Chronic Liver Disease

Liver, just below the diaphragm, right side, approximately 2 kilograms in weight dark red color is a soft organ. Necessary to live a lot of chemical events occur here. Liver Duty: – The day is approximately 4 cups 1 liter secretes bile. – Fat, protein and regulates glucose metabolism. – The body’s temperature settings. – Body in need of water and makes vitamin. – Oil, protein, sugar and blood is necessary for the construction materials store, Adjusts the amount of blood. – On the role of hormones is effective.

Liver can not make any of the above-mentioned tasks will become if, various diseases occur. One of the most important ones, liver failure, liver inflammation, liver cirrhosis, gallbladder stones and gallbladder inflammation is.

Chronic alcohol poisoning, chronic liver tract diseases, malaria, syphilis, jaundice in the case of diseases such as severe liver tissue is damaged.

Instead of the tissue collapsed connective tissue typical of cirrhosis occurs. Usually between the ages of 40-60 is seen in men.

Liver swelling: Any liver disease during liver cell swelling and blockage of the bile duct as a result an emerging. In the language of medicine is called hepatitis jaundice. All the tissues of the patient or an even yellow white of eyes is painted. Urine becomes dark. Itching of the skin is visible.

Liver failure:
Liver the result does not do enough in common tasks is a disease. Symptoms of intestinal gas, abdominal swelling, pain in the right flank, nose, reddening, pale color, face and get spots such as freckles, strawberry tongue, bitter mouth, nausea, constipation, palpitation, swelling of the hands and feet, decreased vision and hearing can be seen. Urine color, dark mornings, the day is clear. Urine is much quit. Patient’s chocolate, spicy foods, pickles, fried food, and should not eat fatty things.

Liver Common Symptoms of disease: The patient feels pains in the right flank are in excess of intestinal gas. Swollen abdomen, anus nasty smells coming out of gas. Skin color and sometimes it turns yellow eye whites. Spots on the face and hands are like freckles. Complains of indigestion. In the language of rust and bitterness in the mouth feels in the morning. Breath also smells. Feels pain in the neck in the morning. Palpitations, loss of appetite is. The color of yellow and dark urine in the morning, in the later hours, the clear and open. I often go to the urine. Calf muscles are sore. The hands and feet are swelling. Does not want to sleep at night. Vision and hearing or feeling weak.
a Digestive disorders, mild nausea, loss of appetite, gas first express symptoms.
a They then jaundice, abdominal dropsy, severe symptoms such as weight loss occurs.
a Leather the color of dirty yellow.
a Most of the time hemorrhoids bleeding are seen.

CAUTION :
Abdominal bloating after seeing the treatment of cases not taken seriously go to the road, but unless the patient can live 3-4 years.

A diet rich in protein should be applied, as well liver should be given nutritious vitamins. Alcohol and fries type food should be forbidden.

Frequently Asked Questions

  1. QUESTION:
    Applying for disability for a chronic liver disease?
    Is it possible for me to recieve disability for a chronic liver disease, biliary atresia? It makes my spleen not function as well as it should so I consistently get sick and weak feeling. On top of this, I am physically restrained because I cannot ger overly tired or damage my spleen due to falling, leaning, or pushing against it. Would this make me a candidate?

    • ANSWER:
      Here is a link that may be of help to you.
      According to this: if you have been diagnosed
      with end stage liver disease and have
      biliary atresia….you would be covered under
      disability for 1 year and then be evaluated
      again.

      http://www.ssa.gov/disability/professionals/bluebook/105.00-Digestive-Childhood.htm

      However, when a patient has multiple medical
      conditions, they will take “all “of them into
      account…so it is best to be sure that all are
      listed. If the doctor has placed you under
      any restriction for what you can or cannot do…
      ask if he would write them down. Keep the
      original, but give them a copy of it when you
      send in your application. Having a doctor
      state that you cannot work and placing that
      in writing is a great plus to helping you get
      disability benefits.

      Hope this helps you. To go to the link provided,
      just click on it.

  2. QUESTION:
    how chronic liver disease, esophageal varices and hematemesis are interconnected?
    pathophysiology of how chronic liver disease is connected to hematemesis?

    • ANSWER:

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  3. QUESTION:
    What would be raised on liver function test in chronic liver disease?
    I have unconjugated hyperbilirubinemia serum total is 94umol/L. Everything else is normal?

    • ANSWER:
      The liver cells make enzymes. If the liver cells become damaged,
      then these enzymes would leak out and go higher in the blood.
      These would be the ALT, AST, GGT, and Alkaline phosphatase.

      The liver functions tests are the Albumin, PT, PTT, INR, and the
      Bilirubin.

      Albumin is a protein that the liver cells makes, which holds fluid
      inside our vessels and also transport bilirubin, that is in the blood,
      to the liver. It tends to go lower in the blood as the liver disease
      progresses, since the liver cells are not able to make it efficiently.

      INR, PT, PTT are to check the time that the blood does clot.
      Because the liver cells are damaged, they cannot make the
      clotting factors to help the blood to clock…therefore it would
      take the blood longer to clot in these patients.

      Bilirubin is a substance made from our dead red blood cells.
      This can be done in the spleen or the liver. Bilirubin is
      a pigment (greenish/yellowish) substance that colors other
      things. Unconjugated bilirubin means that it is in the blood
      and the albumin will pick it up to transport to the liver.
      When it reaches the liver, the liver takes it and converts
      it to a soluble form (conjugated) to become part of the
      bile. Bilirubin has to reach a certain level in the blood before
      Jaundice appears (the yellowing of the whites of the eyes and
      skin and the darkening of the urine).

      Because you stated that all other labs were normal….if this is hyperbilirubinemia…
      could be Gilberts syndrome. However, no one blood testing is 100 % accurate.
      The doctor may do more blood tests to see if this returns to the normal range
      before proceeding with further testing. Each lab has it own reference range
      of what they consider to be the normal range of a healthy person.
      I have read that for a first day test, that anything below 99 is considered
      to be normal. You would have to check your lab sheet to see if this is
      considered to be abnormal for you.

      I hope this information has been of some help. Best wishes

  4. QUESTION:
    The most probable causes for chronic liver disease?

    is the most likely alcohol?

    thank you for al the wonderful answers btw!

    • ANSWER:
      Loading your body with more toxins than the liver can get rid of be it alchohol, unhealthy food, drugs or whatever.

  5. QUESTION:
    What exactly is chronic liver disease?
    Is chronic liver disease a name for just one disease–chronic liver cirrhosis? or is it a general name for an array of diseases concerning the liver (Hepatitis C, cirrhosis, chronic liver failure…).

    • ANSWER:
      A chronic disease is one that is long term or recurrent. Hepatitis C can take over 20 years before liver failure starts to appear. Cirrhosis is when there is permanent scarring of the liver that does not go away. The only cure is a liver transplant. It takes many, many years to develop to cirrhosis. Chronic is a term that can be used in all types of diseases and conditions.

  6. QUESTION:
    Could taking 4000 mg of tylenol for 1 week cause chronic liver disease?
    And if so, how long would it take for the liver to get so damaged to need a transplant?

    (It’s for a school paper, thanks)

    • ANSWER:
      possibly yes, tylenol is extremely toxic when broken down by the liver

  7. QUESTION:
    What is the safest antibiotic in Chronic liver disease?for gram positive and gram negative organisms?

    • ANSWER:
      It is in interesting question and is tough to answer without knowing specifically what disease I am looking to treat. But I am going to assume you come into my ER, looking septic, and I am just gonna give you broad spectrum antibiotics until I can culture you and de-escalate from there. I learn along the way you have chronic liver disease. I feel that the use of cefepime and vancomycin would still be warranted because both are renally excreted. Cefepime is cleared primarily by urinary excretion (85%). Vancomycin is cleared primarily by urinary excretion (75%). This may be different in your area, but around here we get a fair amount of community acquired MRSA infections.
      A very generic answer that can change due to many other factors, especially.
      Also, you could add metronidazole for anaerobe coverage. Metronidazole — Excretion: Renal (60-80%)

  8. QUESTION:
    liver echotexture may indicate fatty infiltration or chronic liver disease?
    what does it mean when the diagnose is heterogeneous liver echotexture may indicate fatty infiltratio or chronic liver diseas. No discrete liver lesion seen

    • ANSWER:
      I am going to be honest it is very hard to tell you what this means without the context of what they were looking for. This sounds like an ultrasound reading? The reading does not sound bad to me, you have no lesions (cancer) but could have some changes going on. I am not sure what they were looking for so I cannot help you with this result and what it means to you. Your best bet is to talk to the doctor who ordered this test, ask him/her what he/she was looking for and if anything was found that would require further testing. If you do not know the doctor, take the result to your primary care doctor and talk to them.

