, smoking.

It is very difficult to make plans and make predictions in such a serious illness. Seeking medical help early, following the recommendations of doctors helps to cope with the disease.

Pneumonia

Infectious disease of the lungs. It is often a complication after colds.

Manifestations are similar to influenza, colds.

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

The doctor after the examination conducts diagnostic examinations :

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

A lung specialist is called a pulmonologist. He is invited to the patient difficult cases. For treatment, expectorants are prescribed for better sputum separation. Antipyretics only for high temperature. Heart drugs for severe dyspnoea. At the stage of recovery, immunomodulators and vitamins are recommended to strengthen the body's defenses.

From folk remedies, a compress of honey and vodka helps well. The skin on the affected side is smeared with honey, moistened with a napkin with vodka, applied to honey, covered with a warm towel on top, left overnight. They make such compresses 3-4 times, but only if there is no pus in the lungs.

Inflammation of the lungs is a severe pathology, it has many complications, it cannot be ignored, it must be treated after treatment. The negative consequences are:

Duodenal ulcer

This is a pathology in which defects, ulcers, form on the wall of duodenum 12.

• stress;
• passion for spicy food;
• alcohol abuse;
• smoking;
• hereditary factor;
• long-term use of certain drugs.

They may manifest clearly, but be perceived as other diseases.

• pain in the upper abdomen under the ribs;
• soreness 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.

• analyzes of urine, blood, feces;
• analysis of gastric juice;
• FGDS;
• Abdominal ultrasound.

A gastroenterologist prescribes treatment. These will be means to reduce the acidity of the stomach, reduce its quantity. Antibiotics are required to destroy pathological microorganisms. With severe pain - antispasmodics, for example, but - shpa.

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 you do not carry out treatment, 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 small, then this may be manifested by a slight soreness, which will not bother you much.

• hit;
• wound;
• tuberculosis of the ribs;
• falling from a great height;
• transport accident;
• chest infection.

The appearance of cracks, fractures of the ribs is affected by the person's age, existing diseases.

Symptoms appear immediately, abruptly, 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 doctor-therapist conducts a primary examination, it shows the site of pain. To confirm the diagnosis, x-rays and computed tomography are performed.

The doctor is a traumatologist. Hospitalization is carried out if damage to internal organs is detected. In case of injury, only the ribs are allowed to be treated at home. Painkillers are prescribed, cold compresses should be applied to the site of injury.

When all the doctor's prescriptions are followed, a full recovery occurs.

Osteocondritis of the spine

A chronic disease in which cartilage and intervertebral discs are damaged.

Causes of pathology:

• hereditary predisposition;
• trauma;
• disturbed metabolism;
• obesity;
• overload of the spine during sports activities;
• violation of posture;
• flat feet.

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

• constant aching pain in the lower back, radiates to the ribs;
• dizziness with a sharp turn of the head;
• blurred vision;
• pain between the ribs when moving;
• loss of sensation in the extremities.

Osteochondrosis is determined using MRI, ultrasound, laboratory examinations.

Therapy must be comprehensive in order to get the desired positive result. Good effect give acupuncture, vacuum therapy, laser treatment. Many doctors recommend dry traction, electrical stimulation, magnetopuncture.

Without quality treatment, a person is doomed to severe consequences leading to paralysis of the limbs. It is necessary to be treated in a timely manner, in good faith, to follow the recommendations of doctors.

Shingles

skin disease viral origin that strikes nervous system and skin cover. Once in the human body, the virus manifests itself in favorable conditions, subsiding under the influence of treatment or the immune system.

Factors affecting the manifestations of lichen:

• constant stress, overwork;
• taking immunosuppressants;
• oncological diseases, their treatment;
• HIV infection;
• Elderly age;
• Pregnancy;
• Persistent colds, hypothermia.

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

• Weakness;
• The temperature is subfebrile, high is rare;
• Headache;
• Violation of the digestive system;
• Pain along the rash on the skin, most often in the right hypochondrium;

Pain in this pathology is special. Lichen 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.

