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What Causes Confused Behaviour In A Person Undergoing Treatment For Cirrhosis?

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Posted on Mon, 9 Jan 2017
Question: My wife has cirrhosis and had a bad bout last Friday. We do not know if alcohol was a factor although it most likely was. She has been confused and she cannot seem to remember current goings on. Does not seem to remember her trips to the hospital, etc.
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Answered by Dr. Bonnie Berger-Durnbaugh (2 hours later)
Brief Answer:
Information

Detailed Answer:
Hello,

I am really sorry that your wife is having this difficulty. A few thoughts:

If she recently went through detoxification, perhaps she is on benzodiazepines, which can cause confusion. These are commonly used for sedation and to prevent delirium tremens during withdrawal from alcohol and for a while afterwards. Examples of benzodiazepines are Xanax (alprazolam) and Ativan (lorazepam). If this is the case, you may want to discus with her doctor about decreasing the dose.

Liver disease itself can cause confusion and sedation from elevated serum ammonia levels.

Also, if the liver is not working well, any medications that are processed by the liver can reach high levels and toxicity because they are not being broken down fast enough.

I don't know how soon detox was started, but it can happen sometimes when people withdraw from alcohol too abruptly that they suffer a stroke. This would be lower on my list of what might be going on.

Confusion can happen as a result of acute alcohol withdrawal as well.

I recommend checking what medications she is currently on and discussing with her doctor about whether they may be causing confusion due to poor liver metabolism of drugs.

I also recommend getting the following tests:
Serum ammonia level (ammonia can build up from an impaired liver and cause mental confusion)
CBC and urinalysis (to look for possible infection)
Electrolytes
Glucose (abnormalities in blood sugar can cause confusion too)
Liver function test/panel

I hope this information helps. Please let me know if I can provide further information.



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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3134 Questions

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What Causes Confused Behaviour In A Person Undergoing Treatment For Cirrhosis?

Brief Answer: Information Detailed Answer: Hello, I am really sorry that your wife is having this difficulty. A few thoughts: If she recently went through detoxification, perhaps she is on benzodiazepines, which can cause confusion. These are commonly used for sedation and to prevent delirium tremens during withdrawal from alcohol and for a while afterwards. Examples of benzodiazepines are Xanax (alprazolam) and Ativan (lorazepam). If this is the case, you may want to discus with her doctor about decreasing the dose. Liver disease itself can cause confusion and sedation from elevated serum ammonia levels. Also, if the liver is not working well, any medications that are processed by the liver can reach high levels and toxicity because they are not being broken down fast enough. I don't know how soon detox was started, but it can happen sometimes when people withdraw from alcohol too abruptly that they suffer a stroke. This would be lower on my list of what might be going on. Confusion can happen as a result of acute alcohol withdrawal as well. I recommend checking what medications she is currently on and discussing with her doctor about whether they may be causing confusion due to poor liver metabolism of drugs. I also recommend getting the following tests: Serum ammonia level (ammonia can build up from an impaired liver and cause mental confusion) CBC and urinalysis (to look for possible infection) Electrolytes Glucose (abnormalities in blood sugar can cause confusion too) Liver function test/panel I hope this information helps. Please let me know if I can provide further information.