Discussions By Condition: Liver conditions

Cirrhosis NASH I need some advise!

Posted In: Liver conditions 6 Replies
  • Posted By: kimmielou2000
  • August 15, 2007
  • 06:47 PM

I have a 54 yr old mentally retarded sister with type 2 diabieties she has been seeing Dr. after Dr. at first they thought it was leukemia but everything there was negative. All her boold counts are very low. Recently we were told she has advanced stages of cirrhosis. The hemotoligist told us all he could do would be to monitor her blood levels until the end of her days. He did tell us anything else as far as what to look for or watch for only to get her to a hospital asap if she beings to hemogiage. The gastro Dr. did an endoscopy and a colonostopy and said that she has varies and hope to see us in a year. Her diabities is getting hard to manage her glucose level are runnung very high (250-400) she is seeing a Dr. for that right now too. We just don't know what to expect no one is telling us how the diesese is going to progress. She in on no med for the cirrhosis and she is not a canidate for a transplant. Any advise anyone has would be a great help.

Reply Flag this Discussion

6 Replies:

  • My hubby is in the same boat as your sister. He was basically told the same thing wait until he's throwing up blood.. he is also diebetic his run high fasting 200-362.His Dr said dieting is the only hope to get his diabeties under control medication isnt working the worse his cirrhosis gets the worse his diabeties gets.Ive got him on a low carb low fat low protein diet hes lost 16 pounds and his daytime highs are doing better but the fastings are climbing. Im sorry you & your sister half to go through this ((((hugs))))) Try cutting down her carbs.... good luck
    Anonymous 42789 Replies
    • August 17, 2007
    • 06:05 PM
    • 0
    Flag this Response
  • Thank You for your reply, I am very sorry that you are going through this, I give you my blessing. The Doctors just have give us nothing, no hope just wait it out and this is very hard to do. I live 300 miles away, I am trying to home as much as I can but it is so ******n all of the family. I am just so scared for her, she doesn't understand and it is really hard for her. We just have to do what we can and trust in God help us.
    kimmielou2000 1 Replies
    • August 20, 2007
    • 00:26 PM
    • 0
    Flag this Response
  • My aunt is now in hospice but when diagnosed with end-stage liver cirrhosis, it shocked us all as she never drank! We discovered, albeit too late now, that she has NASH. Secondary to NASH is diabetes and heart problems, which my aunt also has. To cut to the chase here, the health professionals gave her "lactulose" to help her body get rid of the ammonia build up from the liver non function. The ammonia gets into the bloodstream and into the brain causing confusing, NOT DEMENTIA. However, I questioned this because the lactulose is sugar-based. So with her sugar levels in the 300's how the heck were they supposed to go down when they were feeding her this sugar? Seemed counter-productive to me. So, I did some research, lots of it. At the University of San Francisco (in California, USA) the medications that worked best and improved patient's conditions with the mental confusion caused by the inflammation of the liver (hepatic encephalopathy), interferon and rifimaxin used in combination and the dosages are listed if you go further into the article from their research (called an abstract). Go to www.nih.gov and click on research, then type in NASH. You'll learn alot. I did read using the medications in combination as suggested could reverse a patient's condition. don't give up, be her warrior! Good luck to you.:)
    dawnmarie 2 Replies
    • August 20, 2007
    • 10:31 PM
    • 0
    Flag this Response
  • My aunt is in hospice with the same thing. NASH also has secondary conditions, diabetes and cardiovascular problems. Lactulose (comprised of sugar) helps to rid the body of the build up of ammonia which causes mental confusion. The docs thought my aunt had dementia and doesn't. Anyway, because the liver can't process the toxins and medicines in her body like normal, a build up of ammonia develops in the blood system and goes to the brain. HOWEVER! Upon doing research to try and help my aunt, I found that there are two medications which can reverse the condition and improve the patient. They are interferon and Rifaximin. Please insist that your sisters health provider put her on this medication combo. It's too late for my aunt as she only has days left now but your sibling is too young for