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Liver cirrhosis - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Liver and Gall Bladder
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions

Doctor :   hi
Doctor :  
how can i help u
User :   hi doctor..
Doctor :  
please proceed with your query
User :  
my father was recently diagonsed with liver cirrhosis
Doctor :  
ok
User :  
he was also suffering from varasis...
User :  
portal hypertension
Doctor :  
ok
User :  
thats why he went through endoscopy two times..
Doctor :  
thats correct
User :  
now his varasis is fine..I mean to further internal bleeding..banding and glue stick applied by the doctor..
User :  
I mean no further internal bleeding..banding and glue stick applied by the doctor..

Doctor :  
ok
User :   As of now we use to go though some routine test (LFT, CT/BT etc) after every three months..
Doctor :  
ok
User :   He is following medication course..which is too maintain his portal hypertension(cipilar) and some vitamins tablets..
Doctor :  
ok

Doctor :   hi
Doctor :   are yu back
User :   yes
Doctor :  
please proceed
User :  
So now our major concern is his cirrhosis...
Doctor :  
ok
User :  
As my father liver is already more than 60% damanges..
User :  
we want to protect the further damange...
Doctor :  
i will help u in this
User :   we are following doctor prescription
Doctor :  
can i ask few Q
User :  
yeah sure
User :  
please go ahead
Doctor :  
is he hypertensive or diabetic
User :   no, he is neither of these..

Doctor :  
is he alcoholic
User :  
No, he never touch alcohal in his whole life
Doctor :  
ok
Doctor :  
he is positive for hepatitis B
User :  
No ..
Doctor :  
ok
User :  
doctors actually couldn't identify cause of liver cirrhosis..
Doctor :  
wat is the cause for cirhosis
User :  
thats why they named as cryptogenic liver cirrhosis..
Doctor :  
did the doctor say any thing
User :  
No..
Doctor :  
i know that
User :  
they said..it happens in some rare cases..
Doctor :  
if the cause is not found its called cryptogenic
User :  
yeah
Doctor :  
yes its very rare
Doctor :  
happens in one in lac
User :  
thats what doctor said..we didn't went though biopsy..
User :  
because doctor didn't suggested us..
Doctor :  
ok
User :  
but all the other tests went negative..
Doctor :   ok
User :  
So what else, we can do now..
Doctor :   i will guide u in this
User :   thanks
Doctor :  
are his liver function test normal
User :  
let me tell all his parameters..
Doctor :   ok
Doctor :  
please proceed
User :  
his hemoglobin recently mesured as 9.0 (he is already following recommened diet to overcome this)..
Doctor :  
ok
Doctor :  
thats low
Doctor :  
its because of esophageal varices
Doctor :  
but he can improve that
User :   thats correct

Doctor :  
another 3-4 mg is ok
User :  
he is taking iron rich diet these days..
Doctor :  
regarding LFT
Doctor :  
thats good
Doctor :  
thats liver function test
User :  
let me open the reports..
Doctor :  
ok
User :  
his protherobomine time was 21.6
Doctor :  
ok
User :  
INR ratio was 1.76
Doctor :  
ok
User :  
RBC count was 4.25
User :  
Hemocrit was 9.8
Doctor :  
hemotocrit 9.8??
User :  
sorry it was 30.5
Doctor :  
thats right
User :  
i misread his hemoglobin as hemotocrit
Doctor :  
ok
Doctor :  
cryptogenic cirrhosis is due to XXXXXXXX (nonalcoholic steatohepatitis)
User :   In one of his little older report...

User :   yeah please continue

Doctor :   caused by long standing obesity,
Doctor :  
type 2 diabetes,
Doctor :  
and insulin resistance.
Doctor :  
The fat in the liver of patients with XXXXXXXX is believed to disappear with the onset of cirrhosis
Doctor :   XXXXXXXX is thought to be slow and the diagnosis of cirrhosis typically is made in patients in their sixties.
Doctor :   is your father obese
Doctor :  
wats his ht and wt
User :   as of now weight is 75Kg..and height is around 5'9"
User :  
but when cirrhois detected (June 2008)..his weight was around 70Kg
Doctor :  
ok
Doctor :  
as per his ht and present wt his body mass index comes to 23
Doctor :  
thats over wt\
Doctor :  
his ideal wt is 67- 72 kgs
User :   hmm....
Doctor :  
a reduction of 3-5 kgs will help him a lot
Doctor :  
i will help him to reduce the wt
User :  
he is already following low fat diet
Doctor :   is he able walk without any difficulty
User :  
yeah..
Doctor :  
thats good
User :  
his age is around 62years..but he is perfactly healty..
Doctor :  
does he has jaundice or abdominal swelling
Doctor :  
ok
User :  
yeah he has grown up little tummy recently..
Doctor :  
ok
User :  
but he never had jaundice
Doctor :   as per this type of cirhosis

User :  
doctor had advised him to take less than 1.5ltr liquid everyday...
Doctor :  
the reduction in wt helps in further progression of cirhosis
Doctor :  
ok
Doctor :  
thats right
User :  
fine..
Doctor :  
to prevent ascites
User :   yeah..
Doctor :   recently its found that the mutation in Keratin protien has caused cryptogenic cirhosis

Doctor :  
your know one thing cryptogenic cirhosis is also the commnest indication for liver transplantation
User :   Do you mean we can't do any thing to prevent further deterioation of liver..except liver transplant

Doctor :  
there are few medications which will halt the progress of cirhosis
Doctor :  
other than ciplar is he taking any medications
User :  
yes he do..
Doctor :  
can yu name them
User :   yeah sure..

