Most of bilirubin in the body comes from hemoglobin released by aging red blood cells, including indirect bilirubin and direct bilirubin. Indirect bilirubin is transported to the liver through blood, and direct bilirubin is produced through the action of liver cells. Elevated bilirubin is seen in:
(1) Liver diseases: acute icteric hepatitis, acute yellow liver necrosis, chronic active hepatitis, liver cirrhosis, etc.
(2) Extrahepatic diseases: hemolytic jaundice, transfusion reaction due to blood group incompatibility, cholecystitis, gallstones, etc.
According to the test results you provided, the total bilirubin and direct bilirubin are on the high side. There is something wrong with the gallbladder, but it is not seriously high, and the normalization of other indicators is not a big problem. You can refer to TCM conditioning treatment. The gallbladder wall is rough but has no obvious thickening, indicating mild gallbladder inflammation, but it is not very serious. The landlord can rest assured, pay more attention to diet, eat less spicy and greasy, and eat more light. In terms of traditional Chinese medicine, he can take some drugs to soothe the liver and benefit the gallbladder, such as Jigucao capsules or Shugan Lidan tablets!
Supplement: "B-ultrasound found that gallbladder mucosa is slightly rough, whether it is a disease. It depends on whether you have discomfort or dull pain in the gallbladder area of the right upper abdomen, which affects your diet. If there is no such discomfort, that is, the gallbladder mucosa is rough, it can only be used as a reference for regular follow-up observation. Treat inaction as a disease. If the clinical symptoms are aggravated, then gallbladder mucosa roughness can be called a disease. You have to go to the hospital for further examination.
What is the reason of high total bilirubin?
The life span of human red blood cells is generally 120 days. Red blood cells become indirect bilirubin (I-Bil) after death, which is converted into direct bilirubin (D-Bil) through the liver, forming bile, which is discharged into the biliary tract and finally discharged through feces. The sum of indirect bilirubin and direct bilirubin is total bilirubin (T-Bil). Obstacles in any of the above links will cause jaundice. If too many red blood cells are destroyed, too much indirect bilirubin is produced, and the liver can not be completely converted into direct bilirubin, which can lead to hemolytic jaundice; Hepatocellular jaundice occurs when liver cells are diseased, or because bilirubin cannot be converted into bile normally, or because liver cells are swollen, bile ducts in the liver are compressed, bile excretion is blocked, and bilirubin in the blood is increased. Once tumors or stones occur in the extrahepatic biliary system, the biliary tract will be blocked, bile can not be excreted smoothly, and obstructive jaundice will occur. Jaundice in patients with hepatitis is generally hepatocellular jaundice, that is, both direct bilirubin and indirect bilirubin are increased, while in patients with cholestatic hepatitis, the direct bilirubin is mainly increased.
The normal value of total bilirubin is1.71-17.1μ mol/l (1-10mg/l), and the normal value of direct bilirubin is1.7/kloc.
Why does jaundice occur when hepatitis occurs?
Hepatocytes play an important role in the metabolism of bilirubin (bile component). First of all, when the indirect bilirubin formed by the decomposition of aging red blood cells is transported to the surface of liver cells with blood circulation, it is absorbed by the microvilli of liver cell membrane, enters liver cells, is fixedly combined with Y and Z proteins, and then is sent to smooth endoplasmic reticulum, and is combined with glucuronic acid under the catalysis of glucuronosyltransferase to form direct bilirubin (pigment I and II mixture). Bilirubin is directly excreted into the capillary bile duct with the participation of endoplasmic reticulum, Golgi apparatus and lysosomes. It can be seen that hepatocytes have the functions of bilirubin uptake, binding and excretion.
When suffering from hepatitis, liver cells become the target of various viruses and the base of replication and reproduction. With the participation of immunity, the function of a large number of cells in the liver decreases, resulting in some direct and indirect bilirubin returning to the blood. The increased bilirubin (34.2umol/L) in the blood dyed the sclera and the whole body skin yellow, forming jaundice.
