The main filter and bile-forming organ of the body needs careful handling. The liver daily cleanses the blood of metabolites of chemicals and toxins, participates in the formation of red blood cells, lipid and protein metabolism. The absorption of food and general physical condition depend on her health.
Symptoms of liver problems
The development of liver disease can be suspected by the appearance of the following symptoms³:
- unexplained weakness, fatigue, lethargy;
- feeling of heaviness, discomfort, pain in the right hypochondrium;
- skin itching;
- bitterness, unpleasant taste in the mouth, loss of appetite;
- yellowing of the skin, sclera, visible mucous membranes;
- discoloration of feces, darkening of urine, skin rashes;
- the appearance of vascular “stars” (telangiectasia) on the body - dilated superficial vessels in the form of a cobweb;
- nausea, vomiting with scarlet blood from varicose veins of the esophagus, bloating, increased abdominal volume with thin limbs - a sign of the appearance of free fluid in the abdominal cavity (ascites);
- sudden loss of body weight;
- persistent redness of the palms (palmar erythema);
- any type of stool disorder - diarrhea, constipation, their alternation;
- rapid appearance of bruises even from minor injuries.
Pain in the right hypochondrium may indicate liver problems. Photo: freepik.com
Choleretic medications
This group of medications makes it possible to increase the secretion of bile and the speed of its movement. In a short time, stagnant processes are reduced, which help normalize the digestive process. Choleretic drugs have a number of differences according to additional therapeutic effects:
- Essentiale Forte helps tidy up cell membranes.
- Urosan makes it possible to suppress the production of cholesterol.
- Hofitol helps reduce gas formation and eliminate the feeling of heaviness in the stomach.
- Allochol helps normalize the functioning of the stomach and intestines.
- Holosas has an anti-inflammatory effect, which is an undoubted advantage.
Quite often, Nicodin is prescribed to restore a damaged liver or pancreas. The medication has a choleretic, bactericidal and anti-inflammatory effect. Drugs in this category are prescribed for diseases of cholecystitis, gastroenteritis, biliary dyskinesia, liver diseases and reactive hepatitis. The main component of Nicodin is hydroxymethylnicotinamide.
While taking the medication, side effects may occur such as pain in the right hypochondrium, abdomen, allergic reaction, hives and cough. It is contraindicated to drink Nicodin for people suffering from cholestasis, hypersensitivity to the active substances of the drug, or antacid gastritis. It is also unacceptable to treat children under 10 years of age and women carrying a child.
Liobil is also considered a popular choleretic medication. With its help, you can increase the activity of organs, break down and absorb fats. Doctors prescribe Lyobil for the treatment of:
- hepatitis A;
- olecystitis;
- intestinal atony;
- insufficient secretory activity of the pancreas.
The drug is made on the basis of natural bovine bile. While taking the pills, stool disorders and heartburn may occur. It is unacceptable to use Lyobil for the treatment of pregnant women and people suffering from blockage of the bile ducts with stones and inflammation of the pancreas.
Types of liver diseases
The liver, biliary tract and gallbladder are a single complex that works together. It is called the hepatobiliary system. Damage to this system occurs in the following diseases:
- Functional: disorders of bilirubin metabolism (Gilbert's syndrome), cholestasis of pregnancy.
- Diffuse: hepatitis is an inflammation of liver cells (acute or chronic), which can sometimes transform into cirrhosis (irreversible replacement of normal tissue with scar tissue) in the absence of timely treatment.
- Infiltrative (with focal lesions): granulomatosis (tuberculosis, sarcoidosis), amyloidosis (protein metabolism disorder), excess fat accumulation (alcoholic liver disease, diabetes mellitus), blood diseases, glycogenosis.
- Volumetric neoplasms: cysts, abscesses, benign tumors, cancer (hepatocellular carcinoma), metastases.
- Hepatobiliary: inflammation of the bile ducts (cholangitis), their obstruction in cholelithiasis.
- Vascular: thrombosis of the hepatic veins, venous congestion in the liver with severe pathology of the heart and lungs.
Important!