At the beginning, the therapist deals with the disease. If necessary, a dermatologist and an infectious disease specialist join. If the pathology is severe, neglected, you may need to consult a neurologist.

To relieve pain, doctors prescribe painkillers, such as Ibuprofen, Paracetamol. Specific drugs against herpes are Acyclovir, Zovirax. They contribute to the healing of ulcers, the normalization of the general condition.

Ringworm can cause damage to internal organs. During pregnancy, it can harm the baby. It must be remembered that under favorable conditions it will reappear. His appearance is always unpleasant, reduces immunity, takes strength. hardening, healthy lifestyle life - will serve as an obstacle to the appearance of herpes.

Pain while breathing

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

A dry cough usually accompanies. Even a few years after suffering pleurisy, pain may remain with a deep breath, as a complication. When breathing, pain manifests itself with a tumor of the pleura.

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

Inflammation of the intercostal nerve endings increases with a deep breath. Soreness is localized at the site of the greatest damage to the nerves. The pain may also be aggravated by movements, tilts, unsuccessful turns in the affected direction. Inflammation in the muscles (myositis) is also manifested by pain when breathing.

Soreness on the right under the ribs occurs with renal colic when the stone is in the right kidney or ureter. In this case, the pain will increase with inhalation, give under the shoulder blade.

With such symptoms, you should seek medical help. There are many diseases, they are treated in different ways. Only a professional can make a diagnosis.

Urgently to the doctor!

It is necessary to hurry to seek medical help:

• if it hurts on the right under the ribs for a long time, more than an hour;
• with acute, sudden onset pain;
• with soreness of a bursting nature;
• if a sharp pain in the right hypochondrium is aggravated by walking or any movement.

It is better not to drink painkillers, they will only lubricate clinical picture diseases. If the pain is difficult to endure, it is better to apply cold compress it will ease the pain a bit.

Conclusion

When pain occurs, you need to focus, understand what is happening with the body. It is necessary to remember what happened before this moment, what foods, drinks they used, what they did. Gotta be good host to your body, to 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 will be useful only theoretically.

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

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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 increase 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. right lobe is equal to 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 acute anterior one is in the range of 14 to 20 cm. Experienced physicians should 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 texture. It is easy to feel in the hypochondrium. At various diseases the organ thickens and increases by 5 cm or more. Liver enlargement is detected during ultrasound.

Etiological factors

Experienced physicians know the causes of hepatomegaly. There are the following etiological factors:

• 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;
• trauma;
• hemochromatosis;
• acute and chronic heart failure;
• malaria;
• leishmaniasis
• leukemia;
• lymphogranulomatosis;
• hemolytic disease;
• lipid metabolism disorder;
• helminths;
• cholelithiasis.

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

Hepatomegaly in the inflammatory process

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

The liver becomes inflamed in hepatitis for several reasons. Highest value have the following factors:

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

What symptoms are characteristic of hepatitis, not everyone knows. In this disease, hepatomegaly is combined with icterus 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 learn about the state of the liver by the results of ultrasound, tomography and biochemical analysis.

With echinococcosis, the liver can increase significantly. There are few symptoms of this pathology. Along with hepatomegaly, there are subfebrile temperature, small rash, weight loss, loss of appetite, heaviness in the hypochondrium, diarrhea and nausea with vomiting. The first complaints in a person appear a few months or years after infection.

An increase in 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. In the development of this pathology are involved:

• stenosis of the pulmonary artery;
• thromboembolism;
• insufficiency of the tricuspid valve;
• pulmonary valve insufficiency;
• stenosis of the tricuspid valve;
• pericarditis.

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 of the 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 increase in the abdomen are possible. Palpation is determined by 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 with alcohol

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

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

With an increase in the liver against the background of fatty hepatosis, a person looks healthy. Symptoms are poor. Very often, the disease is discovered by chance. Severe damage rarely develops. Hepatomegaly can be detected on ultrasound. Symptoms include aching pain in the hypochondrium on the right, discomfort and asthenia.

Patient examination plan

With 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:

• general blood analysis;
• biochemical analysis;
• blood test;
• polymerase chain reaction;
• virological research;
• puncture biopsy;
• radioisotope scanning;
• CT scan;
• dopplerography;
• bioassays;
• coagulogram;
• immunological research.