Is jaundice hepatitis?
Jaundice is not necessarily hepatitis. Because:
(1) Some reasons (congenital metabolic enzymes and genetic defects of red blood cells) and physical, chemical, biological and immune factors lead to excessive destruction of red blood cells, anemia and hemolysis, resulting in excessive indirect bilirubin in the blood and prehepatic jaundice.
(2) Bile duct obstruction, bile can not be discharged into the small intestine due to stones, liver, gallbladder, pancreatic tumors and inflammation, which can cause jaundice after hepatitis.
(3) Newborns may have physiological jaundice because a large number of red blood cells are destroyed, the development of liver enzyme system is not fully mature, and the ability of liver cells to absorb bilirubin is insufficient. There are also jaundice caused by congenital non-hemolytic Gilbert disease and jaundice caused by neomycin, both of which are caused by bilirubin binding disorder of hepatocytes. Other infectious diseases, such as septicemia, pneumonia and typhoid fever, can also cause jaundice in a few cases. When heart failure occurs in patients with severe heart disease, the liver is congested and swollen for a long time, and jaundice may occur. Liver cell damage caused by various reasons can cause hepatic jaundice.
In this way, as long as the concentration of indirect bilirubin or direct bilirubin in the blood increases, jaundice can occur, and hepatitis is only one of the reasons for hepatic jaundice. If there is jaundice, we should make a comprehensive judgment according to the specific situation, combined with the physical and chemical examination results such as physical signs, laboratory examination, liver biopsy, B-ultrasound, CT and so on, and find out the cause of jaundice. Never arbitrarily diagnose hepatitis at the sight of jaundice.
Isn't it hepatitis without jaundice?
Because from the etiology, epidemiology, pathology and clinical observation of hepatitis, yellow or not is just the difference of symptoms, and its essence is hepatitis.
Whether hepatitis is contagious is not determined by jaundice, but by viremia, whether the virus is replicating, and whether the replication index in blood and liver is obvious. Take hepatitis B virus as an example. As long as the replication indexes of hepatitis B virus, such as E antigen (HBeAg), deoxyribonucleic acid polymerase (DNAP) and hepatitis B virus deoxyribonucleic acid (HBVDNA), persist, the infectivity to susceptible population is exactly the same regardless of jaundice. Experiments have proved that the serum with double positive HBsAg E antigen is still contagious when diluted to one ten thousandth. This shows that as long as E antigen is positive, whether it is yellow or not, it is contagious.
From the clinical manifestations, non-icteric hepatitis is basically similar to icteric hepatitis. Only there is no latent attack of icteric hepatitis, and the symptoms are mild and slow. This is because the patient's immune response is relatively light, and the degree and breadth of liver cell damage is lighter than that of icteric hepatitis.
Why do some patients with jaundice have yellow urine and white stools?
The bilirubin in normal people's blood is very little and basically free bilirubin, and there is almost no bound bilirubin. Because the conjugated bilirubin produced in the liver is directly discharged into the intestinal cavity from the biliary tract and will not return to the blood. There are a few urine urobilinogen and urine urobilinogen in normal people's urine, which are part of the systemic circulation after fecal urine urobilinogen and urinary urine urobilinogen from the intestine are reabsorbed into the blood and excreted from the urine through the kidney. There is no free bilirubin in urine, because free bilirubin can not be excreted from urine through glomerular filtration, and there is no bound bilirubin, because there is no bound bilirubin in normal blood, so there is no such substance in urine. When suffering from obstructive jaundice and hepatocellular jaundice, the bound bilirubin in the blood increases and is excreted from the urine through the kidney, making the urine dark brown.
