Part 1: identifying symptoms and signs
1, pay attention to jaundice symptoms. Jaundice is excessive bilirubin in the blood, which leads to yellowing of skin, mucosa and white eyes. Bilirubin is an orange pigment in human bile. Because a healthy liver usually excretes excessive bilirubin, jaundice means that there is something wrong with the liver. Besides yellow skin and white eyes, symptoms of jaundice include fatigue, abdominal pain, weight loss, vomiting, fever, loose stool and dark urine.
Symptoms of jaundice usually appear when the liver is seriously damaged, so once these symptoms appear, it is best to seek medical attention immediately.
2. Pay attention to abdominal distension or abdominal pain. If you are not pregnant, abdominal distension usually means the accumulation of fat, liquid or feces, or tumors, cysts, fibromas, or the enlargement of organs such as liver and spleen. If the situation is serious, even if you are not pregnant, it will be like eight months pregnant. Abdominal distension is mostly caused by some basic disease and needs to be examined by a doctor. If there is fluid in the abdomen, this condition is called ascites, which is a common symptom of hepatomegaly.
Abdominal distension usually leads to loss of appetite, and patients will feel that their stomachs are too swollen to eat at all. This symptom is called "early satiety". You may also have no appetite at all because of bloating.
Legs may also swell.
Abdominal pain may be a sign of hepatomegaly, especially in the right upper abdomen, accompanied by other symptoms.
3. Understand the systemic symptoms of hepatomegaly. Fever, loss of appetite, nausea, vomiting, pain in the right upper abdomen and weight loss are not specific symptoms of hepatomegaly. However, if these symptoms are severe, persistent or sudden, they may be caused by liver disease and hepatomegaly. As mentioned above, abdominal distension may cause loss of appetite or loss of appetite. This may also be a symptom of gallbladder disease. Because eating can cause pain, patients are reluctant to eat. Loss of appetite may also be accompanied by cancer and hepatitis.
Doctors usually define obvious weight loss as 10% of the original weight. If you lose weight instead of deliberately, you should see a doctor.
A fever indicates inflammation in the body. Hepatomegaly may be caused by infection such as hepatitis, so you must know how to distinguish and treat when you have a fever.
Light-colored, light gray or white feces may be a problem with the liver.
4. Pay attention to whether it is easy to get tired. I feel tired when I don't do much exercise. This is because the nutrient reserve of the liver is damaged, and the body cannot provide the required nutrients for the muscles as an alternative energy source. Fatigue may mean that there is something wrong with the liver, and swelling is the accompanying symptom. Both viral hepatitis and cancer can make people tired easily.
5. Pay attention to whether the skin is getting itchy. When liver function is damaged, local or whole skin will itch. This is because the bile duct in the liver is blocked, and bile salts secreted into the blood are deposited on the skin, causing itching. You may want to stop itching, but if you suspect that there is something wrong with your liver, you should see a doctor first.
6. Identify spider mites. Spider nevus is a blood vessel that expands radially from the central red dot and looks like a spider web. Spider nevus mostly occurs in the face, neck, hands and upper chest, which is a typical symptom of liver disease and hepatitis. If you only have a spider mole in your body, you usually don't need to worry too much. However, if you are accompanied by other health conditions or symptoms, such as drowsiness, fatigue, abdominal distension or jaundice, you should see a doctor, because this may mean that there is something wrong with your liver. In addition, the complications of multiple spider nevus also indicate that there is something wrong with the liver, so you should see a doctor.
Spider nevus vary in size and can be as long as 5 mm in diameter.
Press the spider nevus with your fingers moderately and forcefully, and the red spots will fade and turn white in a few seconds, because the blood is squeezed out.
Part 2: Obtaining professional diagnosis
1, make an appointment with a doctor. The doctor will ask you a complete medical history first. Be sure to provide information actively and honestly. Please note that doctors may ask some very personal questions, such as drug use, alcohol intake and sexual partners. Your answer is crucial to the diagnosis. Be sure to answer clearly and tell the truth.
Tell your doctor about the medicines or supplements you are taking, including vitamins and herbs.
2. Have a physical examination. Clinical physical examination is the first step to diagnose hepatomegaly. If you haven't mentioned jaundice and spider nevus before, the doctor will check whether the skin has these two symptoms. Then touch the abdomen with your hand to check the liver. Depending on the etiology, the swollen liver may be irregular, soft or hard, with or without a mass. This kind of examination can confirm the size and texture of the liver, so as to evaluate the degree of hepatomegaly. The doctor will examine the liver by palpation and percussion.