  9. QUESTION:
    what is Decompensated Chronic Liver Disease?
    what are the criteria for Decompensated Chronic Liver Disease

    • ANSWER:
      Decompensated liver disease means that the medications and treatments used to treat the cirrhosis is no longer working very well and the liver is near total failure. When symptoms can no longer be controlled with drugs, then that means it is decompensated. It is the very last stage of cirrhosis. Chronic means it is an ongoing problem that does not go away.

  10. QUESTION:
    Is it true that people with chronic liver disease hurt all the time,and if so why?

    • ANSWER:
      What is cirrhosis?

      Cirrhosis is a complication of many liver diseases that is characterized by abnormal structure and function of the liver. The diseases that lead to cirrhosis do so because they injure and kill liver cells, and the inflammation and repair that is associated with the dying liver cells causes scar tissue to form. The liver cells that do not die multiply in an attempt to replace the cells that have died. This results in clusters of newly-formed liver cells (regenerative nodules) within the scar tissue. There are many causes of cirrhosis; they include chemicals (such as alcohol, fat, and certain medications), viruses, toxic metals (such as iron and copper that accumulate in the liver as a result of genetic diseases), and autoimmune liver disease in which the body’s immune system attacks the liver.

      Why does cirrhosis cause problems?

      The liver is an important organ in the body. It performs many critical functions, two of which are producing substances required by the body, for example, clotting proteins that are necessary in order for blood to clot, and removing toxic substances that can be harmful to the body, for example, drugs. The liver also has an important role in regulating the supply to the body of glucose (sugar) and lipids (fat) that the body uses as fuel. In order to perform these critical functions, the liver cells must be working normally, and they must have an intimate relationship with the blood since the substances that are added or removed by the liver are transported to and from the liver by the blood.

      The relationship of the liver to the blood is unique. Unlike most organs in the body, only a small amount of blood is supplied to the liver by arteries. Most of the liver’s supply of blood comes from the intestinal veins as the blood returns to the heart. The main vein that returns blood from the intestines is called the portal vein. As the portal vein passes through the liver, it breaks up into increasingly smaller and smaller veins. The tiniest veins (called sinusoids because of their unique structure) are in close contact with the liver cells. In fact, the liver cells line up along the length of the sinusoids. This close relationship between the liver cells and blood from the portal vein allows the liver cells to remove and add substances to the blood. Once the blood has passed through the sinusoids, it is collected in increasingly larger and larger veins that ultimately form a single vein, the hepatic vein that returns the blood to the heart.

      In cirrhosis, the relationship between blood and liver cells is destroyed. Even though the liver cells that survive or are newly-formed may be able to produce and remove substances from the blood, they do not have the normal, intimate relationship with the blood, and this interferes with the liver cells’ ability to add or remove substances from the blood. In addition, the scarring within the cirrhotic liver obstructs the flow of blood through the liver and to the liver cells. As a result of the obstruction to the flow of blood through the liver, blood “backs-up” in the portal vein, and the pressure in the portal vein increases, a condition called portal hypertension. Because of the obstruction to flow and high pressures in the portal vein, blood in the portal vein seeks other veins in which to return to the heart, veins with lower pressures that bypass the liver. Unfortunately, the liver is unable to add or remove substances from blood that bypasses it. It is a combination of reduced numbers of liver cells, loss of the normal contact between blood passing through the liver and the liver cells, and blood bypassing the liver that leads to many of the manifestations of cirrhosis.

      A second reason for the problems caused by cirrhosis is the disturbed relationship between the liver cells and the channels through which bile flows. Bile is a fluid produced by liver cells that has two important functions: to aid in digestion and to remove and eliminate toxic substances from the body. The bile that is produced by liver cells is secreted into very tiny channels that run between the liver cells that line the sinusoids, called canaliculi. The canaliculi empty into small ducts which then join together to form larger and larger ducts. Ultimately, all of the ducts combine into one duct that enters the small intestine. In this way, bile gets to the intestine where it can help with the digestion of food. At the same time, toxic substances contained in the bile enter the intestine and then are eliminated in the stool. In cirrhosis, the canaliculi are abnormal and the relationship between liver cells and canaliculi is destroyed, just like the relationship between the liver cells and blood in the sinusoids. As a result, the liver is not able to eliminate toxic substances normally, and they can accumulate in the body. To a minor extent, digestion in the intestine also is reduced.

      What are the symptoms and signs of cirrhosis?

      Patients with cirrhosis may have few or no symptoms and signs of liver disease. Some of the symptoms may be nonspecific, that is, they don’t suggest that the liver is their cause. Some of the more common symptoms and signs of cirrhosis include:

      Yellowing of the skin (jaundice) due to the accumulation of bilirubin in the blood
      Fatigue
      Weakness
      Loss of appetite
      Itching
      Easy bruising from decreased production of blood clotting factors by the diseased liver.
      Patients with cirrhosis also develop symptoms and signs from the complications of cirrhosis that are discussed next.

      What are the complications of cirrhosis?

      Edema and ascites

      As cirrhosis of the liver becomes severe, signals are sent to the kidneys to retain salt and water in the body. The excess salt and water first accumulates in the tissue beneath the skin of the ankles and legs because of the effect of gravity when standing or sitting. This accumulation of fluid is called edema or pitting edema. (Pitting edema refers to the fact that pressing a fingertip firmly against an ankle or leg with edema causes an indentation in the skin that persists for some time after release of the pressure. Actually, any type of pressure, such as from the elastic band of a sock, may be enough to cause pitting.) The swelling often is worse at the end of a day after standing or sitting and may lessen overnight as a result of the loss of the effects of gravity when lying down. As cirrhosis worsens and more salt and water are retained, fluid also may accumulate in the abdominal cavity between the abdominal wall and the abdominal organs. This accumulation of fluid (called ascites) causes swelling of the abdomen, abdominal discomfort, and increased weight.

      Spontaneous bacterial peritonitis (SBP)

      Fluid in the abdominal cavity (ascites) is the perfect place for bacteria to grow. Normally, the abdominal cavity contains a very small amount of fluid that is able to resist infection well, and bacteria that enter the abdomen (usually from the intestine) are killed or find their way into the portal vein and to the liver where they are killed. In cirrhosis, the fluid that collects in the abdomen is unable to resist infection normally. In addition, more bacteria find their way from the intestine into the ascites. Therefore, infection within the abdomen and the ascites, referred to as spontaneous bacterial peritonitis or SBP, is likely to occur. SBP is a life- threatening complication. Some patients with SBP have no symptoms, while others have fever, chills, abdominal pain and tenderness, diarrhea, and worsening ascites.

      Bleeding from esophageal varices

      In the cirrhotic liver, the scar tissue blocks the flow of blood returning to the heart from the intestines and raises the pressure in the portal vein (portal hypertension). When pressure in the portal vein becomes high enough, it causes blood to flow around the liver through veins with lower pressure to reach the heart. The most common veins through which blood bypasses the liver are the veins lining the lower part of the esophagus and the upper part of the stomach.

      As a result of the increased flow of blood and the resulting increase in pressure, the veins in the lower esophagus and upper stomach expand and then are referred to as esophageal and gastric varices; the higher the portal pressure, the larger the varices and the more likely a patient is to bleed from the varices into the esophagus or stomach.

      Bleeding from varices usually is severe and, without immediate treatment, can be fatal. Symptoms of bleeding from varices include vomiting blood (the vomitus can be red blood mixed with clots or “coffee grounds” in appearance, the latter due to the effect of acid on the blood), passing stool that is black and tarry due to changes in the blood as it passes through the intestine (melena), and orthostatic dizziness or fainting (caused by a drop in blood pressure especially when standing up from a lying position).