An experienced doctor understands how to make the correct diagnosis. Low concentration of prothrombin and albumin, increased alkaline phosphatase and gamma globulins, indication of alcoholism, parenchymal heterogeneity, increased width portal vein These are all 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:

• dieting;
• the 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, plenty of fluids, avoidance of alcohol, the use of antispasmodics and lactulose preparations. Sometimes cholagogues are prescribed. Patients are shown diet number 5. The causes and treatment of hepatomegaly are directly related.

If an increase in the organ is due to hepatitis B, then detoxification therapy is performed. sorbents are used. Antiviral drugs and alpha-interferon are prescribed. In the terminal stage, it is impossible to reduce the liver. An organ transplant is required.

What to do if the liver has increased against the background of cirrhosis, not everyone knows. In this situation, a strict diet is prescribed. With the development of complications, you need to reduce protein intake. Many drugs are contraindicated. According to indications, Dufalac or Normase is prescribed. Hepatoprotectors are used (Heptral, Essentiale Forte, Hepamerz). Herbal remedies (Liv-52) and homeopathic remedies (Galsten) are often prescribed. With an enlarged liver and spleen against the background of 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. Methods of treatment of alcoholic hepatitis are diet, avoidance of alcohol, intake of cholagogues, inhibitors of tissue proteinases 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. For this you need:

• do not drink alcohol;
• drink only boiled water;
• wash hands before eating;
• wash vegetables and fruits;
• refuse to visit tattoo parlors;
• use sterile instruments for medical procedures;
• eat well;
• live a healthy life;
• treat chronic diseases;
• avoid contact with chemicals.

If the underlying disease is not cured, then complications are possible in the form of liver failure.

hepatit.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.

Exchange disorders

• hemochromatosis;
• pathology of fat metabolism (steatosis);

Toxic damage:

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

Bile flow disorders:

• cholestatic hepatosis;
• cholelithiasis;
• cholecystitis.

Hereditary metabolic diseases:

• Wilson's disease;
• Nimmann-Pick disease.

Helminthiases.

Diseases of the cardiovascular system:

• heart failure;
• hepatic vein thrombosis.

Sarcoidosis.

The 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 directed at viruses cause damage to their own cells.

Damage from toxic substances develop 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, edema develops. The liver increases in size. In areas of necrosis, macrophages begin their work, fibrous tissue is synthesized. Gradually areas of fibrosis increase. cirrhosis develops.

When fat metabolism is disturbed, droplets of fat accumulate in the 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 old, the liver is richly supplied with blood. Therefore, any impact on it causes an increase in size. These can be infectious effects, blood flow disorders, exposure to toxins, tumors, injuries. In children under one year, the severity of other symptoms is insignificant, so it is not always possible to suspect hepatomegaly. Small child can not 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, 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 resulting in activation of alkaline phosphatase.

Fatty hepatosis

A disease that develops on the background of alcohol abuse or diabetes, obesity. Violation of lipid metabolism leads to a delay in the liver cells of fats, their accumulation in the form of drops gradually leads to a breakthrough of the membrane and the release of fatty contents. The work of the liver is disrupted, which manifests itself typical symptoms- fatigue, dyspepsia, stool disorders.

Heart failure

The appearance of disorders in the work of the heart leads to the development of heart failure, which means that the release of blood decreases and the blood flow drops. In the vessels of the liver, blood flow slows down, it stagnates in the veins. Plasma sweats into the liver tissue, edema develops and the organ increases in size.

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

Enlarged lymph nodes

Sometimes there is a primary increase not in the liver itself, but in the lymph nodes located at the gates of the liver. Initially, hepatomegaly becomes noticeable, but during the examination it turns out that the main reason is an increase in lymph nodes.

This may be accompanied by additional symptoms - sweating, weight loss, soreness in the corresponding area, 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 force load leads to the development of pain syndrome. The mechanism of pain is associated with a violation of the outflow of blood and with excessive stretching of the liver capsule, which causes pain. All athletes are affected by this condition.