Most chronic liver diseases remain silent for many years¹. The appearance of severe symptoms indicates serious damage to the organ, an advanced pathological process.
Fatty degeneration of liver cells occurs not only in those who abuse alcohol. In people who don't drink, this condition is called non-alcoholic fatty liver disease (NAFLD)⁵.
Figure 1. Changes in the liver with steatosis (fatty degeneration of liver cells). Image: scio21.ukr.net / Depositphotos
Treatment with folk remedies
In complex treatment of diseases, doctors recommend the use of recipes with natural ingredients. Folk remedies for the liver and pancreas are taken orally. Improve the patient's condition:
- powder from the film of chicken stomachs - on the tip of a teaspoon, washed down with water, taken before meals;
- fresh potato juice in a glass for two days;
- currant berries with honey – a spoon per day half an hour before meals;
- flax seed jelly - half a glass three times a day before meals.
Helps eliminate unpleasant symptoms of diseases:
- herbal decoction of milk thistle seeds - take one spoon every hour, starting from 8 a.m. to 8 p.m.;
- freshly prepared juice, which includes parts in parts - carrots - 7, parsley - 2, celery - 5;
- royal jelly - dissolve on a spoon three times a day;
- drink two crushed cloves of garlic in a glass of water in the morning.
Herbs
It is recommended to use medicinal plants to prepare medicinal mixtures. Herbs for the pancreas and liver are used in the form of decoctions. Add a spoonful of dry or fresh raw materials to a glass of boiling water and leave for 15 minutes. When treating the liver, plants differ in their effects:
- peppermint, tansy – choleretic;
- chamomile flowers - relieve spasms,
- St. John's wort – improves the flow of bile;
- corn silks – normalize metabolism, have a diuretic and choleretic effect;
- immortelle - relieves spasms of the bile ducts, washes away sand and small stones.
When treating pancreatitis, traditional healers recommend herbal decoctions that have a healing effect:
- calendula – disinfects, relieves inflammation, accelerates metabolic processes;
- milk thistle seeds – improve metabolism, remove toxins;
- tea from sea buckthorn leaves – reduces the inflammatory process;
- a mixture of valerian root, hawthorn, barberry, peppermint - restores organ functions.
Classification of drugs for liver restoration
Hepatoprotectors are drugs for liver restoration. They come in the following types⁴:
- containing components of plant origin (milk thistle, licorice, artichoke);
- animal origin;
- with essential phospholipids;
- with detoxifying properties;
- bile acid preparations;
- medications that contain other active ingredients of synthetic origin.
The majority of hepatoprotectors do not have an evidence base and are used only in the CIS. Foreign medicine does not recognize substances that in Russia are positioned as the best drugs for liver restoration.
Liver recovery depends primarily on the timely elimination of the damaging factor¹. Therefore, the use of hepatoprotectors in the treatment of liver diseases is auxiliary.
Preventing liver disease is the best thing you can do for it. You should quit smoking and alcohol, and engage in regular physical activity³. Also, do not forget about vaccination against hepatitis viruses (A, B), COVID-19 infection.
TOP drugs for liver restoration
The rating of drugs that are used in Russia to restore the liver includes the following drugs.
Karsil (Legalon, Forliver)
Milk thistle extracts, including silymarin. They slightly stimulate protein synthesis, stabilize the membranes of liver cells (hepatocytes), protecting them from damage. The instructions for use indicate that the drug has antioxidant properties, enhances tissue restoration, and inhibits the process of fibrosis (replacement of normal tissue with connective tissue - scar tissue)⁴.
However, the mechanism of action has not been fully studied, and the evidence base is questionable. In clinical practice, the effectiveness is comparable to the placebo effect.
Contraindications and special instructions. Tablets with milk thistle extracts are used as auxiliary medications for alcoholic and drug-induced hepatitis. They should not be used as primary treatment. Moderately increase the release of bile, which can be dangerous if there are stones in the gall bladder.
Hofitol
Artichoke leaf extract. Increases the antitoxic functions of the liver, stimulates the production of normal enzymes and tissue regeneration. Has a pronounced choleretic effect⁴.