      Bleeding also may occur from varices that form elsewhere in the intestines, for example, the colon, but this is rare. For reasons yet unknown, patients hospitalized because of actively bleeding esophageal varices have a high risk of developing spontaneous bacterial peritonitis.

      Hepatic encephalopathy

      Some of the protein in food that escapes digestion and absorption is used by bacteria that are normally present in the intestine. While using the protein for their own purposes, the bacteria make substances that they release into the intestine. These substances then can be absorbed into the body. Some of these substances, for example, ammonia, can have toxic effects on the brain. Ordinarily, these toxic substances are carried from the intestine in the portal vein to the liver where they are removed from the blood and detoxified.

      As previously discussed, when cirrhosis is present, liver cells cannot function normally either because they are damaged or because they have lost their normal relationship with the blood. In addition, some of the blood in the portal vein bypasses the liver through other veins. The result of these abnormalities is that toxic substances cannot be removed by the liver cells, and, instead, the toxic substances accumulate in the blood.

      When the toxic substances accumulate sufficiently in the blood, the function of the brain is impaired, a condition called hepatic encephalopathy. Sleeping during the day rather than at night (reversal of the normal sleep pattern) is among the earliest symptoms of hepatic encephalopathy. Other symptoms include irritability, inability to concentrate or perform calculations, loss of memory, confusion, or depressed levels of consciousness. Ultimately, severe hepatic encephalopathy causes coma and death.

      The toxic substances also make the brains of patients with cirrhosis very sensitive to drugs that are normally filtered and detoxified by the liver. Doses of many drugs that normally are detoxified by the liver have to be reduced to avoid a toxic buildup in cirrhosis, particularly sedatives and drugs that are used to promote sleep. Alternatively, drugs may be used that do not need to be detoxified or eliminated from the body by the liver, for example, drugs that are eliminated by the kidneys.

      Hepatorenal syndrome

      Patients with worsening cirrhosis can develop the hepatorenal syndrome. This syndrome is a serious complication in which the function of the kidneys is reduced. It is a functional problem in the kidneys, that is, there is no physical damage to the kidneys. Instead, the reduced function is due to changes in the way the blood flows through the kidneys themselves. The hepatorenal syndrome is defined as progressive failure of the kidneys to clear substances from the blood and produce adequate amounts of urine even though some other important functions of the kidney, such as retention of salt, are maintained. If liver function improves or a healthy liver is transplanted into a patient with hepatorenal syndrome, the kidneys usually begin to work normally. This suggests that the reduced function of the kidneys is the result of the accumulation of toxic substances in the blood when the liver fails. There are two types of hepatorenal syndrome. One type occurs gradually over months. The other occurs rapidly over a week or two.

      Hepatopulmonary syndrome

      Rarely, some patients with advanced cirrhosis can develop the hepatopulmonary syndrome. These patients can experience difficulty breathing because certain hormones released in advanced cirrhosis cause the lungs to function abnormally. The basic problem in the lung is that not enough blood flows through the small blood vessels in the lungs that are in contact with the alveoli (air sacs) of the lungs. Blood flowing through the lungs is shunted around the alveoli and cannot pick up enough oxygen from the air in the alveoli. As a result the patient experiences shortness of breath, particularly with exertion.

      Hypersplenism

      The spleen normally acts as a filter to remove older red blood cells, white blood cells, and platelets (small particles that are important for the clotting of blood.). The blood that drains from the spleen joins the blood in the portal vein from the intestines. As the pressure in the portal vein rises in cirrhosis, it increasingly blocks the flow of blood from the spleen. The blood “backs-up” and accumulates in the spleen, and the spleen swells in size, a condition referred to as splenomegaly. Sometimes, the spleen is so swollen that it causes abdominal pain.

      As the spleen enlarges, it filters out more and more of the blood cells and platelets until their numbers in the blood are reduced. Hypersplenism is the term used to describe this condition, and it is associated with a low red blood cell count (anemia), low white blood cell count (leucopenia), and/or a low platelet count (thrombocytopenia). The anemia can cause weakness, the leucopenia can lead to infections, and the thrombocytopenia can impair the clotting of blood and result in prolonged bleeding.

      Liver cancer (hepatocellular carcinoma)

      Cirrhosis due to any cause increases the risk of primary liver cancer (hepatocellular carcinoma). Primary refers to the fact that the tumor originates in the liver. A secondary liver cancer is one that originates elsewhere in the body and spreads (metastasizes) to the liver.

      The most common symptoms and signs of primary liver cancer are abdominal pain and swelling, an enlarged liver, weight loss, and fever. In addition, liver cancers can produce and release a number of substances, including ones that cause an increased in red blood cell count (erythrocytosis), low blood sugar (hypoglycemia), and high blood calcium (hypercalcemia). For more, please read the Liver Cancer article.

      What are the common causes of cirrhosis?

      Alcohol is a very common cause of cirrhosis, particularly in the Western world. The development of cirrhosis depends upon the amount and regularity of alcohol intake. Chronic, high levels of alcohol consumption injure liver cells. Thirty percent of individuals who drink daily at least eight to sixteen ounces of hard liquor or the equivalent for fifteen or more years will develop cirrhosis. Alcohol causes a range of liver diseases; from simple and uncomplicated fatty liver (steatosis), to the more serious fatty liver with inflammation (steatohepatitis or alcoholic hepatitis), to cirrhosis.
      Nonalcoholic fatty liver disease (NAFLD) refers to a wide spectrum of liver diseases that, like alcoholic liver disease, ranges from simple steatosis, to nonalcoholic steatohepatitis (NASH), to cirrhosis. All stages of NAFLD have in common the accumulation of fat in liver cells. The term nonalcoholic is used because NAFLD occurs in individuals who do not consume excessive amounts of alcohol, yet, in many respects, the microscopic picture of NAFLD is similar to what can be seen in liver disease that is due to excessive alcohol. NAFLD is associated with a condition called insulin resistance, which, in turn, is associated with the metabolic syndrome and diabetes mellitus type 2. Obesity is the most important cause of insulin resistance, metabolic syndrome, and type 2 diabetes. NAFLD is the most common liver disease in the United States and is responsible for 24% of all liver disease. In fact, the number of livers that are transplanted for NAFLD-related cirrhosis is on the rise. Public health officials are worried that the current epidemic of obesity will dramatically increase the development of NAFLD and cirrhosis in the population. For more, please read the Fatty Liver article.
      Cryptogenic cirrhosis (cirrhosis due to unidentified causes) is a common reason for liver transplantation. It is termed cryptogenic cirrhosis because for many years doctors have been unable to explain why a proportion of patients developed cirrhosis. Doctors now believe that cryptogenic cirrhosis is due to NASH (nonalcoholic steatohepatitis) caused by long standing obesity, type 2 diabetes, and insulin resistance. The fat in the liver of patients with NASH is believed to disappear with the onset of cirrhosis, and this has made it difficult for doctors to make the connection between NASH and cryptogenic cirrhosis for a long time. One important clue that NASH leads to cryptogenic cirrhosis is the finding of a high occurrence of NASH in the new livers of patients undergoing liver transplant for cryptogenic cirrhosis. Finally, a study from France suggests that patients with NASH have a similar risk of developing cirrhosis as patients with long standing infection with hepatitis C virus. (See discussion that follows.) However, the progression to cirrhosis from NASH is thought to be slow and the diagnosis of cirrhosis typically is made in patients in their sixties.
      Chronic viral hepatitis is a condition where hepatitis B or hepatitis C virus infects the liver for years. Most patients with viral hepatitis will not develop chronic hepatitis and cirrhosis. For example, the majority of patients infected with hepatitis A recover completely within weeks, without developing chronic infection. In contrast, some patients infected with hepatitis B virus and most patients infected with hepatitis C virus develop chronic hepatitis, which, in turn, causes progressive liver damage and leads to cirrhosis, and, sometimes, liver cancers.
      Inherited (genetic) disorders result in the accumulation of toxic substances in the liver which lead to tissue damage and cirrhosis. Examples include the abnormal accumulation of iron (hemochromatosis) or copper (Wilson’s disease). In hemochromatosis, patients inherit a tendency to absorb an excessive amount of iron from food. Over time, iron accumulation in different organs throughout the body causes cirrhosis, arthritis, heart muscle damage leading to heart failure, and testicular dysfunction causing loss of sexual drive. Treatment is aimed at preventing damage to organs by removing iron from the body through bloodletting (removing blood). In Wilson disease, there is an inherited abnormality in one of the proteins that controls copper in the body. Over time, copper accumulates in the liver, eyes, and brain. Cirrhosis, tremor, psychiatric disturbances and other neurological difficulties occur if the condition is not treated early. Treatment is with oral medication that increases the amount of copper that is eliminated from the body in the urine.
      Primary biliary cirrhosis (PBC) is a liver disease caused by an abnormality of the immune system that is found predominantly in women. The abnormal immunity in PBC causes chronic inflammation and destruction of the small bile ducts within the liver. The bile ducts are passages within the liver through which bile travels to the intestine. Bile is a fluid produced by the liver that contains substances required for digestion and absorption of fat in the intestine, as well as other compounds that are waste products, such as the pigment bilirubin. (Bilirubin is produced by the breakdown of hemoglobin from old red blood cells.). Along with the gallbladder, the bile ducts make up the biliary tract. In PBC, the destruction of the small bile ducts blocks the normal flow of bile into the intestine. As the inflammation continues to destroy more of the bile ducts, it also spreads to destroy nearby liver cells. As the destruction of the hepatocytes proceeds, scar tissue (fibrosis) forms and spreads throughout the areas of destruction. The combined effects of progressive inflammation, scarring, and the toxic effects of accumulating waste products culminates in cirrhosis. For more, please read the Primary Biliary Cirrhosis article.
      Primary sclerosing cholangitis (PSC) is an uncommon disease found frequently in patients with ulcerative colitis (see Ulcerative Colitis article). In PSC, the large bile ducts outside of the liver become inflamed, narrowed, and obstructed. Obstruction to the flow of bile leads to infections of the bile ducts and jaundice and eventually causes cirrhosis. In some patients, injury to the bile ducts (usually as a result of surgery) also can cause obstruction and cirrhosis of the liver.
      Autoimmune hepatitis is a liver disease caused by an abnormality of the immune system that is found more commonly in women. The abnormal immune activity in autoimmune hepatitis causes progressive inflammation and destruction of liver cells (hepatocytes), leading ultimately to cirrhosis.
      Infants can be born without bile ducts (biliary atresia) and ultimately develop cirrhosis. Other infants are born lacking vital enzymes for controlling sugars that leads to the accumulation of sugars and cirrhosis. On rare occasions, the absence of a specific enzyme can cause cirrhosis and scarring of the lung (alpha 1 antitrypsin deficiency).
      Less common causes of cirrhosis include unusual reactions to some drugs and prolonged exposure to toxins, as well as chronic heart failure (cardiac cirrhosis). In certain parts of the world (particularly Northern Africa), infection of the liver with a parasite (schistosomiasis) is the most common cause of liver disease and cirrhosis.