Symptoms

A slight increase in the liver is not accompanied by overstretching of its capsule. So subjective feelings do not arise. Gradually, the process of resizing will manifest itself with other symptoms.

There is weakness, increased fatigue. 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. Digestion disorders indicate a serious pathology of the liver, this is manifested by bloating, flatulence, constipation and diarrhea. Symptoms of intoxication join - fever, malaise, headache.

In some cases, it appears pruritus, 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. Its cause may be in increased hemolysis of red blood cells, damage to the liver itself, and impaired bile outflow.

Effects

An increase in the liver associated with an inflammatory response to an infection disappears without a trace if there is no gross damage 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 give an idea of ​​the cause given state. To do this, you need to conduct an in-depth diagnosis.

At the first visit to the patient, an anamnesis is carefully collected, all complaints are clarified. Pay attention to the following issues:

• how long ago the malaise, pain appeared;
• whether there are dyspeptic disorders;
• the relationship of the onset of symptoms with food intake, the use of certain foods;
• what digestive disorders have appeared recently;
• worried about itchy skin;
• whether the color of feces, urine, skin changed;

Next, proceed to inspection. It is possible to determine violations of fat metabolism by the general physique. The veins of the anterior abdominal wall can bulge, forming a bizarre plexus - the "head of a jellyfish." This condition develops with portal hypertension. Also, this condition is characterized by the development of ascites and edema of the whole body.

Pay attention to hemorrhages in the skin. Their presence indicates violations in the coagulation system. Skin color is important for establishing a violation of bilirubin metabolism. The patient is asked to show the tongue - often it is lined with a yellow coating.

After examination, the doctor performs palpation. In the supine position, the liver is palpated through the anterior abdominal wall. Normally, its edge is hidden behind the costal arch. But with an increase, it will protrude from under them. Palpation determines the consistency, soreness, the edge of the liver, the presence of separate large formations.

Laboratory diagnostics

Examination of blood and urine helps to suggest the cause of hepatomegaly. In the general blood test, there 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 it 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. Perhaps the development of cytolysis syndrome - the destruction of hepatocytes under the influence of a damaging factor. It is characterized by an increase in ALT, AST, GGTP, LDH, bilirubin due to two fractions. Cholestasis in the analyzes is characterized by an increase in alkaline phosphatase, GGTP, 5-nucleotidase, and a decrease in the content of fat-soluble vitamins.

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

Ultrasound of the liver

This is a painless public method that allows you to determine the size of the liver, the state of its parenchyma, the presence of volumetric formations, and blood flow. A big plus is the absence of radiation exposure, so it can be used in young children and pregnant women.

To get the maximum 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 study, it is necessary to refuse food that promotes increased gas formation. These are legumes, bread and milk, sweets. If there is constipation, mild laxatives such as lactulose syrup are recommended.

Ultrasound is performed on an empty stomach, 8-10 hours after eating. But for emergency indications, you can conduct a study at any time.

During the study, the size of the liver, its deviation from the norm, is determined. Heterogeneity of the parenchyma, a decrease in echogenicity, depletion of the vascular pattern, together with an increase in the liver, indicate an inflammatory process. Nodes of regeneration, tuberosity, changes in the vascular pattern and signs of portal hypertension are signs of cirrhosis.

X-ray of the liver

Methods x-ray examination very varied. Plain radiography allows you to determine the size of the organ, its location relative to neighboring ones, the presence of various inclusions, cysts, calcifications.

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

Computed tomography is a series of layered x-rays. They clearly show the size of the organ, the change in its shape, the condition of the bile ducts, the presence of volumetric formations - cysts, abscesses, tumors.

Liver biopsy

Examination of liver tissues is necessary in the presence of a tumor (except for hemangioma), cirrhosis. This method allows you to determine the histological structure of the tissue, 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 the tactics of treatment or to monitor the effectiveness of the therapy.

Cyst biopsy is performed with therapeutic purpose- a drainage is established through which it is possible to administer the drug and wash the cyst cavity.

