Cirrosi alcolica
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Che cos'è la cirrosi alcolica
La cirrosi alcolica è un processo infiammatorio progressivo ai danni del fegato legato al consumo eccessivo di alcolici. Non tutti coloro che abusano di bevande alcoliche sono destinati a sviluppare una cirrosi alcolica. Anzi, di solito la cirrosi alcolica si manifesta nel 10-15% dei soggetti, facendo pensare che possano essere importanti anche altri fattori. Tutti i forti bevitori tendono a manifestare in un primo tempo unasteatosi (fegato grasso) che tuttavia rappresenta una situazione assolutamente reversibile alla sospensione del consumo di alcolici e non viene quindi considerata come una condizione destinata a evolvere in cirrosi. Molto importante per la comparsa dellacirrosi alcolica sembra essere invece l'epatitealcolica, (infiammazione del fegato), che può contribuire alla progressione della fibrosi , che porta alla cirrosi. Se il soggetto interessato continua a bere alcolici si verifica un' evoluzione del processo, con la morte di nuove cellule e la produzione di altro tessuto fibroso,che forma una ragnatela, delimitando le cellule epatiche e producendo noduli. Nonostante le cellule del fegato tendano a riprodursi, il numero di quelle che muoiono supera quello delle cellule rigenerate e a lungo andare si verifica una diminuzione del tessuto epatico. I sintomi dell' epatite alcolica possono essere simili a quello di un' epatite virale:
nauseavomitomancanza d'appetitodiminuzione di pesodolori addominali.
Talvolta può essere presente febbre e nei casi più gravi possono manifestarsi i sintomi di una severainsufficienza epatica con encefalopatia,sanguinamento e ascite. La guarigione generalmente è abbastanza lenta, potendo impiegare anche se mesi dopo la completa sospensione delle bevande alcoliche.
Sintomi
La cirrosi alcolica può essere inizialmente senza sintomi, può iniziare a manifestarsi in maniera subdola, generalmente anche dopo una decina di anni di abuso di alcolici. All'inizio può verificarsi un:
calo di pesoriduzione della muscolaturaa sensazione di stanchezzaformazione di lividi
Segni di malridotto funzionamento del fegato e dell' aumento della pressione nel circolo portale si manifestano di solito con:
itteroasciterischio di emorragie dalle varici esofageesintomi di encefalopatia.
Si osserva un:
aumento delle dimensioni della milzaun arrossamento del palmo delle manila formazione di reticoli di vasi superficiali.
Possono essere anche presenti:
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deformazione delle dita che si allargano assumendo un aspetto che ricorda quello delle bacchette di tamburotumefazione di alcune ghiandole salivari e lacrimaliedema periferico(vale a dire una raccolta di liquidi nei tessuti).
Negli uomini si verificano:
perdita di peliaumento delle dimensioni delle mammelleatrofia dei testicoli.
Nelle donne possono essere talvolta presenti:
irregolarità nelle mestruazionisegni di virilizzazione.
Nell'arco di pochi anni (di solito tra 3-5 anni) si assiste ad un progressivo peggioramento delle condizioni, con aggravamento dell'ascite e degli altri sintomi di ipertensione portale. Un' eventuale emorragia delle varici esofagee può portare al coma epatico spesso mortale.
Terapia
Fondamentale nella terapia delle cirrosi alcolica è l'astensione dall'alcol. E' poi importante che l'ammalato segua una dieta ricca di calorie, di zuccheri e in assenza di encefalopatia anche di proteine. Deve essere prestata molta attenzione ai farmaci, soprattutto a quelli che vengono trasformati o eliminati attraverso il fegato. Altre cure saranno indirizzate ai sintomi specifici. In presenza di una raccolta di liquido nell'addome sarà necessario ridurre l'apporto di sale e assumere diuretici; se sono presenti varici esofagee si possono somministrare farmaci che riducono la pressione nel circolo della vena porta.
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Farmaci per la cura della cirrosi-My Personal Trainer
Le informazioni contenute in questo sito non devono in alcun modo sostituire il rapporto medico-paziente; si raccomanda di chiedere il parere del proprio dottore prima di mettere in pratica qualsiasi consiglio o indicazione riportata.
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