      How is cirrhosis diagnosed and evaluated?

      The single best test for diagnosing cirrhosis is biopsy of the liver. Liver biopsies, however, carry a small risk for serious complications, and, therefore, biopsy often is reserved for those patients in whom the diagnosis of the type of liver disease or the presence of cirrhosis is not clear. The possibility of cirrhosis may be suggested by the history, physical examination, or routine testing. If cirrhosis is present, other tests can be used to determine the severity of the cirrhosis and the presence of complications. Tests also may be used to diagnose the underlying disease that is causing the cirrhosis. The following are some examples of how doctors discover, diagnose and evaluate cirrhosis:

      In taking a patient’s history, the physician may uncover a history of excessive and prolonged intake of alcohol, a history of intravenous drug abuse, or a history of hepatitis. These pieces of information suggest the possibility of liver disease and cirrhosis.
      Patients who are known to have chronic viral hepatitis B or C have a higher probability of having cirrhosis.
      Some patients with cirrhosis have enlarged livers and/or spleens. A doctor can often feel (palpate) the lower edge of an enlarged liver below the right rib cage and feel the tip of the enlarged spleen below the left rib cage. A cirrhotic liver also feels firmer and more irregular than a normal liver.
      Some patients with cirrhosis, particularly alcoholic cirrhosis, have small red spider-like markings (telangiectasias) on the skin, particularly on the chest, that are made up of enlarged, radiating blood vessels. These spider telangiectasias also can be seen in individuals without liver disease, however.
      Jaundice (yellowness of the skin and of the whites of the eyes due to elevated bilirubin in the blood) is common among patients with cirrhosis, but jaundice can occur in patients with liver diseases without cirrhosis and other conditions such as hemolysis (excessive break down of red blood cells).
      Swelling of the abdomen (ascites) and/or the lower extremities (edema) due to retention of fluid is common among patients with cirrhosis though other diseases can cause them commonly, e.g., congestive heart failure.
      Patients with abnormal copper deposits in their eyes or certain types of neurologic disease may have Wilson’s disease, a genetic disease in which there is abnormal handling and accumulation of copper throughout the body, including the liver, that can lead to cirrhosis.
      Esophageal varices may be found unexpectedly during upper endoscopy (EGD), and they strongly suggesting cirrhosis.
      Computerized tomography (CT or CAT) or magnetic resonance imaging (MRI) scans and ultrasound examinations of the abdomen done for reasons other than evaluating the possibility of liver disease may unexpectedly detect enlarged livers, abnormally nodular livers, enlarged spleens, and fluid in the abdomen that suggest cirrhosis.
      Advanced cirrhosis leads to a reduced level of albumin in the blood and reduced blood clotting factors due to the loss of the liver’s ability to produce these proteins. Thus, reduced levels of albumin in the blood or abnormal bleeding suggest cirrhosis.
      Abnormal elevation of liver enzymes in the blood (such as ALT and AST) that are obtained routinely as part of yearly health examinations suggests inflammation or injury to the liver from many causes as well as cirrhosis.
      Patients with elevated levels of iron in their blood may have hemochromatosis, a genetic disease of the liver in which iron is handled abnormally and which leads to cirrhosis.
      Auto-antibodies (antinuclear antibody, anti-smooth muscle antibody and anti-mitochondrial antibody) sometimes are detected in the blood and may be a clue to the presence of autoimmune hepatitis or primary biliary cirrhosis, both of which can lead to cirrhosis.
      Liver cancer (hepatocellular carcinoma) may be detected by CT and MRI scans or ultrasound of the abdomen. Liver cancer most commonly develops in individuals with underlying cirrhosis.
      If there is an accumulation of fluid in the abdomen, a sample of the fluid can be removed using a long needle. The fluid then can be examined and tested. The results of testing may suggest the presence of cirrhosis as the cause of the fluid.

      How is cirrhosis treated?

      Treatment of cirrhosis includes 1) preventing further damage to the liver, 2) treating the complications of cirrhosis, 3) preventing liver cancer or detecting it early, and 4) liver transplantation.