Contraindications and special instructions. The mechanism of action is poorly understood, as is the composition of the tablets. Use is strictly prohibited for cholelithiasis, acute liver and kidney diseases. In high doses, it can cause diarrhea.
Heptral
Ademetionine. A molecule that consists of the amino acid methionine and ATP (a source of energy). Normally present in body tissues.
Ademetionine is an effective medicine for liver restoration that increases the concentration of glutathione (a natural antioxidant) in cells. When used as a course, it promotes a rapid decrease in biochemical parameters (AST, ALT) in the blood and has a slight calming effect. Often used for alcohol and toxic liver damage².
Contraindications and special instructions. Clinical effectiveness remains controversial, so research into the beneficial properties of ademetionine continues. This drug does not help in case of irreversible changes (fibrosis, cirrhosis).
Phosphogliv
Essential phospholipids. In theory, they restore cell membranes and have an antioxidant effect. But when taken orally, the bioavailability is low, that is, the drugs may not reach the liver at all.
Contraindications and special instructions. There is no normal evidence base². Prohibited during pregnancy and antiphospholipid syndrome.
Ursosan
Ursodeoxycholic acid. Improves the fluidity of bile, prevents the formation of stones in the gall bladder. Reduces the toxicity of bile acids to liver cells, takes part in immunological protection. One of the few hepatoprotectors with proven effectiveness⁵.
Figure 2. Liver diseases and their treatment. Image: pch.vector / freepik.com
With long-term use, it can dissolve small stones in the gall bladder. Indicated for reflux of bile from the duodenum into the stomach, treatment of primary biliary cirrhosis (compensated).
Contraindications and special instructions. An expected side effect from use in properly selected doses is loose stools. Prohibited for acute inflammatory diseases of the abdominal organs, calcified gallstones, decompensation of liver and kidney diseases.
Hepa-Merz
Ornithine aspartate. Binds excess ammonia, which is released in large quantities during severe liver damage (cirrhosis). Stimulates protein metabolism, production of insulin and growth hormone. Increases cell resistance to damaging factors².
Healthy liver - healthy brain
If ammonia levels get out of control, hepatic encephalopathy develops.
A person’s thinking abilities slow down, cognitive functions and attention suffer. In severe cases, coma develops. That is, for the brain to function properly, a healthy liver is needed. Contraindications and special instructions. Not suitable for the treatment of children, women during lactation and patients with severe renal failure.
Vitamins B and E
Universal protectors of cell membranes, have an antioxidant effect. It is recommended to take it not in the form of synthetic additives, but from food products - vegetable oils, fresh vegetables, fruits, nuts, seeds².
Contraindications and special instructions. Allergic reactions to synthetic vitamins are common.
Metadoxyl
Metadoxine. Enhances metabolism, removes alcohol from the body, reduces the toxic effects of ethanol⁴. Used in the complex treatment of alcoholic liver disease. Dosage form: tablets. The dose and frequency of administration are determined by the doctor.
Contraindications and special instructions. Cannot be used by pregnant and lactating women. Individual intolerance is possible.
The best way to restore the liver is a healthy lifestyle without the unreasonable use of medications and dietary supplements. Liver cells have enormous regenerative abilities; they most often do not need additional “help” in the form of drugs. Often, it is the refusal of excessive amounts of pharmaceuticals that improves the patient’s condition³.
Berlition
Alpha lipoic (thioctic) acid. A natural antioxidant that is often used for detoxification in cases of poisoning. Indicated for alcoholic and diabetic polyneuropathy.
Contraindications and special instructions. Enhances the effect of hypoglycemic drugs, helps reduce the concentration of glucose in the blood. Prohibited for women during pregnancy and lactation, and children.
Reamberin
Meglumine sodium succinate. Detoxification agent for intravenous drip administration.
Contraindications and special instructions. Prohibited during pregnancy, severe edema syndrome, chronic kidney damage.
In case of alcohol intoxication of the liver, the patient may be prescribed droppers. Photo: tumsubin / freepik.com
succinic acid
Included in many combined hepatoprotectors (Cytoflavin, Remaxol). Increases the energy supply of liver cells and their resistance to damaging factors.
