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Hep C, bleeding esophageal varices - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Liver and Gall Bladder
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3391 Questions
User :   Hello Sir,

Good day to you sir. This is regarding my father aged 72 years who was diagonised with Hep C 3 years back when he was hospitalised for bleeding esophageal varices. The bleeding was stopped by EVL and thereafter he is stable. At present there is only a single grade 1 varix with basal colour white. Rest everything in the endoscopy report is Normal.

His latest Liver Function Test parameters are as follows

Bilirubin Total - 1.0


He is presently Taking the following medications:
Tab Ciplar 20mg 1-0-1.
Tab Repace AF 1-0-1/2.
Tab Lasix (40) 1/2-0-0.
Tab Pan 20 1-0-0.
Tab A-Z 0-1-0.
In addition to this he takes 32 units of insulin in the morning before breakfast and 8 units at night.

His BP is usually 130 / 70 and sugar levels are in the range of 80-100 fasting and 180-200 PP.

His Latest Ultrasound report says...Liver is Normal in morphology and echotexture with a smooth capsule. No focal lesion noted. Portal vein is 11 mm in diameter. No free fluid in the abdomen.

Small gall stones of approx.7mm are present.

Rest of the report is normal.

His latest Hep C viral load is 15,000 IU (2 years back it was 50,000 and last year it was 8000 IU).

He has a good appetite, No nausea, vomiting. Only occassional flatulance is there. No excessive tiredness (only feels a bit tired after his walk). No abdominal pain or discomfort (except for the bloated feeling after meals).

My queries are:
1. What do you feel about the functioning of the liver. Is it something to worry about as of now.

2. He is not taking any medications for Liver support. Is it the right thing to do?

3. Our gastroenterologist does not agree for interferon treatment fearing the side effects. Is this the right line of action?

4. Considering the present status of the liver is
User :   it necessary to get the endoscopy done every 3 months (our doc insists to get it done every 3 months). Since the procedure causes discomforts, can it be done once every 6 months.

I would be grateful if you could kindly advice me in this regard.

Warm Regards

AAAAAAA B.Bharadwaj.
Doctor :   hi
User :   Hello Sir
Doctor :   dr AAAAAAA here
User :   i need teh advice of a gastroenterologist / Hepatologist....
User :   Good day..
User :   can you help me please...
Doctor :   let me read what you have typed
User :   sure sir...
Doctor :   I am a general practitioner
Doctor :   Have you consulted with our panel gastroenterologist?
User :   ok.....
User :   no...
User :   i was directed to this directly...
Doctor :   ok
Doctor :   what symptoms does your father have at present?
User :   He does not have any symptoms as such...except for occassional flatulance
Doctor :   ok.
Doctor :   if he is asymptomatic and responding well to treatment
User :   well he is not under any treatment for Hep C...
Doctor :   then the endoscopy should be done when needed.
User :   ok...
User :   so it is not necessary every 3 months right?
Doctor :   Blood tests would be required for regular monitoring
Doctor :   endoscopy is not required
User :   yes that we get it done every 3 months...
User :   ok fine.....
User :   and what do you feel about his liver functioning sir?
Doctor :   it is functioning good now
Doctor :   but monitoring is required
Doctor :   as most of the problems are progressive in Hepatitis C
User :   i get your point sir....
User :   i have heard that Hep C is a very slow progressing it true..
Doctor :   Yes, it is so

User :   ok sir...thank you very much for your valuable suggestion and advice
Doctor :  
For any further clarification, you can consult our Gastroenterologist
User :   ok i will do that sir...
User :   thank you so much.
Doctor :   Thanks for consulting, bye for now
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