      Preventing further damage to the liver

      Consume a balanced diet and one multivitamin daily. Patients with PBC with impaired absorption of fat soluble vitamins may need additional vitamins D and K.
      Avoid drugs (including alcohol) that cause liver damage. All patients with cirrhosis should avoid alcohol. Most patients with alcohol induced cirrhosis experience an improvement in liver function with abstinence from alcohol. Even patients with chronic hepatitis B and C can substantially reduce liver damage and slow the progression towards cirrhosis with abstinence from alcohol.
      Avoid nonsteroidal antiinflammatory drugs (NSAIDs, e.g., ibuprofen). Patients with cirrhosis can experience worsening of liver and kidney function with NSAIDs.
      Eradicate hepatitis B and hepatitis C virus by using anti-viral medications. Not all patients with cirrhosis due to chronic viral hepatitis are candidates for drug treatment. Some patients may experience serious deterioration in liver function and/or intolerable side effects during treatment. Thus, decisions to treat viral hepatitis have to be individualized, after consulting with doctors experienced in treating liver diseases (hepatologists).
      Remove blood from patients with hemochromatosis to reduce the levels of iron and prevent further damage to the liver. In Wilson’s disease, medications can be used to increase the excretion of copper in the urine to reduce the levels of copper in the body and prevent further damage to the liver.
      Suppress the immune system with drugs such as prednisone and azathioprine (Imuran) to decrease inflammation of the liver in autoimmune hepatitis.
      Treat patients with PBC with a bile acid preparation, ursodeoxycholic acid (UDCA), also called ursodiol (Actigall). Results of an analysis that combined the results from several clinical trials showed that UDCA increased survival among PBC patients during 4 years of therapy. The development of portal hypertension also was reduced by the UDCA. It is important to note that despite producing clear benefits, UDCA treatment primarily retards progression and does not cure PBC. Other medications such as colchicine and methotrexate also may have benefit in subsets of patients with PBC.
      Immunize patients with cirrhosis against infection with hepatitis A and B to prevent a serious deterioration in liver function. There are currently no vaccines available for immunizing against hepatitis C.
      Treating the complications of cirrhosis

      Edema and ascites. Retention of salt and water can lead to swelling of the ankles and legs (edema) or abdomen (ascites) in patients with cirrhosis. Doctors often advise patients with cirrhosis to restrict dietary salt (sodium) and fluid to decrease edema and ascites. The amount of salt in the diet usually is restricted to 2 grams per day and fluid to 1.2 liters per day. In most patients with cirrhosis, however, salt and fluid restriction is not enough, and diuretics have to be added.

      Diuretics are medications that work in the kidneys to promote the elimination of salt and water into the urine. A combination of the diuretics spironolactone (Aldactone) and furosemide can reduce or eliminate the edema and ascites in most patients. During treatment with diuretics, it is important to monitor the function of the kidneys by measuring blood levels of blood urea nitrogen (BUN) and creatinine to determine if too much diuretic is being used. Too much diuretic can lead to kidney dysfunction that is reflected in elevations of the BUN and creatinine levels in the blood.

      Sometimes, when the diuretics do not work (in which case the ascites is said to be refractory), a long needle or catheter is used to draw out the ascitic fluid directly from the abdomen, a procedure called abdominal paracentesis. It is common to withdraw large amounts (liters) of fluid from the abdomen when the ascites is causing painful abdominal distension and/or difficulty breathing because it limits the movements of the diaphragms.

      Another treatment for refractory ascites is a procedure called transjugular intravenous portosystemic shunting (TIPS, see below).

      Bleeding from varices. If large varices develop in the esophagus or upper stomach, patients with cirrhosis are at risk for serious bleeding due to rupture of these varices. Once varices have bled, they tend to rebleed and the probability that a patient will die from each bleeding episode is high (30%-35%). Therefore, treatment is necessary to prevent the first (initial) bleeding episode as well as rebleeding. Treatments include medications and procedures to decrease the pressure in the portal vein and procedures to destroy the varices.

      Propranolol (Inderal), a beta blocker, is effective in lowering pressure in the portal vein and is used to prevent initial bleeding and rebleeding from varices in patients with cirrhosis. Another class of oral medications that lowers portal pressure is the nitrates, for example, isosorbide dinitrate ( Isordil). Nitrates often are added to propranolol if propranolol alone does not adequately lower portal pressure or prevent bleeding.
      Octreotide (Sandostatin) also decreases portal vein pressure and has been used to treat variceal bleeding.
      During upper endoscopy (EGD), either sclerotherapy or band ligation can be performed to obliterate varices and stop active bleeding and prevent rebleeding. Sclerotherapy involves infusing small doses of sclerosing solutions into the varices. The sclerosing solutions cause inflammation and then scarring of the varices, obliterating them in the process. Band ligation involves applying rubber bands around the varices to obliterate them. (Band ligation of the varices is analogous to rubber banding of hemorrhoids.) Complications of sclerotherapy include esophageal ulcers, bleeding from the esophageal ulcers, esophageal perforation, esophageal stricture (narrowing due to scarring that can cause dysphagia), mediastinitis (inflammation in the chest that can cause chest pain), pericarditis (inflammation around the heart that can cause chest pain), and peritonitis (infection in the abdominal cavity). Studies have shown that band ligation may be slightly more effective with fewer complications than sclerotherapy.
      Transjugular intrahepatic portosystemic shunt (TIPS) is a non-surgical procedure to decrease the pressure in the portal vein. TIPS is performed by a radiologist who inserts a stent (tube) through a neck vein, down the inferior vena cava and into the hepatic vein within the liver. The stent then is placed so that one end is in the high pressure portal vein and the other end is in the low pressure hepatic vein. This tube shunts blood around the liver and by so doing lowers the pressure in the portal vein and varices and prevents bleeding from the varices. TIPS is particularly useful in patients who fail to respond to beta blockers, variceal sclerotherapy, or banding. (TIPS also is useful in treating patients with ascites that do not respond to salt and fluid restriction and diuretics.) TIPS can be used in patients with cirrhosis to prevent variceal bleeding while the patients are waiting for liver transplantation. The most common side effect of TIPS is hepatic encephalopathy. Another major problem with TIPS is the development of narrowing and occlusion of the stent, causing recurrence of portal hypertension and variceal bleeding and ascites. The estimated frequency of stent occlusion ranges from 30%-50% in 12 months. Fortunately, there are methods to open occluded stents. Other complications of TIPS include bleeding due to inadvertent puncture of the liver capsule or a bile duct, infection, heart failure, and liver failure.
      A surgical operation to create a shunt (passage) from the high-pressure portal vein to veins with lower pressure can lower blood flow and pressure in the portal vein and prevent varices from bleeding. One such surgical procedure is called distal splenorenal shunt (DSRS). It is appropriate to consider such a surgical shunt for patients with portal hypertension who have early cirrhosis. (The risks of major shunt surgery in these patients is less than in patients with advanced cirrhosis.) During DSRS, the surgeon detaches the splenic vein from the portal vein, and attaches it to the renal vein. Blood then is shunted from the spleen around the liver, lowering the pressure in the portal vein and varices and preventing bleeding from the varices.
      Hepatic encephalopathy. Patients with an abnormal sleep cycle, impaired thinking, odd behavior, or other signs of hepatic encephalopathy usually should be treated with a low protein diet and oral lactulose. Dietary protein is restricted because it is a source of the toxic compounds that cause hepatic encephalopathy. Lactulose, which is a liquid, traps the toxic compounds in the colon. Consequently, they cannot be absorbed into the blood stream and cause encephalopathy. To be sure that adequate lactulose is present in the colon at all times, the patient should adjust the dose to produce 2-3 semiformed bowel movements a day. (Lactulose is a laxative, and the adequacy of treatment can be judged by loosening or increasing frequency of stools.) If symptoms of encephalopathy persist, oral antibiotics such as neomycin or metronidazole (Flagyl), can be added to the treatment regimen. Antibiotics work by blocking the production of the toxic compounds by the bacteria in the colon.

      Hypersplenism. The filtration of blood by an enlarged spleen usually results in only mild reductions of red blood cells (anemia), white blood cells (leukopenia) and platelets (thrombocytopenia) that do not require treatment. Severe anemia, however, may require blood transfusions or treatment with erythropoietin or epoetin alfa (Epogen, Procrit), hormones that stimulate the production of red blood cells. If the numbers of white blood cells are severely reduced, another hormone called granulocyte-colony stimulating factor is available to increase the numbers of white blood cells. An example of one such factor is filgrastim (Neupogen).

      No approved medication is available yet to increase the number of platelets. As a necessary precaution, patients with low platelets should not use aspirin or other nonsteroidal antiinflammatory drugs (NSAIDS) since these drugs can hinder the function of platelets. If a low number of platelets is associated with significant bleeding, transfusions of platelets usually should be given. Surgical removal of the spleen (called splenectomy) should be avoided, if possible, because of the risk of excessive bleeding during the operation and the risk of anesthesia in advanced liver disease.