There are fecal urobilinogen and fecal bile in the feces of normal people. Because bilirubin discharged into the intestine is reduced and oxidized into fecal urobilinogen and fecal bile, most of it is discharged from the feces to make the feces yellow. When bile cannot be discharged into the intestine for some reasons, such as biliary obstruction, liver cell pathological changes, etc., there is no bilirubin in the intestine that can be converted into fecal urine urobilinogen and fecal bile, and then the stool becomes gray.
What diseases can jaundice be seen in?
Jaundice refers to the yellow staining of skin and mucosa caused by bilirubin deposition. When jaundice occurs, the serum bilirubin content is often above 34.2μmol/L(2mg).
Jaundice should first be distinguished from yellow skin staining caused by taking large doses of Hexapine and Carotene. The latter two kinds of yellow staining are mostly simple skin yellowing without scleral yellow staining, and serum bilirubin does not increase. In addition, jaundice in the elderly should be differentiated from subconjunctival fat accumulation. The latter is more obvious in the inner canthus, and there are many uneven patches in the conjunctiva.
Jaundice is a common symptom in the following diseases.
(1) Infectious diseases: common viral hepatitis, necrotizing cirrhosis, typhoid fever, septicemia (complicated with bacterial liver abscess), leptospirosis, liver tuberculosis, etc. Among them, viral hepatitis and necrotizing cirrhosis are the most common.
(2) Hepatobiliary and pancreatic diseases: such as liver or bile duct tumors, gallbladder and bile duct inflammation or stones, pancreatic head cancer, etc. Jaundice occurs because the bile duct is compressed or blocked, which affects the excretion of bile into the intestine. If the bile duct is completely blocked, the stool can turn gray.
(3) Toxic hepatitis: The liver can handle poisons, toxins and drugs from the gastrointestinal tract, convert them into nontoxic substances and excrete them. In the process of dealing with poisons or toxins, it will cause liver damage and toxic hepatitis. Common poisons and drugs that cause liver injury are phosphorus, arsenic, carbon tetrachloride, chlorobenzene (BHC), ether, chloroform, barbiturates, chlorpromazine and so on.
(4) Severe heart disease and chronic heart failure: due to systemic blood circulation disorder, liver congestion and swelling or cirrhosis have occurred, especially when pulmonary embolism occurs, jaundice is easy to occur.
(5) Hemolytic jaundice: When hemolysis occurs due to some reasons, such as improper blood transfusion and paroxysmal nocturnal hemoglobinuria, jaundice occurs due to excessive destruction of red blood cells.
(6) Congenital metabolic defects of bilirubin: chronic idiopathic jaundice and intermittent jaundice in childhood.
Among the above diseases, the first two are the most common in clinic.
What are yin yellow and yang yellow, and what is the relationship with bile pigment metabolism?
Traditional Chinese medicine has a preliminary understanding of jaundice in Neijing. Su Wenping's Theory of Human Meteorology pointed out: "Those who have yellow eyes are called jaundice." The classification of jaundice in synopsis of golden chamber can be divided into five categories: jaundice, valley jaundice, alcoholic jaundice, female jaundice and black jaundice. After that, there are 28 phases, nine yellows and thirty-six yellows. It shows that the observation and description of jaundice by predecessors through practice is very detailed. According to the nature of this disease, health treasures in Yuan Dynasty can be divided into two categories, namely "Huang Yang" and "Yin Huang". This syndrome differentiation has important guiding significance for the differential diagnosis and treatment of jaundice.
The content of bilirubin (mainly indirect bilirubin) in normal plasma is very small, about 1.0mg% (jaundice index is below 6 units). If it exceeds 2.0mg% (the jaundice index is above 15 unit), the sclera, mucosa and skin will turn yellow, which is called jaundice. According to the quality of bilirubin increase in blood (mainly indirect bilirubin or direct bilirubin), jaundice can be divided into hemolytic jaundice, hepatocellular jaundice and obstructive jaundice from the pathogenesis. It is helpful to distinguish these three kinds of jaundice clinically.
