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What Causes Swelling Of Feet In Total Liver Failure?
Question: Very concerned about my friend who suffered with alcoholism and had total liver failure 18 months ago. Managed to survive and had been doing very well and alcohol free for 18 months. Recently travelled to Spain from XXXXXXX for holiday for one week and on return, noticed she had very swollen lower limbs. Condition exacerbated over a number of days. Tonight she has severe leg pain - only one limb. Heaviness in both limps and both legs are severely swollen++ and she cannot actually walk at all. Her GP prescribed Ixprim (which concerns me due to her hepatic impairment) and has also doubled her dose of Frusemide. I am VERY concerned.
Brief Answer:
Hyoalbuminemia
Detailed Answer:
Hello
Thanks for the query
Swelling of feet in total liver failure is due to hypoalbuminemia. Hypoalbuminemia in liver disease is because liver helps in the production of albumin and also in these patients the food intake is not sufficiectly rich in proteins. It is a common problem faced in patients with liver disease. Here are my suggestions
1. Swelling of the both lower limbs could be due to hypoalbuminemia however what is of concern is the severe leg pain. Severe leg pain could be due to cellulitis which will require treatment with antibiotics is Tab Clindamycin for 5-7 days. Please continue taking lxprim for the pain
2. Doubling the dose of Frusemide is the only logical next step to reduce the swelling. If the swelling does not reduce then you will have to admit her for IV diuretics.
3. Infusion of albumin will help in these patients but it is very expensive.
4. Look out for jaundice and altered behaviour.
5. Make sure she is passing stools daily, constipation is not a good sign.
6. Let her follow a high carbohydrate diet
I hope I was of help, if you have any further queries please get back to me
Regards
Hyoalbuminemia
Detailed Answer:
Hello
Thanks for the query
Swelling of feet in total liver failure is due to hypoalbuminemia. Hypoalbuminemia in liver disease is because liver helps in the production of albumin and also in these patients the food intake is not sufficiectly rich in proteins. It is a common problem faced in patients with liver disease. Here are my suggestions
1. Swelling of the both lower limbs could be due to hypoalbuminemia however what is of concern is the severe leg pain. Severe leg pain could be due to cellulitis which will require treatment with antibiotics is Tab Clindamycin for 5-7 days. Please continue taking lxprim for the pain
2. Doubling the dose of Frusemide is the only logical next step to reduce the swelling. If the swelling does not reduce then you will have to admit her for IV diuretics.
3. Infusion of albumin will help in these patients but it is very expensive.
4. Look out for jaundice and altered behaviour.
5. Make sure she is passing stools daily, constipation is not a good sign.
6. Let her follow a high carbohydrate diet
I hope I was of help, if you have any further queries please get back to me
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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