      Spontaneous bacterial peritonitis (SBP). Patients suspected of having spontaneous bacterial peritonitis usually will undergo paracentesis. Fluid that is removed is examined for white blood cells and cultured for bacteria. Culturing involves inoculating a sample of the ascites into a bottle of nutrient-rich fluid that encourages the growth of bacteria, thus facilitating the identification of even small numbers of bacteria. Blood and urine samples often are obtained as well for culturing because many patients with spontaneous bacterial peritonitis also will have infection in their blood and urine. In fact, many doctors believe that infection may have begun in the blood and the urine and spread to the ascitic fluid to cause spontaneous bacterial peritonitis. Most patients with spontaneous bacterial peritonitis are hospitalized and treated with intravenous antibiotics such as ampicillin, gentamycin, and one of the newer generation cephalosporin. Patients usually treated with antibiotics include:

      Patients with blood, urine, and/or ascites fluid cultures that contain bacteria.
      Patients without bacteria in their blood, urine, and ascitic fluid but who have elevated numbers of white blood cells (neutrophils) in the asciticfluid (>250 neutrophils/cc). Elevated neutrophil numbers in ascitic fluid often means that there is bacterial infection. Doctors believe that the lack of bacteria with culturing in some patients with increased neutrophils is due either to a very small number of bacteria or ineffective culturing techniques.
      Spontaneous bacterial peritonitis is a serious infection. It often occurs in patients with advanced cirrhosis whose immune systems are weak, but with modern antibiotics and early detection and treatment, the prognosis of recovering from an episode of spontaneous bacterial peritonitis is good.

      In some patients oral antibiotics (such as Cipro or Septra) can be prescribed to prevent spontaneous bacterial peritonitis. Not all patients with cirrhosis and ascites should be treated with antibiotics to prevent spontaneous bacterial peritonitis, but some patients are at high risk for developing spontaneous bacterial peritonitis and warrant preventive treatment:

      Patients with cirrhosis who are hospitalized for bleeding varices have a high risk of developing spontaneous bacterial peritonitis and should be started on antibiotics early during the hospitalization to prevent spontaneous bacterial peritonitis
      Patients with recurring episodes of spontaneous bacterial peritonitis
      Patients with low protein levels in the ascitic fluid (Ascitic fluid with low levels of protein is more likely to become infected.)
      Prevention and early detection of liver cancer

      Several types of liver disease that cause cirrhosis are associated with a particularly high incidence of liver cancer, for example, hepatitis B and C, and it would be useful to screen for liver cancer since early surgical treatment or transplantation of the liver can cure the patient of cancer. The difficulty is that the methods available for screening are only partially effective, identifying at best only 50% of patients at a curable stage of their cancer. Despite the partial effectiveness of screening, most patients with cirrhosis, particularly hepatitis B and C, are screened yearly or every six months with ultrasound examination of the liver and measurements of cancer-produced proteins in the blood, e.g. alpha fetoprotein.

      Liver transplantation

      Cirrhosis is irreversible. Many patients’ liver function will gradually worsen despite treatment and complications of cirrhosis will increase and become difficult to treat. Therefore, when cirrhosis is far advanced, liver transplantation often is the only option for treatment. Recent advances in surgical transplantation and medications to prevent infection and rejection of the transplanted liver have greatly improved survival after transplantation. On average, more than 80% of patients who receive transplants are alive after five years. Not everyone with cirrhosis is a candidate for transplantation. Furthermore, there is a shortage of livers to transplant, and there usually is a long (months to years) wait before a liver for transplanting becomes available. Therefore, measures to retard the progression of liver disease and treat and prevent complications of cirrhosis are vitally important.

      What is new and in the future for cirrhosis?

      Progress in the management and prevention of cirrhosis continues. Research is ongoing to determine the mechanism of scar formation in the liver and how this process of scarring can be interrupted or even reversed. Newer and better treatments for viral liver disease are being developed to prevent the progression to cirrhosis. Prevention of viral hepatitis by vaccination, which is available for hepatitis B, is being developed for hepatitis C. Treatments for the complications of cirrhosis are being developed or revised and tested continually. Finally, research is being directed at identifying new proteins in the blood that can detect liver cancer early or predict which patients will develop liver cancer.

      Cirrhosis At A Glance
      Cirrhosis is a complication of liver disease which involves loss of liver cells and irreversible scarring of the liver.
      Alcohol and viral hepatitis B and C are common causes of cirrhosis, although there are many other causes.
      Cirrhosis can cause weakness, loss of appetite, easy bruising, yellowing of the skin (jaundice), itching, and fatigue.
      Diagnosis of cirrhosis can be suggested by the history, physical examination and blood tests, and can be confirmed by liver biopsy.
      Complications of cirrhosis include edema and ascites, spontaneous bacterial peritonitis, bleeding from varices, hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, hypersplenism, and liver cancer.
      Treatment of cirrhosis is designed to prevent further damage to the liver, treat complications of cirrhosis, and preventing or detecting liver cancer early.
      Transplantation of the liver is becoming an important option for treating patients with advanced cirrhosis.

  11. QUESTION:
    I have a chronic liver disease with unusual lab and biopsy findings.?
    Labs: Elevated AST and ALT. GGT is consistently above 500. AP, Bilirubin, PT, LDH are WNL. Hepatitis profile for B and C were wnl. (vaccinated against A in 2000). Sed Rate 40. All ANA tests normal. Cerulugen normal. CBC normal.

    CT shows multiple large cysts consistent with Poly cystic Liver disease without renal involvement. CT showed same density in spleen and liver.

    Biopsy showed occasional cellular edema with Mast Cells, Eosinophils, and some lymphocytes. No fibrosis. Mild patches of fat noted.

    No history of drug or alcohol consumption. Non-smoker.

    Maybe some medical student out there can figure this one out. Ask on of your professors. All the physicians I have seen have no idea other than say it may be combination of conditions.
    additional details:

    University based Hepatologist have already been consulted. They don’t know either

    • ANSWER:
      Figure out what? You have liver disease which has multiorgan impact. What is it that you don’t understand or want us to tell you? Bottom line, liver disease is a complex disease, so just work with you doctors on this. Except for entertainment it’s not a discussion appropriate to YA. Hopefully you have a liver specialist on your team and not just a primary care MD. Good luck.

  12. QUESTION:
    Which pain reliever is safe to use for minor aches with a chronic liver disease patient?

    • ANSWER:
      if possible use liniment such as omega pain reliever, salonpas and other externally applied so as not to cause irritation on your chronic liver desease.

  13. QUESTION:
    Endoscopy for Chronic Liver Disease?
    My Grandma is a CLD (chronic liver disease) patient. She has been diagnosed with it since 3 months. She is also diabetic, around 85 years old.

    Doctor is recommending Endoscopy for her.

    My questions are:

    1) When is Endoscopy necessary for CLD patients?
    2) Keeping in mind her old age and weakness, should I go for her endoscopy? (I am afraid due to her old age).

    • ANSWER:
      I had liver failure and had a transplant. My doctors wanted me to get an endoscopy done every 3-6 months to help lower the risk of me bleeding internally. Unwanted veins called varix can grow inside with liver disease. They are not like the veins we are born with since they can be weak, leak and even burst. Should they be quite large, a person can actually bleed to death in a short time.

      When they do an endoscopy, they can check for these varices. When they see one that could be a problem, they will tie what looks like a little rubber band around it which cuts off its blood supply. Within a few days, the varix will die and fall off taking away the risk of it ever bleeding. The procedure for doing this is called banding. For the most part, endoscopes are quite safe and are low risk for anything to happen, but I certainly understand you questioning how necessary this is at her age. I think a lot would depend on how advanced her liver disease is right now and how much of a risk she has for internal bleeding based on the stage of her disease. Only her doctor is going to be able to answer that.

      They put the patient out with the “twilight” sleep which is not deep anesthesia. There is really no pain or real stress involved in this procedure. They do everything after they put you out. I used to get mine done as an outpatient which took about 2-3 hours total. The actual procedure depending on the banding only takes about 15 minutes or so. I often went shopping after wards even though they suggest you take it easy for the day.

  14. QUESTION:
    Chances of chronic liver disease.?
    my pop has chronic liver disease and has been in hospital on life support in a coma. he is bleeding internally .what are the chances of him beating this? please help.