Judging from the pathogenesis, color, course and treatment of jaundice in TCM, "Huang Yang" seems to belong to jaundice with indirect bilirubin increase (including hemolytic jaundice and hepatocellular jaundice), while "Yin Huang" belongs to jaundice with direct bilirubin increase (such as obstructive jaundice).
Traditional Chinese medicine believes that jaundice is related to dampness. "synopsis of the golden chamber" says: "Huang Jia gets wet." According to the source of dampness, it can be divided into "dryness-heat dampness" and "coldness-dampness dampness dampness". The former hair is "yang yellow" and the latter hair is "yin yellow".
"Yang Huang" is transformed from heat, which is related to the spleen and stomach, liver and gallbladder. If the function is abnormal, it will lead to internal dampness. Heat is yang qi and pathogenic excess, which occurs rapidly due to the struggle between good and evil, and seems to belong to the acute phase of viral hepatitis. Due to the inflammation of liver cells, indirect bilirubin in blood can not be absorbed and processed to become direct bilirubin. In addition, lysosomes in liver cells release β-glucuronidase, so that the bound bilirubin is partially decomposed into indirect bilirubin and returned to the blood, which increases the indirect bilirubin in the blood. If it exceeds 2.0mg%, the sclera and skin will turn yellow. Because indirect bilirubin is difficult to pass through the capillary wall, at this time, the skin color is bright yellow, such as orange yellow, and it seems to belong to the category of "yang yellow" mentioned by Chinese medicine. The principle of treatment is to clear away heat and toxic materials and promote diuresis. Such as the commonly used Yinchenhao decoction (Chen Yin, Gardenia, rhubarb), in which Chen Yin contains folic acid, which is good for the liver. Chen Yin mainly increases bile secretion and has the effect of yellowing; Gardenia is beneficial to gallbladder function and can reduce bilirubin in blood; Rhubarb can promote intestinal peristalsis, which is not conducive to the reabsorption of urobilinogen in feces (urine) and reduce intestinal and liver circulation.
"Yin Huang" refers to the change from wet to cold. The so-called "cold" refers to the excessive decline of the body's functional metabolic activities, which makes the dampness abundant in yang, the cold and dampness stagnate in the spleen and stomach, the yang is weak, and bile overflows without following the normal way. The onset is slow and the course of disease is long, which seems to be obstructive jaundice. Because the direct bilirubin after liver treatment cannot be discharged into the intestinal cavity through the biliary tract and flows back to the blood, the direct bilirubin in the blood is mainly increased at this time. Direct bilirubin easily penetrates the capillary wall, and the initial tissue is dark yellow, which is "positive yellow". With the prolongation of the course of disease, the direct bilirubin in the blood continues to rise, jaundice deepens progressively, bilirubin in tissues can be oxidized into biliverdin, and the skin color is dull, which belongs to what Chinese medicine calls "yin-yellow". The principle of treatment is to strengthen the spleen and stomach, warm, cold and damp; Deficiency of spleen and blood can strengthen spleen and tonify qi and blood.
It can be seen that the classification of "yin-yellow" and "yang-yellow" in traditional Chinese medicine is very detailed in pathogenesis, clinical manifestations and treatment. Here, whether jaundice is mainly caused by indirect bilirubin increase or direct bilirubin increase, and the causes of jaundice are all related to "yin yellow" and "yang yellow", which is helpful for further research. However, it must be pointed out that "yin-yellow" and "yang-yellow" are manifestations of different stages of lesion development and can be transformed into each other.
How about jaundice? Under what circumstances will jaundice occur?