Treatment

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

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

Patients with severe toxic liver damage are treated in toxicology or intensive care units. Detoxification methods are used with the use of drop solutions, hepatoprotectors. Poisoning with some hepatropic poisons requires the introduction of an antidote.

Hepatomegaly caused by a violation of the outflow of bile is treated depending on the condition. Calculous cholecystitis, which has led to blockage of the duct by 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 the liver enlargement is a heart pathology, then the 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 a consultation with a vascular surgeon and further surgical elimination of heart pathology will be required.

Liver tumors and metastases are treated according to the degree of spread. Surgically, the affected lobe of the liver is removed in the presence of a limited formation, adjacent lymph nodes. Surgery is supported by chemotherapy and radiation treatment. Efficiency depends on the stage at which the tumor was detected, its sensitivity to drugs for treatment.

It is possible to use such a method as embolization of the vessels that feed the tumor. For this, endoscopic blockage of the vessel is performed, which has the main function of maintaining it. As a result, necrosis of the pathological tissue and healing develop.

Some severe toxic or diffuse liver lesions can only be cured by an organ transplant. The liver has good regenerative abilities and can recover from a small fragment. Part of an organ can be used for transplant 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 be radically cured only with a liver transplant. The remaining methods are aimed at maintaining the function of the organ. Different groups of heptoprotectors are used - essential phospholipids, ursodeoxycholic acid, plant extracts. They have the ability to restore cell membranes, have a protective effect, regulate metabolism in liver cells. For antioxidant protection and regulation of metabolic processes are prescribed vitamin complexes, amino acids.

The development of ascites is an unfavorable symptom, for the treatment of which diuretics are used. Be sure to follow the daily routine and special nutrition.

Diet

For patients with liver pathology, diet No. 5 according to Pevzner is prescribed. Its main principles are sparing food and fractional nutrition sufficient in terms of calories and nutrient content. Alcohol, fried foods, fatty foods are strictly prohibited. great content salt. Marinades and preserves of industrial and home production, sauces (mayonnaise, ketchup) contain a lot of sugar and salt, vinegar, which irritates the digestive system.

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

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

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What does an enlarged liver mean?

An enlarged liver is not a disease, but a symptom of a liver problem. 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. To detect an enlarged liver, a simple medical examination is sufficient.

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 examination of liver enzymes, the presence of viral infections and other disorders.

Biopsy. This study is prescribed for suspected cancer or fatty disease.

Causes of liver enlargement

Liver diseases:

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

  Cholestatic hepatosis (impaired flow of bile)

  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

  Cancer tumors

Exposure to toxins:

• Alcohol defeat

  drug lesion

Cholelithiasis

Defeat by helminths

An enlarged liver can be determined independently when the following symptoms appear:

Feeling of discomfort in the right hypochondrium, a feeling of heaviness

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

Change in the color of the skin - jaundice, characteristic of hepatomegaly.

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

Since the above signs may indicate other disorders in the body, for an accurate diagnosis, you need to contact a specialist. No need to delay the visit to the doctor - on time Taken measures help avoid serious consequences.

Enlarged liver in a child

At infants an enlarged liver may be associated with neonatal jaundice. She does not need treatment, as it passes within a month. The causes of this condition can be birth trauma, diabetes and other disorders in work. endocrine system at mother.

In a child under the age of 7 years, hepatomegaly is a completely normal physiological phenomenon. It is considered normal if the baby's liver slightly protrudes 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, an enlarged liver may indicate the following diseases:

Inflammatory processes in the body.

Congenital TORCH infections

Damage to the liver by toxins or drugs.

Pathology of metabolism

Disorders of the biliary tract, blockage of the bile ducts

Metastases or tumors

The reason for concern is the enlargement of the liver in children in combination with other "danger signals": fever, venous network on 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, gastroenterologist. To identify exact reason liver enlargement requires a number of tests and ultrasound.

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Diet with an enlarged liver

A properly organized diet will help the liver cope with hepatomegaly. Diet with an increase in the liver excludes spicy, salty, fatty foods. The diet must contain proteins, vitamins, minerals and fiber. Food should be ingested in small portions so as not to overload the diseased liver. Fractional meals (6-7 times a day) are recommended for better digestion. Read more about what you can eat and what you can not with liver diseases.