this to happen and for anyone to throw up their hands, go to another until they listen! Review article: the current pharmacological therapies for hepatic encephalopathy. Bass NM.UCSF Liver Transplantation Service, School of Medicine, University of California, San Francisco, CA 94143-0538, USA. nathan.bass@ucsf.edu Effective treatment options for hepatic encephalopathy are limited. Based on the principle that intestinal-derived ammonia contributes to the pathogenesis of hepatic encephalopathy, current therapeutic approaches are directed at reducing bacterial production of ammonia and enhancing its elimination. Non-absorbable disaccharides are first-line therapy for hepatic encephalopathy, but published clinical studies evaluating their safety and efficacy are limited. Alternative therapies such as benzodiazepine receptor antagonists, branched-chain amino acids, and l-ornithine-l-aspartate also have limited clinical data supporting their use. Studies of antibiotics indicate that they are effective in the treatment of hepatic encephalopathy, but adverse effects and concerns about long-term safety have limited the widespread use of most. Rifaximin is a minimally absorbed antibiotic that concentrates in the gastrointestinal tract and is excreted mostly unchanged in faeces. It has been studied extensively in the treatment of hepatic encephalopathy and appears to confer therapeutic benefits greater than those of placebo and non-absorbable disaccharides and at least comparable with those of systemic antibiotics. Rifaximin was also well tolerated in patients with hepatic encephalopathy and is not associated with clinical drug interactions or clinically relevant bacterial antibiotic resistance. In conclusion, non-absorbed antibiotics such as rifaximin offer a favourable benefit-risk ratio in the treatment of hepatic encephalopathy and may help to improve patient outcomes. PMID: 17295849 Related LinksRifaximin, a nonabsorbed oral antibiotic, in the treatment of hepatic encephalopathy: antimicrobial activity, efficacy, and safety. Management of hepatic encephalopathy: focus on antibiotic therapy. Role of antibiotics in the management of hepatic encephalopathy. Non-absorbable disaccharides for hepatic encephalopathy: systematic review of randomised trials. Oral L-ornithine-L-aspartate therapy of chronic hepatic encephalopathy: results of a placebo-controlled double-blind study. The principle that intestinal-derived ammonia contributes to the pathogenesis of hepatic encephalopathy, current therapeutic approaches are directed at reducing bacterial production of ammonia and enhancing its elimination. Non-absorbable disaccharides are first-line therapy for hepatic encephalopathy, but published clinical studies evaluating their safety and efficacy are limited. Alternative therapies such as benzodiazepine receptor antagonists, branched-chain amino acids, and l-ornithine-l-aspartate also have limited clinical data supporting their use. Studies of antibiotics indicate that they are effective in the treatment of hepatic encephalopathy, but adverse effects and concerns about long-term safety have limited the widespread use of most. Rifaximin is a minimally absorbed antibiotic that concentrates in the gastrointestinal tract and is excreted mostly unchanged in faeces. It has been studied extensively in the treatment of hepatic encephalopathy and appears to confer therapeutic benefits greater than those of placebo and non-absorbable disaccharides and at least comparable with those of systemic antibiotics. Rifaximin was also well tolerated in patients with hepatic encephalopathy and is not associated with clinical drug interactions or clinically relevant bacterial antibiotic resistance. In conclusion, non-absorbed antibiotics such as rifaximin offer a favourable benefit-risk ratio in the treatment of hepatic encephalopathy and may help to improve patient outcomes. PMID: 17295849
    dawnmarie 2 Replies
    • August 20, 2007
    • 10:44 PM
    • 0
    Flag this Response
  • Thank you for the link, it is hard to find helpful info.
    Anonymous 42789 Replies
    • August 21, 2007
    • 11:02 AM
    • 0
    Flag this Response
  • I am the administrator of the BBS which provides discussion to patients with liver diseases, Mabel. Our BBS is newly-opened. You can get much useful information and let others share your experiences there. Welcome to visit http://liver-health.info/. Thank you.
    mabel8499 3 Replies
    • January 19, 2008
    • 01:23 AM
    • 0
    Flag this Response
Thanks! A moderator will review your post and it will be live within the next 24 hours.