Clinically, the yellow staining of skin, sclera and urine is called "jaundice", which is caused by the increase of bilirubin (including indirect bilirubin and direct bilirubin) in blood. Because bilirubin is yellow, jaundice will appear. So, under what circumstances will bilirubin in the blood increase? First of all, let's review the normal metabolism of bilirubin in human body: the average life span of red blood cells in human blood is 120 days. After their aging and death, their hemoglobin will become indirect bilirubin; Indirect bilirubin is absorbed by the liver and processed into direct bilirubin; As an important part of bile, direct bilirubin is discharged from the liver to the gallbladder through the bile duct, and then discharged from the gallbladder to the small intestine when eating, which helps the digestion and absorption of food; After entering the large intestine, urine urobilinogen and urobilin are formed and excreted. Urobilin is yellow, so the stool is yellow. Part of urine urobilinogen in the large intestine can be absorbed into the blood (called enterohepatic circulation) and excreted from the urine. Therefore, under normal circumstances, urine also contains urinary urobilinogen and urobilin. Therefore, if the red blood cells are destroyed too much, the indirect bilirubin in the blood will increase, thus causing "hemolytic jaundice". (2) If the liver is sick, indirect bilirubin can't be ingested and processed, and indirect bilirubin will also increase; Moreover, when the liver is sick, the direct bilirubin formed in the liver can not be discharged into the biliary tract, but will return to the blood, which will increase the direct bilirubin in the blood and cause "hepatocellular jaundice". ③ If the biliary tract is obstructed, the direct bilirubin cannot be discharged into the intestine, and the direct bilirubin in the blood will also increase, causing "obstructive jaundice".
In clinical practice, patients with jaundice should first know whether they have jaundice, then judge the degree of jaundice and further clarify the nature of jaundice. The most reliable method is to detect the content of bilirubin in serum. When the bilirubin content exceeds the normal value, it means that jaundice exists. The higher the bilirubin content in the blood, the heavier the jaundice.
What are the types of jaundice and what are its characteristics?
According to the pathogenesis, jaundice can be divided into the following three types.
(1) Hemolytic jaundice: Jaundice occurs due to the massive destruction of red blood cells in a short time, and the bilirubin released greatly exceeds the processing capacity of liver cells. The increase of serum bilirubin is mainly indirect bilirubin. Such as neonatal jaundice, falciparum malaria or jaundice caused by improper blood transfusion, all belong to this category. The latter may have chills, fever, headache, muscle pain, nausea and vomiting. The urine is soy sauce color with hemoglobinuria, but there is no bilirubin in the urine.
(2) Hepatocellular jaundice: Due to the extensive damage of hepatocytes, the ability to handle bilirubin decreased, resulting in the accumulation of indirect bilirubin in the blood; At the same time, due to the obstruction of bile excretion, the direct bilirubin in the blood stream also increases. Because of the increase of indirect and direct bilirubin in blood, urinary bilirubin and urinary urobilinogen also increase. Jaundice caused by hepatitis and liver cirrhosis belongs to this category.
(3) Obstructive jaundice: bile excretion is blocked (which can be caused by intrahepatic or extrahepatic lesions, usually biliary obstruction), and direct bilirubin in bile flows back into the blood and jaundice occurs. Clinically, it can be detected that the content of direct bilirubin in serum increases, bilirubin in urine is positive and urobilinogen in urine decreases or disappears. Because bilirubin and other bile substances remain in the body, it will cause itchy skin and bradycardia. Jaundice caused by cholelithiasis, tumor and other oppression of biliary tract belongs to this category.
Why does the skin, sclera and urine turn yellow when hepatitis patients have jaundice, but saliva doesn't?
When the serum bilirubin of hepatitis patients exceeds 34.2μmol/L(2mg/ 100ml), jaundice may appear in skin and mucosa. Clinically, jaundice first appears in conjunctiva and sclera, followed by soft and hard palate and mucosa of oral cavity. Bilirubin is a yellow dye, which needs to be combined with protein to make body fluids, tissues and organs yellow for a long time. Because bilirubin is most closely combined with tissues containing elastin, once the sclera, blood vessels, ligaments, meibomian and skin are dyed yellow, it will slowly fade. However, saliva and cerebrospinal fluid contain very little protein, and the amount of bilirubin combined with protein is also very small, so saliva and cerebrospinal fluid of patients with jaundice can keep their original colors without yellowing. The yellowing of urine is the result of part of bilirubin being excreted through the kidney with urine.
