HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
159 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction

Cirrhosis With Esophageal Varices. History Of Encephalopathy. On Lactulose. Unable To Pass Stools. Help

I have patient of cirrhosis with oesophageal varices .15 days back he had hemetemesis and landed into encephalopathy .patient recovered from encephalopathy and endoscopy revealed large bleeding eso.varices. His EVL was done and patient is fine now.there is no hemetemesis. He is on lactulose along with all other supportive therapy.for last two days despite taking lactulose 30 ml. Twice a day patient has not passed stool.should I increase the dose of lactulose or add some other laxative. His intake is not adequate also.on examination he is haemodynamically stable afebrile, no jaundice .no sign of chf/ lvf,his abdomen is soft bowel sounds normal .
Wed, 29 May 2013
Report Abuse
Internal Medicine Specialist 's  Response
Hi,
Welcome to HCM,
After going through the history of the patients, he is having Cirrhosis of liver with portal hypertension with Esophageal Varices.

The cause of hematemesis is varices and EVL (Endoscopic Variceal Ligation) is done to prevent the further bleeding. Blood in intestine causes ammonia level to rise he has recovered from encephalopathy.
Please continue treatment lactulose is good drug can be taken 3 times a day after consulting your treating doctor.
Dietary supplementation with branched-chain amino acids is useful and even addition of probiotics with advise from your doctor may help.
Take care.
good Luck.
Dr.Akhilesh Dubey M.D.
I find this answer helpful

Note: For further follow up on digestive issues share your reports here and Click here.
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer. For a more detailed, immediate answer, try our premium service [Sample answer]
Share on
 

Recent questions on Hepatic encephalopathy


Loading Online Doctors....
Cirrhosis With Esophageal Varices. History Of Encephalopathy. On Lactulose. Unable To Pass Stools. Help

Hi, Welcome to HCM, After going through the history of the patients, he is having Cirrhosis of liver with portal hypertension with Esophageal Varices. The cause of hematemesis is varices and EVL (Endoscopic Variceal Ligation) is done to prevent the further bleeding. Blood in intestine causes ammonia level to rise he has recovered from encephalopathy. Please continue treatment lactulose is good drug can be taken 3 times a day after consulting your treating doctor. Dietary supplementation with branched-chain amino acids is useful and even addition of probiotics with advise from your doctor may help. Take care. good Luck. Dr.Akhilesh Dubey M.D.