Is it necessary to go for liver transplant apart from taking udiliv, ciplar for liver cirrhosis?
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Hi, my father aged 61 years 4 months is diagnosed with liver cirrhosis in XXXXXXX this year. We had done a lot of tests (LFT,KFT,CBC,AFP, etc.) as per the doctor's advise and all parameters are almost normal except PT INR (17, 1.44), Total bilirubin (2.50) and HbA1c (6.5). doctor has performed endoscopy and applied 4 bands also. I wanted to know that how does the medicine my father is taking helps to treat liver cirrhosis (what do they do). UDILIV 400, NEKSIUM 40, CIPLAR 10, EVION 40 & URIMAX 0.4 mg. apart from this he is on a tight sugar controlled diet with low salt diet. though he looks / feels better as compared to what he was during the time when the cirrhosis was diagnosed. he has gained 2 KGs weight in last 3 months, though lost almost 12 KGs in last 12 months. How do you see this and what would be your suggestion on liver transplant, how long one can lead a good life with liver cirrhosis. I also want to mention that my father's gall bladder was removed for gall bladder stone treatment 6 yesrs ago. Regards MXXXXX
Posted Tue, 17 Dec 2013 in Digestion and Bowels
Answered by Dr. Ratnakar Kini 10 hours later
Brief Answer: Detailed answer given below Detailed Answer: Hi, Thanks for posting your query. I am Dr.Ratnakar Kini and I am pleased to assist you. Liver cirrhosis is a condition in which liver is damaged and the normal tissue is replaced by scar tissue. The liver becomes shrunken and its function is affected. In early stages it tries to compesate. But later it gets decompensated and lot of complications occur. There is increased resistance to blood flow through it leading to complications like varices ( engorged blood vessels). These varices may "burst" causing blood vomiting and black stools. Banding and other treatment are given to prevent this. Other complications include accumulation of fluid in the abdomen ( ascites), leg swelling, derangement of kidney and brain function etc. Cirrhosis can occur due to many causes. Some of them are alcohol intake, viral infections hepatitis B and C and non-alcoholic fatty liver disease. Most often, cirrhosis is irreversible and liver transplant is the only definitive treatment. Coming to your question about the medications he is taking - 1. Ciplar - This reduces the pressure in the blood vessels carrying blood to liver and there by decrease the complications like varices and bleeding 2. Urimax - He is having prostatomegaly. This blocks the flow of urine. Urimax tries to relieve this block. Other medications are just supportive medications. Liver transplantation provides the permanent solution. He has to get registered in the organ transplant registry. It is done based on the availability of the donor and the patient's condition ( which is analyzed with certain scoring system). The life expectancy depends on the severity and it is calculated with certain scoring system ( CTP score). I hope that answers your question. Let me know if I can assist you further. Regards, Dr.Ratnakar Kini
Follow-up: Is it necessary to go for liver transplant apart from taking udiliv, ciplar for liver cirrhosis? 1 hour later
Thanks Dr. Kini, but you have not even explained the use of supportive medication (medicine wise) with regards to the liver cirrhosis, especially UDILIV. also, you have not commented on the PT INT, BILIRUBIN, HbA1c scores & relevance on weight loss and regain. i would alos like to know that how would the CTP score be calculated. Kindly help with this query. Thanks & Regards.
Answered by Dr. Ratnakar Kini 30 hours later
Brief Answer: Detailed answer given below Detailed Answer: Hi, If I am right you asked two questions and I have given answers for both the question. And also given a long explanation about cirrhosis and its complications. Since you have more questions, I would try to answer them also. Regarding the medications, only ciplar and urimax have a direct role to play. Ciplar to reduce the pressure and urimax for treating prostate enlargement. Other medications have no direct role to play in either of these conditions. That is why I have clearly mentioned they are "just supportive" medications. Evion is vitamin E, Udiliv facilitates flow of bile from the liver and neksium reduces acidity in stomach. PT/INR is slightly prolonged and albumin is lower than normal which all indicate that the function of liver is affected. It is a feature of chronic liver disease. Bilirubin level alone cannot be taken to analyze ( it is a bit high in his case). It can be included in the CTP score calculation. HbA1C below 7 is considered good and his level is 6.5 which indicates his blood glucose control over the past 3 months is good. Weight gain could indicate accumulation of fluid which has to be confirmed clinically and with certain tests. You have not provided adequate details for me to calculate the CTP score. Online calculators are available to calculate it. Below is one such link - WWW.WWWW.WW You have not mentioned about the encephalopathy factor. The utrasound scan done in July says there is no fluid (ascites). But the current status has not been mentioned. Thats the reason why I could not calculate it for you. Let me know if I can assist you further. Regards, Dr.Ratnakar Kini
Follow-up: Is it necessary to go for liver transplant apart from taking udiliv, ciplar for liver cirrhosis? 16 hours later
Thanks Dr. Kini, your answers are really helpful. Thanks a lot.
Answered by Dr. Ratnakar Kini 36 minutes later
Brief Answer: Welcome Detailed Answer: .
Follow-up: Is it necessary to go for liver transplant apart from taking udiliv, ciplar for liver cirrhosis? 2 days later
Answered by Dr. Ratnakar Kini 3 minutes later