Your total bilirubin is really high, but don't be discouraged. No big deal. I think having a good mood every day is the best treatment for you now. Look at the following routines, which are very helpful to you. See you must learn to control your emotions, control your communication, and try not to drink. There are two words you should remember, long-term anger hurts the liver, and long-term drunkenness also hurts the liver.
Your liver function is normal (check your liver function every 3 months for 2-3 years 1 time), which is called "stable little three yang" and has low infectivity.
The situation of patients with small sanyang is not simpler than that of patients with large sanyang; Comprehensive analysis should be carried out according to the specific situation. Patients with hepatitis B should be examined for HBV- Dan and liver function. If HBV- Dan (+) and liver function are abnormal, it means that the virus is highly contagious and should be treated with comprehensive antiviral therapy. At present, there are some effective drugs for treating hepatitis B, such as interferon-α, ritalin, lamivudine, famciclovir and thymopentin. However, the results of this treatment are mostly limited to the negative conversion of HBVDNA and the reduction of fibrosis, and have little effect on the further negative conversion of other antigens (including antibodies HBcIgG and IgM). There is no evidence of virus replication in a few anti-HBe positive chronic liver diseases, and the virus may have been eliminated, but the autoimmune reaction continues to develop. Antiviral therapy and immunosuppressive therapy may not be effective for such patients.
If both halves of hepatitis B are small three-positive, HBV- Dan (PCR and dot method should be used for simultaneous detection; It is best to confirm the diagnosis by liver biopsy)) Yes (-) and the liver function, B-ultrasound and AFP are normal for a long time, indicating that the virus has been eliminated and is not contagious, so the third line of hepatitis B is still in a small three-yang state, which may be due to the memory continuity of the immune system (like scars left by healing wounds), and may even be lifelong. So there is no need for isolation treatment; Because there is no recognized effective drug to further treat hepatitis B on the basis of this small three-yang; Blindly taking a large number of therapeutic Chinese and western medicines after turning negative will only increase the burden on the liver and even lead to adverse consequences. Such patients with hepatitis B can get married, have children, live, work and study like healthy people. There is no scientific basis for the so-called shortened life span. In view of the fact that the virus of this kind of small three-positive patients has been eliminated, there may be hepatitis B virus susceptibility genes in their bodies. Therefore, if both spouses are negative for hepatitis B, it is necessary to inject hepatitis B vaccine as soon as possible in order to produce antibodies [HBsAb] before marriage and childbirth. Men should use condoms before sexual intercourse. After the baby is born, it should be injected with hepatitis B vaccine and hepatitis B immunoglobulin under the guidance of a doctor.
Patients need to continue to pay attention to self-protection and review regularly to prevent virus replication and strive for complete recovery. Patients with hepatitis B should have good living habits, regular daily life, proper physical and mental exercise, keep optimistic mood, avoid moldy food, have a light diet, and be rich in vitamins and protein, so as to strengthen their physique, improve their immunity and prevent the occurrence of cirrhosis and liver cancer.
You should remember the following points:
1. Enough protein.
One of the main functions of the liver is to synthesize and secrete plasma albumin. Normal people synthesize about 10 ~ 16g of plasma albumin every day and secrete it into the blood circulation, which plays an important role. Liver diseases, such as viral hepatitis, liver cirrhosis, alcohol and drug poisoning, will cause abnormal synthesis and secretion of protein in liver cells, which will reduce the level of plasma albumin, and then affect the repair and function of human tissues and organs.