User :   As per gastroentrologist prescription..he is taking pan-40, Donstral, spacid, duplac

User :  
oflone
Doctor :  
pan 40 is for acidity
Doctor :   its Domstal for nausea and vomiting
Doctor :  
duphalac is to avoid constipation
Doctor :   as constipation can worsen varices
Doctor :  
and even the cirhosis
Doctor :   he is on any liver tonic

Doctor :  
or syrup
User :  
However as per liver specist docoor..he is taking..ocid, zevit, mecobal, evion,
Doctor :  
ok
Doctor :  
thats mainly vitamins
User :   aprat from this he is not taking anything...

Doctor :  
ok
Doctor :  
now coming to treatment part
User :   Can you please recommend any liver tonic

Doctor :  
the liver has tissue is already replaced by the fibrous tissue
Doctor :  
so we need to halt the progression
User :  
yeah
Doctor :  
i will do that for you
Doctor :  
1. regarding diet
User :  
please go ahead
Doctor :  
Proteins: 15%
Carbohydrates: 55%
Doctor :   fat totally reduced
Doctor :   a) take more of green leafy veg
Doctor :  
b) mainly spinach, methi, and palak
Doctor :   c) oil to be limited use safflower oil in limits
Doctor :  
d)water to be restricted to 1.4- 1.5 lts
Doctor :  
e) proteins to be reduced as they contain more ammonia
Doctor :  
ammonia is a waste toxic product
Doctor :  
hi are back
User :   yesh
User :  
yeah
Doctor :  
And, diets high in fat for people with cirrhosis may cause potential digestion problems.
Doctor :   Reduce salt intake
Doctor :   Vegetables such as beets squashes, bitter gourds, egg-plants, tomatoes, carrots, radishes and papayas are useful in this condition.
Doctor :   stop butter, ghee, thick curd, panner
Doctor :  
Raw juice diet for three to five days. During this period a glass of fresh fruit or vegetable juice diluted with water should be taken
Doctor :   Tea, coffee, sugar, white flour and products made with them, all refined foods, fried foods and flesh foods, condiments, pickles,
Doctor :   Especially Beneficial: Red beet, red beet juice, lemon, garlic and cucumber.
Doctor :   regarding exercises aerobic walking
Doctor :  
and breathing is advised
Doctor :  
its very important to take the tablets at a proper time
Doctor :   Syrup. Hepamerz 1 tsp 2 times a day

Doctor :  
for 1-2 months
Doctor :  
its very important not to use
Doctor :  
any pain killers
Doctor :  
as they damage the liver and also a risk for hemetemsis
Doctor :  
hi are yu there
User :  
yeah
Doctor :  
did he take hepatitis B vaccination
User :   Not sure..
Doctor :  
ok
User :  
Should we provide him..
Doctor :  
its not the must
Doctor :  
but to be on a safer side
Doctor :  
finally its Get regular exercise and rest
Doctor :   reduce stress
User :  
now.will there be any side effect of taking additional hepatitis vaccination
Doctor :  
Eat a healthy, well-balanced diet that follows the new
Food Guide Pyramid. This diet is low in fat and salt,
Doctor :   no usually we give three doses of hepatitis B vaccine
Doctor :  
and a booster dose every 5 yrs
Doctor :   because its protection is for only % yrs
Doctor :  
5 yrs
User :  
got it
Doctor :  
please fill the feed back form
Doctor :   not to worry

Doctor :  
every thing will settle
Doctor :  
but it will take little time
Doctor :  
YYYY@YYYY is that correct
User :   yeah

Doctor :  
Is there any thing else I can help you with?
User :   Nothing else..apart from doctor referal in agra...and your contact num..

Doctor :   yes i will do that
Doctor :  
The number is +91-80-0000.



Doctor :   but its chargeble its better yu come for chat
Doctor :  
This is a paid service,
User :   thanks i will...I need some help regarding my subcription..
Doctor :   proceed
User :  
as per last email received ..i can go for maximum 25 sessions..
Doctor :   ok
User :  
how exaclty helath care determine sessions..
Doctor :  
Please allow me to explain
Doctor :   each time you chat with us
Doctor :  
it becomes a session
User :   ok..and how much time i can take in session..

Doctor :  
So you have the facility to log in and chat with us 25 times
Doctor :  
We do not have a limit as of now
Doctor :  
but we assume that a chat will be for one medical query
Doctor :  
for a reasonable period of time
User :  
yeah thats reasonable..
User :  
:)
User :  
Thank you doctor for your help ....
Doctor :   Is there anything that I can help you with, on the medical side?
Doctor :  
Not a problem
Doctor :  
My pleasure
User :  
Nothing...
Doctor :  
Have a nice day then
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