The goiter is an enlargement of the thyroid gland. Goiter: Symptoms, classification, causes, treatment

In the human body, the thyroid gland plays a very important role. Referring to the endocrine system, the body takes part in the regulation of energy metabolism. Two lobes of it are connected by a neck, are on the sides of the trachea. The energy that enters the body is distributed among the cells, if it is not enough, the hormones of the thyroid gland interfere. If the deficit is permanent, a certain change in tissues takes place and a goiter develops. There are several forms and degrees of the disease, which differ in the causes and symptoms. Any kind of pathology requires diagnosis and treatment.

Goiter of the thyroid gland

The mechanisms of formation of tumors in the thyroid gland have not yet been sufficiently studied. The methods of treatment known in medicine today can not always be sufficiently effective and cure the pathology completely.

Thyroid gland tissue is made up of follicles - globular cells. Disturbances in the body associated with organ dysfunction lead to deformities. Multinodular goiter of the thyroid gland causes changes in individual areas, and diffuse - throughout the tissue. In addition to increasing follicles, the disease can be characterized by the occurrence of cystic formations (cystic-nodal goiter). Progression of pathology can lead to the degeneration of nodes in malignant ones.

Causes

The goiter is a disease that includes various damage to the thyroid gland. There are several types, forms and degrees of pathology, which differ in the nature of the course, causes and symptoms. The main reason for the development of toxic endemic goiter is the lack of iodine in the body, which reduces the secretory activity of the thyroid gland. Bad ecology also affects the functioning of the thyroid gland. Exposure to toxic substances can slow the activity of the thyroid gland, suppressing the endocrine system.

Insufficient use of iodine-containing products (milk, fruit, fish) can also cause goiter. The causes of the development of the nodal kind of the disease are the cancerous process of the thyroid gland or adenoma. Differentiation and division of cells in this case occurs under the influence of toxic substances, radiation, and can be hereditary in nature.

Basedova pathology occurs due to the effect on the body of special antibodies of the immune system. Treatment consists in taking medications that inhibit the production of hormones, sometimes the problem is solved by surgical intervention.

Symptomatics

The goiter is a disease that does not manifest itself in the initial stages, and the patient may not even suspect its presence. Only in connection with a significant increase in thyroid gland develops a definite clinical picture. Symptoms of thyroid disease are characterized by its edema on the front of the neck and compression of adjacent tissues. At the same time, patients complain of the appearance of dry cough, hoarseness of the voice, a feeling of "coma in the throat", shortness of breath. When the head moves, there is a feeling of tension and dizziness, which is due to the constriction of the vessels of the neck. To some extent, swallowing is disturbed due to compression of the esophagus. Various nodes appear on the thyroid gland. What to do in such situations - so it is at the first suspicions to consult a doctor.

With the development of pathology due to iodine deficiency, the clinical picture is supplemented by other symptoms associated with hypothyroidism: flatulence, frequent respiratory diseases, low blood pressure. With thyroid adenoma or Graves' disease there are signs of hyperthyroidism: weight loss, irritability, hand trembling, hunger, fever.

Diffuse euthyroid goiter

Pathology develops as a result of a lack of iodine. Compensatory character of hyperplastic and hypertrophic processes in the thyroid gland is aimed at providing the body with a sufficient level of thyroid hormones. Adaptation mechanisms for iodine deficiency are associated with the re -ilization of endogenous iodine, a decrease in the secretion of iodide by the kidneys, the synthesis of triiodothyrosine, and enhanced iodine uptake by the thyroid gland. In this way the body compensates for iodine deficiency, but there is a development of hypertrophy of thyroid cells, which ensures the preservation of thyroid functions. Euthyroid goiter can complicate its course due to factors such as excess calcium, a lack of trace elements (molybdenum, copper, cobalt, selenium, zinc, manganese), taking certain medications, chronic infections, emotional stress, smoking.

In most cases, clinical manifestations do not develop, since with this disease, the function of the thyroid gland practically does not suffer. Sometimes in a patient's condition one can observe general weakness, fatigue, and increased fatigue. The enlargement of the thyroid gland is largely accompanied by a visible cosmetic defect and a sensation of pressure in the neck. Other symptoms of thyroid disease are associated with hypertrophy of the organ, which can be the cause of serious complications: inflammation of the gland, hemorrhage, compression of the esophagus, trachea. Against the background of this pathology, other, more complex types of goiter may develop.

Diffuse toxic goiter

In middle-aged women, the predominantly diffuse toxic goiter. This disease affects children and seniors much less often. Until one hundred percent is established, what factors influence the development of pathology, but the majority of medical experts consider genetic defects as the main reason, as a result of which the system of regulation of antibody production is violated in the immune system. These disorders lead to the fact that antibodies are produced against the tissue of the patient's own thyroid. Genetic defects in this case is not an absolute predisposition, but a statistical regularity, that is, not necessarily a child will be ill if the disease has a goiter in one of the parents.