The half-life of normal human albumin is 20 ~ 60 days. Experiments show that even if albumin production stops completely, the plasma albumin concentration will only drop by 25% after 8 days. Therefore, in acute liver injury (including acute viral hepatitis), the plasma albumin level will not decrease significantly. However, with chronic liver injury (including chronic hepatitis and cirrhosis), only 3.5~5.9g plasma albumin can be synthesized every day. Therefore, rich exogenous albumin must be provided to make up for the repair and function of liver tissue and improve the demand for albumin. It is generally believed that at least protein 1.5 ~ 2g/kg should be provided every day. But you can't eat protein without restraint. Protein in food can be decomposed by intestinal bacteria to produce harmful substances such as ammonia, which can induce and aggravate hepatic encephalopathy. Therefore, patients with liver cirrhosis and hepatic encephalopathy should strictly limit the intake of protein. After the patient is awake, protein should be given 0.5g/kg every day. If the tolerance is good, it can be increased to 1.0g/kg per day, 40 ~ 50g per day. Dairy products are the best animal protein, because dairy products produce the least ammonia, followed by eggs and meat. At present, plant protein is popularized to replace animal protein, which increases the daily intake to 40 ~ 80g. Advantages of plant protein: (1) less aromatic amino acids and sulfur-containing amino acids; (2) It is rich in cellulose, which can regulate nitrogen metabolism of intestinal flora and promote intestinal peristalsis; (3) An amino acid in plant protein has the potential function of reducing ammonia production.
2 Appropriate amount of carbohydrates (sugar)
The main function of sugar is to supply energy for life activities. As we all know, 1g sugar is completely decomposed and oxidized in the body, producing 4. 1kcal heat energy. 50 ~ 70% of the heat energy needed by human body is provided by the oxidative decomposition of sugar. Patients with acute hepatitis can be given some high-sugar foods or even intravenous injection of 10% glucose solution under the condition of obvious digestive tract symptoms and low food intake to ensure the heat energy needed by patients in daily life. At the same time, the liver can convert glucose absorbed by the digestive tract into glycogen, promote the repair and regeneration of liver cells, and enhance the resistance to infection and toxins. But it is not easy to eat too much sugar. After the intake of sugar meets the needs of glycogen synthesis and other needs, the excess sugar will synthesize fat in the liver and be stored in the liver. If the storage capacity is too large, it may cause fatty liver. In addition, excessive sugar intake may lead to overload operation and dysfunction of pancreatic β cells, which may lead to food-borne diabetes. The main sources of carbohydrates are cereals, potatoes and beans.
3 the right amount of fat
Liver is an important organ for lipid digestion, absorption, decomposition, synthesis and transportation. When liver function is damaged, the synthesis and secretion of bile are reduced, and symptoms such as fat indigestion and aversion to greasy food appear. If you eat too much fat, you will still have fatty diarrhea. Therefore, we should limit the intake of fat, especially in the acute episode of hepatitis. However, too little intake will affect appetite and the absorption of fat-soluble vitamins A, D, K, E and β-carotene, so a proper amount of fat must be given. 40 ~ 50g per day, accounting for 25 ~ 30% of the total calories. If you want to eat less animal fat, you should give priority to plant fat, such as sesame oil, rapeseed oil, peanut oil, soybean oil and sunflower oil. It contains more unsaturated fatty acids, such as linoleic acid, linolenic acid and arachidonic acid. These unsaturated fatty acids cannot be synthesized in the body and must be supplied by food, so they are called essential fatty acids. In the absence of essential fatty acids, the synthesis of high-density lipoprotein is reduced, and the fat transport in the liver is blocked, which is easy to form fatty liver.