Contraindications and special instructions. Allergic reactions are possible.
Obeliva
Obeticholic acid. Used together with ursodeoxycholic acid for the treatment of non-alcoholic fatty liver disease, primary biliary cholangitis, and diabetes mellitus. FDA approved⁵.
Contraindications and special instructions. Prohibited in cases of complete biliary obstruction.
Acetylcysteine
N-acetyl L-cysteine (NAC). Antidote for paracetamol poisoning with proven effectiveness. It can be prescribed together with glucocorticosteroids for other drug-induced hepatitis.
Contraindications and special instructions. Do not use during bleeding from stomach and duodenal ulcers, lungs, or in children under 2 years of age.
Prednisolone (and/or other glucocorticosteroids)
It is used for autoimmune and alcoholic hepatitis, drug-induced liver damage, and eosinophilia. It is often prescribed in combination with cytostatics (azathioprine).
Contraindications and special instructions. It has an extensive list of contraindications - from peptic ulcers to severe diabetes. Treatment is carried out under the supervision of a doctor until stable remission is achieved, which is also often supported by hormones.
Rosuvastatin (and/or other statins).
It is used more in cardiology as a vital drug for the prevention of cardiovascular accidents. On the one hand, many of the statins have a toxic effect on the liver, which often becomes the reason for replacing pills. At the same time, their ability to reduce the amount of “bad” cholesterol (LDL, VLDL) in the blood is beneficial in the treatment of non-alcoholic fatty liver disease. If the treatment regimen for NAFLD is chosen correctly, statins acquire hepatoprotective properties⁵.
Contraindications and special instructions. Not suitable for patients with lactose intolerance, children under 18 years of age, pregnant and lactating women, as well as for severely impaired liver and kidney function.
The ability to rapidly repair itself makes the liver suitable for extensive transplantation. She will be able to completely regenerate even if only 25% of her original mass remains³.
Treatment
It is unacceptable to self-medicate these important organs. After contacting the doctor, the patient is sent for examinations to accurately diagnose the disease and exclude benign or malignant tumors. Complex treatment of the liver and pancreas includes general measures:
- refusal to drink alcoholic beverages;
- smoking cessation;
- strict adherence to the diet;
- exclusion of fatty, spicy, fried, smoked and sweet foods;
- normalization of drinking regime;
- fractional meals.
If an attack occurs, the patient is sent to hospital treatment. Pancreatitis, a disease of the pancreas, requires giving the organ a rest from stress on the first day and stopping the excessive production of enzymes. In this case, fasting, rest, and cold on the abdominal area are recommended. With an accurate diagnosis, doctors prescribe medications for the liver and pancreas:
- hepatoprotectors;
- anti-inflammatory drugs;
- antispasmodics;
- choleretic agents.
In case of severe inflammation and the risk of complications, the treatment regimen includes the use of hormonal drugs. In addition, they use:
- herbal remedies that inhibit cell destruction;
- vitamin complexes - to strengthen defenses;
- enzymes that activate the functioning of the glands;
- cleansing preparations - intravenous infusions of glucose, saline solutions to remove toxins and waste from organ tissues;
- restorative agents that promote cell renewal during remission.
Sources
- Diseases of the liver and gall bladder / Educational method. manual / T. A. Bich, A. S. Portyanko. Minsk: BSMU, 2013. – 40 p.
- Register of Medicines of Russia RLS Doctor: Gastroenterology and Hepatology. — 16th issue/Ed. G.L. Vyshkovsky.— M.: LIBROPHARM, 2012.— 512 p. ISSN 1680.3124.
- Fundamentals of clinical hepatology. Diseases of the liver and biliary system - Radchenko V.G., Shabrov A.V., Zinovieva E.N. 2005 year. 864 pp.
- Belovol A. N. Clinical pharmacology of hepatoprotectors / A. N. Belovol, I. I. Knyazkova //. – 2022. – No. 5/6. – pp. 18–25.
- EASL–EASD–EASO. Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. 2015. European Association for the Study of the Liver. Published by Elsevier BV