It is rare for this pathology to increase the thyroid gland in volume. In 30% of patients there is an eye enlargement (Graves' ophthalmopathy, endocrine ophthalmopathy, exophthalmos). The main symptomatology for diffuse toxic goiter is associated with an excess of hormones produced by the thyroid gland. Because of the excessive activity of hormonal effects in the patient, the functions of the heart are violated, up to the development of arrhythmia. Strengthening metabolic processes lead to weight loss. In patients, such signs as deterioration of sleep, tearfulness and weakness, irritability, the appearance of a tremor can be observed.

Nodular goiter

Nodular goiter is a series of pathologies with one common feature - the formation of nodes in the thyroid gland. After suspicion of the development of the disease, the patient needs to undergo another series of examinations to determine the degree and type. If a patient has more than one node, then the multinodular goiter of the thyroid gland is diagnosed. The most common manifestation of pathology is colloid euthyroid goiter. Symptoms as such do not occur, but there are defects in the neck, up to deformation. Together with painful sensations, complications appear, which indicates a rapid growth of the formations: hemorrhage to the node, the appearance of inflammation, and the thyroid gland increases even more. Nodes of large size can squeeze the trachea or esophagus, which is accompanied by a violation of breathing and swallowing.

The development of nodular goiter is promoted by such factors as genetic predisposition, chronic viral and bacterial infections, drugs, zobogenic factors of food, environmental factors. The main reason is the lack of iodine in the body. Do not bring the disease to a state of neglect. Address immediately to the doctor if you feel the knots on the thyroid gland. What to do next, how to get rid of them and avoid complications - it can be learned at a specialized consultation after a full set of examinations. Only after this, you can take some measures and prescribe treatment.

Degrees

The degree of nodular goiter is determined based on how much the thyroid gland is enlarged. Nodes can be of different sizes and in different quantities. For today, there are two classifications of nodular goiter in terms of degrees. The first is for Nikolaev. There are 5 groups. At zero degree of a thyroid gland it is not visible and she is not felt at a palpation. At the first - it is not visible, but palpated. The second degree is characterized by a visible manifestation of the gland during swallowing. With the third, the contour of the neck increases and thickens. The fourth manifests itself as an obvious goiter, which breaks the configuration of the neck. The fifth, last, degree of the disease is fraught with complications. The huge size of the thyroid gland leads to squeezing of neighboring organs, which is why the functions of the respiratory, cardiovascular and gastrointestinal tract are disrupted.

According to WHO classification, there are three (zero, first and second) degrees of the disease. With zero goiter there, the first one is not visible, but it is palpable and at the second degree the goiter is felt, and it can be seen with the naked eye. If the initial stages of development of pathology do not pose a visible danger to the body, then the progression of the disease can lead to serious consequences, because goiter is a serious enough disease, which, besides external changes, negatively affects the work of all systems and organs.

Methods of diagnosis

Primary examination of the patient is performed with the help of palpation. If a neoplasm is found, an ultrasound is performed to determine the thyroid volume and the exact size of the lesion. A fine needle aspiration biopsy is performed when the size of the formation exceeds 1 cm, or there is a suspicion of a malignant tumor. Ultrasound in combination with a biopsy increases the informative value of research.

Thyroid goiter, when placed in a squeezed and large size, may shift towards the respiratory tract, which causes complications. To prevent this, x-rays are prescribed by contrasting the chest and esophagus barium. Magnetic resonance imaging is used for the purpose of detailed study of the retrosternal goiter. In ordinary cases, it is not prescribed.

How to treat goiter

Treatment of goiter can be conservative and operative. The first option is used if a diffuse, nodular, multinodal goiter of the thyroid gland was diagnosed. Absolute contraindication to surgery is also the reason for conservative treatment. It consists of several steps. First, you need to revise your diet and replace it with a balanced diet. Still need to improve sanitation and hygiene conditions. They can prescribe treatment at a specialized resort. Important components of conservative treatment are: normalization of liver and intestine functions, sanitation of foci of chronic infections, normalization of iodine metabolism in the body. The latter is achieved by taking such drugs: "Triiodothyronine", "Thyreoidin", "Thyreotom", "Thyreocombe".

Operative treatment is prescribed if there are indications for surgery: diffuse goiter of IV and V degrees, diffuse goiter of grade III, which does not lend itself to conservative therapy, mixed and nodular goiter, if the thyroid gland is enlarged. The goiter is removed in two ways: hemistrumectomy and partial resection. Operative intervention is conducted by the surgeon under the close supervision of the endocrinologist. It is also possible to treat goiter with folk remedies. The most tested and effective way is the use of grass elecampane. An infusion of vodka is prepared from it and used to rinse the throat until complete cure.

Prophylaxis of goiter

In order not to run into the disease of goiter, you need to ensure that the conditions under which the disease can not develop. It's about prevention, which in this case can be mass, group, individual. Mass consists in the use of iodized salt, which per 1 ton contains 25 grams of potassium. This method is especially important in the areas of increased risk of iodine deficiency. Group prophylaxis is performed with the help of the drug "Antistrumin". Use it in military units, children's and school groups in a dose of 1 tablet per week. Patients who have arrived in the zone with iodine deficiency are also prescribed Antistrum.

Specific prophylaxis should be carried out in conjunction with the elimination of aggravating factors with the help of a number of sanitary and social measures (combating intestinal infections, sanitary culture of the population, prevention of hypovitaminosis, balanced nutrition, improvement of living conditions).