4 Adequate vitamins
Vitamins are low-molecular-weight compounds necessary to maintain normal human life. They are neither raw materials for tissues nor energy-supplying substances, but they are indispensable substances for human body and play an important role in substance metabolism. For example, vitamin B 1 can inhibit cholinesterase, reduce acetylcholine hydrolysis, increase gastrointestinal peristalsis and gland secretion, and help improve appetite and digestive function. Vitamin C can promote glycogen synthesis, enhance immunity, detoxify and fight cancer. Therefore, patients with viral hepatitis should take vitamin B 1 and C regularly. Vitamin E is a powerful antioxidant, which can prevent the peroxidation of unsaturated fatty acids and protect the membrane system of liver cells and micro-organs in liver cells. Vitamin K is an essential substance for liver to synthesize coagulation factors (Ⅱ, ⅶ, ⅸ, ⅹ). Most vitamins cannot be synthesized in the body and must be provided by food. There are two main reasons for the increase of vitamin demand in viral hepatitis: (1) patients' appetite drops sharply due to indigestion, and vitamin intake is insufficient; (2) Infection and fever increase the consumption and demand of vitamins. Therefore, when viral hepatitis is particularly active, it is necessary to provide rich vitamins from outside, including vitamins in food.
Vitamin C is widely found in fresh fruits and green leafy vegetables because it is rich in tomatoes, oranges and fresh dates. Vitamin B 1 mainly exists in rice bran, wheat bran, soybean, yeast and lean meat. Vegetable oils such as wheat germ oil, cottonseed oil and soybean oil, as well as walnuts, pumpkin seeds, pine nuts, fungus and egg yolk are rich in vitamin E. Vitamin K 1 is abundant in green-leaf plants, such as alfalfa and spinach, and animal livers. Vitamin K2 is a bacterial metabolite. Human intestinal bacteria can be synthesized.
No drinking.
After drinking, 80% of ethanol is absorbed by the stomach and small intestine, and 90 ~ 98% of it is oxidized to acetaldehyde in the liver. Both ethanol and acetaldehyde are harmful to the liver, which can cause a series of metabolic changes, such as hyperuricemia, hypoglycemia, acidosis, lipodiarrhea and hyperlipidemia, aggravate the metabolic disorder of the liver, aggravate the pathological changes of liver cells, and then form alcoholic fatty liver, alcoholic hepatitis and alcoholic cirrhosis. Alcoholism can also cause low cellular immune function, affect the ability of viral hepatitis (especially viral hepatitis B and C) to clear the virus, make the disease persist, and develop into chronic hepatitis and posthepatitic cirrhosis. Alcohol may also be an auxiliary carcinogen, and if hepatitis B or hepatitis C virus infection occurs again, it may lead to hepatocellular carcinoma. Therefore, drinking alcohol should be prohibited for viral hepatitis.
2. Take a proper rest and exercise moderately.
When the liver function of hepatitis patients is damaged, the level of cholinesterase in blood decreases, causing neuromuscular physiological dysfunction. The disorder of glucose metabolism makes the process of transforming lactic acid into hepatic glycogen slow, and it also causes lactic acid accumulation, so patients are often accompanied by symptoms such as fatigue, listlessness, and heavy soreness in both lower limbs. Patients often reduce their activities, which can lead to abdominal distension and constipation. Therefore, the daily activities of patients should be arranged according to the condition. In the obvious period of hepatitis symptoms, bed rest should be given priority to, especially for patients with jaundice. Generally, the bed rest time should last until the symptoms and jaundice subside obviously (serum bilirubin < 20 ~ 30μ mol/L) before getting up. At first, you can take a walk indoors. Later, with the improvement of symptoms and liver function and the recovery of physical strength, the scope and time of activities can be gradually increased. Generally speaking, the control of activities is based on not feeling tired after activities. The purpose of bed rest is not only to reduce the consumption of physical strength and calories, but also to reduce the burden of excessive glycogen decomposition, protein decomposition and lactic acid production on the liver after exercise. At the same time, the blood flow of the liver increases obviously when lying in bed, which improves the oxygen supply and nutrition to the liver and is conducive to the repair of liver tissue damage. However, bed rest cannot be overemphasized. If you have too little activity and too much nutrition, you can gain weight continuously, and fatty liver may be formed.
I wish you a speedy recovery! You know, a good mood can be the enemy of all diseases! ~