3. Assess liver status by percussion. Doctors can assess the size of the liver by percussion to ensure that it does not exceed the lower edge of the right rib. The lower edge of the right rib is like a protective railing of the liver. Percussion is to analyze the state of organs from the sound. The doctor will tap on the body surface and listen to the sound. If it is voiced, the knocked-out liver will exceed the lower edge of the rib by more than 2.5 cm next time, and the liver is likely to be swollen. Note that if you have abdominal distension, you can't draw an accurate conclusion by percussion, and you need to do abdominal ultrasound examination. If the doctor's dominant hand is his right hand, he will put his left hand on your chest and press the chest wall with his middle finger. Then tap the center of the left middle finger with the right middle finger. When you knock, you use your wrist to exert your strength, which is a bit like playing the piano.
Knocking from under the breast should produce a drum sound. This is because the lungs filled with gas are here.
When the drums become voiced, the doctor will tap them along a straight line covering the liver. This means that the doctor has knocked on the liver. They will continue to tap, and as their fingers get closer to the end of the ribs, pay close attention to whether there is still voiced sound and how long it lasts. When the voiced sound becomes a bowel sound, stop tapping.
If the liver exceeds the end of the rib, the doctor will calculate how many centimeters it exceeds. This is usually a symptom of disease, because the role of the chest is to protect important organs, such as the liver and spleen. If you are diagnosed with pulmonary dilatation and there are no other health problems, the doctor may also touch the edge of the liver.
4. Confirm the shape and hardness of the liver by palpation. Doctors also use palpation to confirm whether the liver is swollen. Like palpation, doctors will touch and press organs with their hands. If the doctor is right-handed, he will put his left hand on your right. You need to take a deep breath and then exhale slowly, while the doctor tries to "hold" the liver with both hands. They will touch the edge of the liver and the end of the ribs with their fingertips to find important details, such as shape, hardness, surface texture, softness and boundary clarity.
Doctors will feel whether the surface texture of the liver is rough, irregular and nodular, and whether there is a hard feeling. They will also ask if your liver hurts when it is pressed.
5. Blood test. The doctor may take a sample of your blood to evaluate your liver function and health. Blood tests can also confirm whether there is a virus infection, such as hepatitis. Blood test can detect the level of liver enzymes, which is very important for understanding the health and function of the liver. You may also need to do other blood tests, including complete blood cell count, hepatitis virus screening and coagulation test. The latter test is particularly useful for evaluating liver function, because the liver is responsible for producing coagulation factors.
6. Conduct imaging examination. Doctors usually recommend ultrasound, computed tomography and magnetic resonance imaging to confirm the diagnosis and check the morphology and structure of the liver and surrounding tissues. These tests can provide doctors with specific information and then make an informed assessment of the liver condition. Abdominal ultrasound: In this examination, you need to lie down and the doctor moves the probe over your abdomen. The probe emits high-frequency sound waves, which are reflected by the body organs and then received by the computer. Then the computer converts these sound waves into image information of abdominal organs. The doctor will tell you some preparations in advance. In most cases, you can't eat anything before the examination.
Abdominal computed tomography: This examination uses X-rays to create a cross-sectional image of the abdomen. You need to lie on a narrow examination table, slide into the scanner slowly, and stay still during the X-ray rotation and scanning. The computer will convert the received signal into an image. The doctor will tell you what you need to prepare in advance. Sometimes, patients need to take oral or intravenous contrast media (a special dye) first, so they may ask to fast anything before the examination.
Abdominal magnetic resonance imaging examination: This examination uses magnetic fields and radio waves instead of radiation (X-rays) to create images of the interior of the abdomen. You need to lie on a narrow examination table and slowly slide into a large scanner that looks like a tunnel. Sometimes it may be necessary to use contrast agents to show organs more clearly. The doctor will discuss this problem with you before the examination. Like other tests, you may not eat or drink anything before.
7. endoscopic retrograde cholangiopancreatography (ERCP). This test will confirm whether there is something wrong with the bile duct. The bile duct is responsible for transporting bile from the liver to the gallbladder and small intestine. In this examination, the doctor will insert an intravenous needle into your arm and inject drugs to help you relax. After that, the endoscope is inserted into the esophagus and stomach through the mouth and reaches down to the small intestine, which is the intestine closest to the stomach. Then, the catheter was inserted into the bile duct of the spleen and gallbladder through endoscope. Inject x-ray contrast agent. Contrast agent helps doctors to see the problem area clearly.
This kind of examination is usually performed after imaging examination, including ultrasound, computed tomography or magnetic resonance imaging.
