Drug hepatitis develops chronic administration of drugs that have toxic effects on the liver (hepatotoxic drugs) or when administered in large doses. More and more often the cause of drug-induced hepatitis in women is a long-term use of hormonal contraceptives.

Drug-induced hepatitis - Causes of

Drug hepatitis develops chronic administration of drugs which have hepatotoxic effects, that is toxic to liver cells (hepatocytes). This is because the drugs are degraded in the liver and excreted from the body and then through the intestine in the bile and urine through the kidneys. The toxic effects of drugs is increased if the patient already has some kind of liver disease, kidney or systemic failure of the connective tissue (eg, rheumatoid arthritis), as well as in elderly patients and pregnant women.

Some drugs (eg, acetaminophen) have a direct toxic effect on the liver cells in excess of recommended dosages, while others have an impact after decomposition in the liver by toxic metabolic products (metabolites) - because there are, for example, tetracyclines.

Sometimes toxic damage of liver cells develops at individual intolerance of some medications. Such reactions to medications occur irrespective of the dose, usually a few days (sometimes three months) from the start of the reception, and if the drug has not been abolished, can lead to death of the patient.

The most well-known drugs with hepatotoxic include paracetamol, some anti-TB drugs (isoniazid, rifampicin, pyrazinamide, and others.), Anticonvulsants (phenytoin, carbamazepine), sulfonamide drugs, which include estrogen, including hormonal contraceptives antifungal agents (e.g., keto kenozol), tetracycline antibiotics, nonsteroidal anti-inflammatories (especially diclofenac Diclofenac - relieve inflammation and pain , Ibuprofen, indomethacin). There are many other gepatotokicheskih drugs whose action is enhanced by increasing the dose and duration of administration.

The symptoms of drug-induced hepatitis

Symptoms of hepatitis drug depend on the drug that caused it, and the original state of the patient, so they can be very different. There ka lightweight and virtually asymptomatic drug liver damage and severe lightning with necrosis of the liver cells and the formation of acute liver failure. Liver damage ascertain when elevated blood liver enzyme ALT to more than three times, total bilirubin - twice.

Medications for hepatitis type hypersensitivity reactions usually develops after a few weeks of treatment, especially in the re-appointment of drugs such as NSAIDs, sulfonamides, quinine drugs, anticonvulsants.

In less severe drug-induced hepatitis only sign of liver damage can be changes in laboratory parameters. Such hepatitis Hepatitis - the scourge of our time   after the abolition of the drug, calling it can pass on their own.

Lightning fast (fulminant) for drug-induced hepatitis is characterized by acute onset, rapid rise in temperature, pain in the right hypochondrium, nausea, vomiting, headaches and rapid transition into the hepatic coma. If such a patient is not provided with adequate medical care, he will die.

Treatment of drug-induced hepatitis

Treatment begins with the abolition of the drug that caused liver toxicity, as well as any other medication or food, which could have a toxic effect on the liver cells. It should also eliminate the heavy physical load and stress.

Diet is of great importance in the drug-induced hepatitis. Appointed table number 5 - nutrition with the exception of fatty foods of animal origin. All dishes should be boiled or steamed.

In severe hepatitis carried detoxification therapy - medicinal solution is injected intravenously with the purpose of washing the body of toxic substances. At the same time appointed adsorbents (smectite, activated charcoal Activated carbon - old but indispensable , Polysorb, etc.) to remove the drug from the intestine.

When toxic hepatitis Toxic hepatitis - the impact of harmful substances on the liver Caused by paracetamol, designate specific antidote - acetylcysteine ​​- it binds toxic metabolites of paracetamol. Toxic liver disease associated with allergic reactions require the appointment of glucocorticoid hormones.

Despite the fact that the incidence of hepatitis B drugs is growing, promptly appointed an adequate treatment could prevent the development of severe liver damage.

Galina Romanenko

Heartburn is described as a burning sensation rising from the stomach or lower part of the sternum to the neck and is often combined with a sour taste in the mouth. This is a very common condition that affects every fifteenth person in the world. Thus, it is estimated that the symptoms of heartburn occur in fifty million Europeans, although in different countries statistics differ significantly. Thus, heartburn is a problem for the health of any country.

Etiology and pathogenesis

Almost all people experience occasional heartburn, and it is not a cause for concern, but when heartburn occurs two or more times a week, it is considered a sign of gastroezofagoreflyuksnoy disease (GERD), and requires action.

Gastroezofagoreflyuksnaya disease caused by throwing of gastric hydrochloric acid and pepsin in the esophagus. In the lumen of the esophagus Wednesday alkaline. Pepsin and hydrochloric acid, are active in an acidic environment, thus, regular throwing acid in an alkaline environment - reduces the acidity level of the esophagus, and therefore hydrochloric acid and pepsin begin their aggressive effect on the esophageal mucosa.

The incidence of heartburn is directly related to the severity of the disease gastroezofagoreflyuksnoy proportionally reducing the quality of life of the patient. In studies conducted on this subject have shown that the quality of life of these patients is lower than that of patients suffering from a stomach ulcer or, for example, hypertension Hypertensive heart disease - the prognosis is poor .

Aggravating factors for heartburn are:

• eating fatty and fried foods
• have a snack
• excess weight
• sporting postprandial
• pregnancy.

Heartburn is also a symptom of gastric ulcer and duodenal ulcers, hiatal hernia, diseases of operated stomach.

Classification and Diagnosis

Endoscopy allows divided patients with heartburn, into two groups. The first includes patients who experience heartburn, but they have the most careful study, found no change in the esophagus. Heartburn in this case is considered to be functional.

The second group includes patients whose endoscopy revealed diseased esophageal wall. In this case, as one of heartburn symptoms requiring accurate diagnosis and appropriate treatment.

Diagnosis is based on the complaints of heartburn patient details collected history, taking into account the frequency, time of its occurrence and intensity. Confirms the diagnosis by endoscopy, biopsy is sometimes required for differential diagnosis. It is used as a method of daily measurement of acidity, some other methods.

Treatment and prevention

Heartburn is extremely unpleasant, and therefore requires urgent action. My favorite way to people - a solution of soda - is not recommended by doctors as cider soda causes an acid rebound, that is, after a short feeling better heartburn comes back with greater intensity.

For relief of heartburn Heartburn - no cause for concern?   better to take the advice of medical or drugs such as Maalox, Fosfalyugel. Buying medicine at the pharmacy, study its composition, because some drugs are based on soda and enjoy all of its shortcomings.

Treatment of heartburn are best left to the doctor, but first it is possible to compete with its own symptoms. Within two weeks, you need to keep a diary, which highlights all the moments of the day - time and composition of food, physical activity, the occurrence of heartburn. During this time, you can identify the factors that provoke heartburn and try to avoid them.

Avoid overeating, eating fatty and fried foods, spirits, smoking, both active and passive. Well helps compliance with the daily routine, slow eating, sleeping Dreams: how to understand our dreams   at high cushion.

In the absence of positive dynamics is not necessary to put off a visit to the doctor.

Svetlana Shimkovich