    • ANSWER:
      Jake, I’m sorry about your Dad. Is there a reason you can’t ask his doctor this question? Sometimes they will be very honest with you, if they know you are ready to hear the truth. Nurses and staff caring for someone on life support also know more than they can say, but sometimes you can engage a nurse in conversation and she will hint at it. This is difficult for the family, especially for the one responsible for the decision to pull the plug. I’ve had to make it with family members, and quite frankly, it sucks. Everyone should have a living will. Here’s one thing to think on until you learn more from the doctor. If his EEG shows brain activity, and the internal bleeding stops, he has a chance. How big a chance, I can’t say, but a chance. If EEG shows no activity, it’s time already.

  15. QUESTION:
    Continued driniking even after Chronic Liver disease.?
    Hi, My father-in-law has been drinking day and night for past one year and has been hospitalized twice since then for Chronic liver disease , this August he was diagnosed to have Chronic liver disease with heptic encephalopathy and was hospitalized for almost 20 days. Doctors strictly asked him to quit drinking , but he resumed regular drinking within a months time. He is also taking his medications along with his drinking problem. How harmful is drinking for him at the moment when his liver is still damaged. Is there any amount of alcohol that is OK for him to take? Is there any side affects of being on liver medications and yet taking alcohol? Please advice what can be done to help him quit drinking and regain his damaged liver.

    • ANSWER:

  16. QUESTION:
    What are the risks to an unborn child if I have chronic liver disease?
    I have had liver disease for a little over nine months. I am now 22 and first got ill when I was 21. The doctors don’t know what caused it (though they keep trying to imply that it was drug use or drink which I am happy to say have never done drugs and did not drink excessively)

    They are telling me that its probably chronic liver disease and I need to know what the risks are if I were to potentially get pregnant.

    If anyone has any experience or information that would be gratefully received.

    Thank you very much
    x!

    • ANSWER:
      Since your doctor knows your history and has possibly performed a physical, can run this past him/her for the absolute right answer for you. I suspect the pregnancy would be very hard on your liver, and all around harder on you than the growing fetus. Doc can also tell you to what degree the liver is functioning, if there are toxins that could harm a fetus, etc.

  17. QUESTION:
    what is the best diet for chronic liver disease?

    • ANSWER:

  18. QUESTION:
    Progressive Chronic Liver Disease?
    is it true that Chronic Hepatitis B and C untreated over few years, has 80% Chance of developing Hepatocellular Carcinoma of the Liver?
    You see, my father passed away at the age of 59 from Hepatocellular carcinoma. as investigated by his previous Liver Specialist, that he was given a treatment medication to control his Hepatitis B and told it will get worse if it stopped. but my fathers regular physcian told him he don’t need to take it if his liver is healthy so my father stopped his treatment after three years of use. After two years of living without Hepatitis treatment, my dad got sick. after many blood or X-ray scans, they have diagnosed him with Chronic Hepatitis B and a stage four of Hepatic Cellular Carcinoma. Since stage four is difficult to treat. it spreaded to his lungs and killed him after being in the hospital for two weeks. after that i wanted to know if it is possible if there are people who got diagnosed with this type of cancer after living without treatment for Hepatitis B.

    • ANSWER:
      My guess is that it is not true because that is quite high to say the least. I know quite a number of people who have hep C and none of them have cancer. I know the risk is higher for anyone having a liver disease, but never heard any statistics even close to this figure.

  19. QUESTION:
    What is the sequence of stages that brings about advanced liver disease caused by chronic alcohol toxicity?
    a. Fat accumulation, fibrosis, cirrhosis

    b. Fibrosis, gout, cirrhosis

    c. Fibrosis, cirrhosis, fat depletion

    d. Cirrhosis, fat accumulation, fibrosis

    • ANSWER:
      Your answer is A.
      Overdosing on alcohol can cause fat
      accumulation inside the liver. This can
      damage the cells of the liver. When
      this happens, the immune system responds
      to this and cause inflammation to develop
      in the liver. This put more pressure on the
      cells and the cells can start to die, forming
      first fibrosis and then this advances to
      cirrhosis of the liver which is death of the
      liver cells and forming of scar tissue inside
      the liver that blocks the flow of blood
      through and to the liver cells…it is a progressive
      disease with no known cure.

  20. QUESTION:
    diuretics drug in chronic liver disease?

    • ANSWER:
      If you mean how diuretics are useful in chronic liver diseases, the answer would be: to treat ascites (the abnormal accumulation of fluid in the abdominal cavity) which could rise as a complication of portal hypertension (increase in the pressure within the branches of the portal vein that run through liver) which is common in chronic liver diseases.

  21. QUESTION:
    about chronic liver disease-my hisband’s weight is 63kg SGOT-423,SGPT-460,NAT-138,K+-4.3?

    • ANSWER:
      There are blood tests that the doctor does to
      check the liver:
      (1)The liver enzymes which will give the doctor
      an idea if the cells of the liver have become
      damaged. (SGOT,SGPT[also known as ALT,
      AST], GGT and Alkaline phosphatase.
      (2)The liver function tests which will give the
      doctor an idea if the liver cells are able to do
      the functions they once did to keep the body
      healthy (Bilirubin, INR, Albumin)
      (3) The viral testing to see if a virus has entered
      the body and gone into the liver and is causing
      problems like Hepatitis A,B,C.

      Your husbands liver enzymes are high.
      The NA is sodium and it is fine. The K is
      potassium and it is also fine.

      There are many things that can cause a problem
      in the liver:
      (1) alcohol consumption (2) medication
      toxification (3) chemical exposure
      (4) hereditary conditions where the body holds
      onto excess amounts of iron or copper
      (5) fatty liver disease caused by any of these: alcohol, weight, diabetes, metabolic problems
      (6) biliary obstruction, malformations, twisting of
      or stricture of (7) viral infections such as Hepatitis A,B,C, etc (8) A deficiency in a enzyme being made by the liver. (9) Cardiac problems (10) Auto immune disease (11) glycogen
      storage disease ….and there are others.

      The doctor has to first find out what the cause
      is before he can be treated. Please remember
      that blood testing is not 100% accurate…the
      doctor may do more to be sure of the results.
      He may do an exam by placing his hand
      on the upper right hand quadrant of the abdomen
      ..just under the rib cage…to see if the liver
      is enlarged. If the liver is enlarged…it means
      that there is inflammation inside the liver because
      the immune system of the body has responded
      to the damage to the liver cells. He may then
      have an ultrasound done to look at the liver
      and see if the blood is flowing well through the
      liver, if it has any nodules or growths and how
      enlarged it is.

      If the cause of the inflammation is removed
      and it is treated, the liver cells can heal.
      However, if it can’t…it can lead to Cirrhosis of
      the liver.

      Your husband should be referred to a
      gastroenterologist or hepatologist if this is
      a true liver problem. The sooner he is
      treated…the more chance of the problem in
      the liver can be reversed.

      Some of the liver enzymes are made in other
      organs, also…therefore you need the results
      of the other blood tests I mentioned to be
      sure it is a problem in the liver/biliary area.

      I hope this information is of some help to you.

  22. QUESTION:
    Anyone KNOW about preg/chronic liver disease?Trusted Dr says your good canidate to terminate.3kids need mom .?

    • ANSWER:

      http://www.naspgn.org/sub/Chronic_liver_disease.htm

  23. QUESTION:
    any chronic painers; liver disease people out there.?
    sister has liver disease dont know what one yet, prob chirosis (spelled wrong). anyhow she has fibermyalgia and takes percocet,oxycontin for the pain. doctor wants her off the meds now ; she drank for years but quit a year ago so . anyone has liver disease and pain, what kind of meds do you take for pain? all testing being done right now, im just trying to ease her fear cause she has alot of pain. only if you are in this situation or know someone please answer. thanks

    • ANSWER:

  24. QUESTION:
    What is chronic parenchymal liver disease?
    My fater aged 65 yrs effected with Pnemonia & hospitalised. Now report shows that he is having CPLD. In the report it is also mentioned that “Liver is coarse echo texture with multiple tiny scatted hypoecholic nodular involving both the lobes of liver” what does this mean. He is also a diabetic patent. While he was hospitalised his blood sugar increased and after giving insulin & other medicines & diet now it is normal. He never have alchohol nor smoke. he is vegitarian. Doctor says that cold lead to Pnemonia. what is the treatment. what is the diet. whether cureable or what precautions to be taken?? Please help.