Sample menu for liver enlargement for a week

Monday.

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

2 reception - A glass of freshly squeezed apple juice, oatmeal cookies

3 reception - Boiled river fish

4 reception - Boiled carrots, grated

5 reception - Steamed vegetable dish (without salt and spices)

6 reception - Fresh fruit

Tuesday

1 meal - Omelette from one egg (without yolk), rosehip broth or green tea, diet biscuit cookies

2 reception - Dried fruits (dried apricots, prunes, raisins), previously filled with boiling water.

4 reception - Freshly squeezed carrot juice, oatmeal cookies

5 reception - Low-fat cottage cheese

6 reception - Salad of greens and cucumbers

Wednesday

1 reception - Low-fat kefir or cottage cheese

2 reception - Rosehip broth with honey, oatmeal cookies

3 reception - Steam meatballs

4 reception - Pumpkin puree, herbal tea

5 reception - Baked cheesecakes with the addition of dried fruits

Meal 6 - Freshly squeezed fruit juice, oatmeal cookies

Thursday

1 meal - Oatmeal with milk, green tea with honey and lemon

2 reception - Compote with dried fruits, diet biscuit cookies

3 reception - Steamed river fish, bran bread

Meal 4 - Fresh fruit juice, oatmeal cookies

5 reception - Vegetable casserole, bran bread

6 reception - Herbal tea

Friday

1 reception - Boiled pasta in a small amount

2 reception - A glass of freshly squeezed apple juice, biscuit cookies

3 reception - Dietary buckwheat soup, bran bread

4 reception - Dried fruits soaked in boiling water

5 reception - Milk porridge, diet biscuit cookies

6 reception - Green tea with honey, oatmeal cookies

Saturday

1 meal - Buckwheat porridge boiled in water without salt and sugar, herbal tea

2 reception - Fruit platter

3rd reception - Veal or chicken broth, bran bread

4 reception - Salad of sauerkraut

5 reception - Marshmallow or fruit marmalade

Sunday

1 meal - Cheesecakes with dried fruits cooked in the oven, green tea with honey and lemon

2 reception - Fruit or vegetable juice, biscuit biscuits

3 reception - Veal or turkey, boiled and mashed with the addition of boiled carrots or pumpkin

4 reception - Rosehip broth, bran bread

5 reception - Kefir or cottage cheese, oatmeal cookies

6 reception - Salad of fruits or vegetables

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

Palpation is one of the most informative diagnostic methods carried out by a doctor at the stage of initial examination sick. We will talk about him today.

Liver anatomy

Before proceeding to the study of the issue of palpation of the liver, it is necessary to 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 anteroposterior (upper) surface is adjacent to the surface of the diaphragm and protrudes in accordance with its curvature. 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 it can be attributed to the posterior surface of the organ.

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

The right lobe is divided by furrows into several secondary lobes. In one of these grooves are the gallbladder and separated by a piece of liver tissue, which is called the caudate process.

One of the important parts of the organ is the transverse deep groove, which is called the gates of the liver. Through this formation, large hepatic arteries, portal vein and nerves enter the organ, and the efferent hepatic duct leaves it (evacuation of bile to the gallbladder) and

In the right lobe, a square lobe, which is bounded by the gates of the liver, a round ligament and a fossa from the gallbladder, and a caudate lobe, located between the gates of the liver and the portal vein.

Liver functions

• Metabolic (control over the exchange of fluid, trace elements and vitamins, hormones, amino acids, lipids, proteins, carbohydrates).
• Depositing (BJU, vitamins, microelements, hormones accumulate in the body).
• 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 in a variety of non-infectious and infectious diseases. That is why, at the first treatment of the patient, it is necessary to palpate this organ.

Palpation and percussion of the liver

Before probing the liver, it is recommended to determine its boundaries with the help of percussion. This will allow not only to assume an increase in the organ, but also to understand where exactly the palpation should begin. During percussion, the liver tissue gives a dull (deaf) sound, but due to the fact that the lower part of 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.