Like many tests mentioned above, the doctor will explain the whole process and tell you what will happen during the process. You need to agree and don't eat or drink anything for 4 hours before the examination.
Endoscopic retrograde cholangiopancreatography is a good choice, and doctors can also use it as an auxiliary treatment. For example, if stones or other obstructions are found in the bile duct during the examination, the doctor can remove them.
8. Liver biopsy. Generally speaking, hepatomegaly or other liver diseases can be diagnosed by medical history, physical examination, blood test and imaging examination. However, in some cases, the doctor may advise you to have a biopsy, especially if the diagnosis is unclear or cancer is suspected. This test requires inserting a slender needle into your liver to obtain a liver tissue sample, which is usually performed by a liver specialist, such as a gastroenterologist or hepatologist. This is an invasive examination, so local or general anesthesia is needed. The collected samples will be sent to the laboratory for further analysis, especially to check whether there are cancer cells.
9. Magnetic vibration elastography (MRE). This is a relatively new imaging technology, which combines magnetic resonance imaging with sound waves to create an elastic map to measure the hardness of body tissue. Liver cirrhosis is a symptom of chronic liver disease, which can be detected by magnetoelastic imaging. This is a non-invasive procedure that can replace liver biopsy. Magnetoelastic imaging is a rapidly developing new technology. At present, only a few medical centers provide this service, but it has been paid more and more attention. Ask the doctor if this applies to you.
Part 3: Understanding Risk Factors
1. Understand the risks of hepatitis. Hepatitis A, B and C can cause liver inflammation, hepatomegaly, smooth liver margin and tenderness. If you have any type of hepatitis, your liver will be more prone to swelling. The liver is damaged because blood and immune cells flood into the liver to try to fight hepatitis infection.
2. Consider whether you have right heart failure. Right heart failure can cause hepatomegaly, smooth liver margin and tenderness. The heart can't pump blood effectively, which leads to blood accumulation in the liver. The heart doesn't work properly, so the blood returns to the liver.
3. Understand the risk of liver cirrhosis. Cirrhosis refers to the long-term damage of the liver, which leads to liver fibrosis and produces too much scar tissue. Cirrhosis is usually caused by a lifestyle that is not conducive to the health of the liver, especially alcoholism can directly cause cirrhosis. Liver cirrhosis can cause hepatomegaly or liver atrophy, in which hepatomegaly is the most common.
4. Consider whether you have any genetic or metabolic problems. Some genetic or metabolic problems increase the risk of hepatomegaly, such as hepatolenticular degeneration and Gaucher's disease.
5. Understand the risks of cancer. Cancer patients may develop hepatomegaly because cancer cells have metastasized to the liver. If you are diagnosed with cancer, especially organ cancer near the liver, you will be more prone to hepatomegaly.
6. Beware of excessive drinking. Long-term or excessive drinking (drinking more than several cups a week) will damage the liver and affect the regeneration of liver cells. Both of these conditions will lead to irreversible liver function and structural damage. The liver slowly loses its function due to the intake of alcohol, and its detoxification ability decreases and it becomes swollen. Heavy drinking can also lead to fatty liver.
The National Institute of Alcoholism and Alcoholism defines "moderate drinking" as no more than 65,438+0 servings per day for women and no more than 2 servings for men.
7. Consider your drug use. Many over-the-counter drugs can cause liver damage if used for a long time or taken in excess of the recommended dose. The most harmful drugs to the liver are oral contraceptives, anabolic steroids, diclofenac, amiodarone, statins and so on. If you need to take medicine for a long time, you should have regular physical examination and strictly follow the doctor's advice.
Taking too much paracetamol (Tylenol) is a common cause of liver failure, which can lead to hepatomegaly. If you take paracetamol with alcohol, the risk will be even greater.
Note that some herbal supplements may also increase the possibility of liver injury, such as black cohosh, ephedra and mistletoe.
8. Pay close attention to fat intake. Eating greasy food often will lead to fat accumulation in the liver, causing fatty liver. This includes French fries, hamburgers or other junk food. Too much fat accumulation will eventually destroy liver cells. Liver function will be damaged, and hepatomegaly will occur due to the decreased ability to handle blood and toxins and the accumulation of fat.
Being overweight or obese can also increase the risk of liver disease. To know whether the body is overweight or obese, you can refer to the body mass index (BMI) which measures the degree of body fat and thin. Body mass index is the number of kilograms divided by the number of square meters of height. A body mass index between 25 and 29.9 is considered overweight, and over 30 is considered obese.