Organ palpation (technique)

When probing the liver, certain rules must be observed:

• The position of the subject is lying on his back, while the head is slightly raised, and the legs are barely bent at the knees or straightened. Hands rest on the chest to limit its mobility during inhalation and relax the abdominal muscles.
• The doctor is located on the right, facing the patient.
• slightly bent right palm the doctor lays flat on the patient's stomach in the region of the right hypochondrium, three to five centimeters lower than the border of the liver, previously determined by percussion, is located. With his left hand, the doctor covers the chest (its lower part on the right), while four fingers must be placed behind, and one (thumb) finger should be placed on the costal arch. This technique will ensure the immobility of the chest during inspiration and increase the downward displacement of the diaphragm.

• When the patient exhales, the doctor effortlessly pulls down the skin and, dipping his fingers right hand into the abdominal cavity, asking the patient to take a deep breath. At this time, the edge (lower part) of the organ descends, penetrates into 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 shifted a few centimeters up. This manipulation is performed, moving higher and higher until the right hand stumbles on the costal arch, or until the hepatic edge is palpated.

Peculiarities

• The liver is palpated, usually along the rectus abdominis muscle (its outer edge) or the mid-clavicular right line. But if such a need arises, probing is performed along five lines (from the anterior axillary on the right to the parasternal left).
• In the case of accumulation of large volumes of fluid in the abdomen, palpation is difficult. Then they resort to balloting jerky probing of the organ. To do this, the second, third and fourth fingers of the right hand perform shock-shocks on the front wall of the abdomen, starting from the bottom and ending with the costal arch until a dense formation is found - the liver. During the push, the organ first goes deep, 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 mid-clavicular line on the right.
• In a healthy person, the edge of the organ is sharp or slightly rounded. It is soft, painless, easily tucked up when touched, smooth.

Evaluation of the data obtained (pathology)

• If the liver is enlarged, on palpation it will be located below the costal arch, which may also indicate its displacement. In confirmation of 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 borders of hepatic dullness are shifted down, this is a sign of organ prolapse.
• The displacement of only the lower border indicates an increase in the liver, which occurs when venous stasis, inflammation in biliary tract and liver, acute infections (malaria, cholera, typhoid fever, dysentery), cirrhosis (at the initial stage).
• If the lower limit shifts 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). This is more often observed due to the high position of the diaphragm during pregnancy, ascites, flatulence, due to the low location of the diaphragm in enteroptosis, pneumothorax, emphysema, and also 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 an upward displacement of the upper border of the organ.
• In some cases, not only palpation of the edge of the liver, but also of the whole organ is available. To do this, the fingers are placed directly under the right costal arch. The doctor, gently pressing, examining the liver with sliding movements, while evaluating its surface (hilly, smooth, even), consistency (dense, soft), the presence / absence of pain.

• A soft, even, smooth surface and a rounded, painful edge on palpation are signs of inflammatory processes in the organ or a manifestation of acute blood stasis due to heart failure.
• A bumpy, uneven, dense edge is observed with echinococcosis and syphilis. A very dense ("wooden") liver is determined when the organ is damaged by cancer cells.
• The dense edge of the liver indicates hepatitis, and in combination with tuberosity - cirrhosis.
• Pain during palpation of the liver may 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 liver of a newborn, as a rule, is carried out at the level of the mid-clavicular and anterior axillary lines by sliding palpation. At the same time, the hand of the examining pediatrician slides off the edge of the liver, which makes 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 hepatic margin 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 the age of seven, the edge of the liver, as a rule, protrudes from under the right costal arch and is accessible for palpation. For up to three years, the definition of the edge of the liver 2 or 3 centimeters below the right hypochondrium is considered the norm. After seven years, they correspond to those in adults.

Examination of the liver by 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, with the help of tapping (percussion), the upper limit is determined, and then the lower limit is determined by palpation (or percussion). Moreover, in accordance with the oblique course of the lower edge of its boundary, 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 nome, the dimensions should be 9, 8, 7 cm, respectively.