    • ANSWER:

  25. QUESTION:
    Liver disease with chronic alcohol abuse help?
    Heey :) Im 20 and my mam is a veryy bad alcoholic, she has been drinking litterally everyday for the pst 2 years…brandy and vodka. she is violently ill and is vomitting everyday. she is soo addicted to drink, she just sits in bed all day drinking her brndy until she vomits. She was admitted to a rehab clinic loads of times but keeps checking herself out again, she now has jaundice and cirrosis of the liver. i want to know how long do you think she has left? And cn her liver disease be cured? Honest answers please, and non judgemental! Thanks A Mill (:

    • ANSWER:

  26. QUESTION:
    Prevalence of cirrhosis/liver disease in Japan?
    Does anyone know the prevalence of chronic liver disease and cirrhosis in Japan? I can’t seem to find it anywhere. If you have an internet source confirming it, that would be great. Thanks.

    • ANSWER:
      I found this article about cirrhosis in Japan… (the web url got cut off…it’s one website, so you have to connect the two parts!)

      http://ije.oxfordjournals.org/ cgi/content/abstract/20/4/921

      I hope it helped?!

  27. QUESTION:
    I’m 29 w/ chronic kidney disease for 4yrs, tylenol induced liver disease 3yrs. Wil I get kidney failure?
    I recently had another kidney infection and I was wondering if I take care of myself if I will get kidney failure eventually. My infection was about 3 weeks ago and my urologist think I still may have it. If you have any exp on this please let me know. I’m a single mother of 3 children and have been very weak, tired and have lost over 50 pounds in 11 months. My last urine tests are below perhaps if you know anything about them as well.. it’d be helpful. I was also peeing blood clots brown and stringy (yucky I know). But I go next week to get an ultrasound and ct scan on my kidneys. How likely is it that I die from kidney or liver disease?

    spec gravity 1.005
    ph 8
    leukocytes 1+
    nitrates neg
    protein trace
    glucose neg
    ketones neg
    urobillnogin neg
    billirubin 1+
    blood trace

    assement 599.0

    Thanks for your help any information would be greatly appreciated.
    I recently had another kidney infection and I was wondering if I take care of myself if I will get kidney failure eventually. My infection was about 3 weeks ago and my urologist think I still may have it. If you have any exp on this please let me know. I’m a single mother of 3 children and have been very weak, tired and have lost over 50 pounds in 11 months. My last urine tests are below perhaps if you know anything about them as well.. it’d be helpful. I was also peeing blood clots brown and stringy (yucky I know). But I go next week to get an ultrasound and ct scan on my kidneys. How likely is it that I die from kidney or liver disease?

    spec gravity 1.005
    ph 8
    leukocytes 1+
    nitrates neg
    protein trace
    glucose neg
    ketones neg
    urobillnogin neg
    billirubin 1+
    blood trace

    assement 599.0

    Thanks for your help any information would be greatly appreciated.

    Okay I have had kidney disease for 4 years it was diagnosed 5/?/04. I had a kidney infection but have the disease.

    • ANSWER:
      When you said you had “chronic kidney disease for 4yrs”, do you mean recurrent kidney infections? Or something else — like being told by your doctor that you have proteins in your urine, or that your kidneys are not functioning at 100%?

      Chronic Kidney Disease (CKD) is actually a medical entity with a very specific set of definitions: http://www.kidney.org/professionals/kdoqi/guidelines_ckd/p4_class_g1.htm
      On the other hand, people can have recurrent urinary infections without ANY kidney disease — their infections stay in the bladder, and never involve the kidneys themselves.

      To know whether your infections have actually done damage to the kidneys, you need blood tests (such as “creatinine” and “blood urea nitrogen”) in addition to urine tests. For example, kidney failure (medically known as End-Stage Renal Disease) usually does not occur until the creatinine goes above 4 or 5 (normal being around 1). It will be very helpful if you have your blood test results.

      Finally, your urine test is consistent with a urinary tract infection, but it does not tell us whether the infection is only in the bladder, or in the kidney(s) as well.

      The ultrasound and CT scan will look at the sizes of your kidneys (kidneys damaged by severe CKD tend to be smaller), but also see if the tubes connecting the kidneys to the bladder (ureters) are stretched by stagnant urine flow.

      I’m sure you will have more questions after the scans are done. Feel free to ask more questions then.

      Good luck.

  28. QUESTION:
    What are some things that are harmful to your liver?
    I’m doing a project on the liver (organ) and I need to know about 2 other things that you can do to harm it. For example, The abuse of alcohol shuts down your liver, causing a chronic liver disease called cirrhosis (which is caused by alcoholism, hepatitis b, hepatitis c and fatty liver disease).

    What are 2 other things you can to do harm your liver and what can that lead to?

    • ANSWER:
      There are a number of causes of a liver problem
      that can lead to cirrhosis of the liver:

      Alcohol consumption: some people are
      more sensitive to alcohol than others are.
      When the liver cannot handle the amount
      of alcohol taken into the body, then it
      stays in the blood and goes into the
      brain and causes a reaction there.
      The liver converts all toxic substances
      to a non toxic form so the body can
      dispose of them…however, this may not
      happen if the patient consumes too much
      alcohol and the liver cannot convert it
      fast enough…the alcohol itself, and its
      by product, can produce damage to the
      liver cells.

      Medication toxifications: it has been shown that acetaminophen taken with alcohol can cause permanent liver cell damage almost immediately. There are a lot of drugs on the market, including over the counter, herbs, and even prescription drugs that are very hard on the liver. Most all medications go through the liver first, to be broken down, before going to the rest of the body.
      Liver patients are told to only takes drugs
      prescribed by their doctors…if the liver
      cells become damaged…then this medication has to be adjusted according
      to how much damage there is.

      Chemical exposure: such as Carbon
      Tetrachloride..

      Mushroom poisoning: some people try to pick their own mushrooms…not knowing that some are very dangerous. This
      also can cause immediate damage to
      the cells of the liver and a very early death.

      Autoimmune disease: this is where the body’s immune system, turns on itself and causes destruction of its own cells. This can be a disease like Biliary cirrhosis or Sclerosing Cholangitis. In Sclerosing
      cholangitis…the bile ducts that the bile
      flows through from the liver to the
      gallbladder to be stored or to the intestines,
      become twisted or malformed.

      Hereditary Conditions: like Hemochromatosis where the body tend to retain iron too much. Or a disease where it retains copper.

      Gallbladder stones development where the
      stones move out of the gallbladder and into the biliary ducts and blocks them causing the bile to back up into the liver and harming the cells.

      Virus infections such as Hepatitis A,B,C,etc.

      Fatty liver disease which is caused by alcohol or non alcoholic reasons like hereditary conditions, weight, or metabolism problems.

      (There is even having a traffic accident where the liver may be lacerated or injured.
      Being gun shot or even stabbed with a knife.
      Sometimes sports accidents can also
      damage the liver.)

      Hepatitis is inflammation of the liver cells caused by any of those things I mentioned above. Any damage to the liver cells can cause the immune system of the body to respond to it and cause this inflammation.

      A liver is usually very smooth and soft…anyone that has cooked liver knows what it looks like. When inflammation develops, then it enlarges in size and takes on a spongy appearance. This inflammation cause more pressure inside the liver cause the liver is surrounded by a capsule membrane.

      If the inflammation is treated and the cause can be removed (as you can see, some cannot be removed)..then the liver cells
      may heal, if it is not done then it will progress to death of the liver cells and scar tissue forming inside the liver. This scar tissue blocks the flow of blood through the liver and also to the liver cells and even more
      cells will die off…it is a progressive disease that the doctors can only try to slow down, Known as cirrhosis then. Cirrhosis is the death of the liver cells that lead to fibrosis and scar tissue formation.
      When cirrhosis takes place, the liver will start to shrink in size and become hard in texture.

      I hope this information has been of some
      help to you.
      Here are a couple links to explain more about this disease and causes:

      http://www.medicinenet.com/cirrhosis/article.htm

      http://www.mayoclinic.com/health/cirrhosis/DS00373

  29. QUESTION:
    fatty liver or chronic liver? is it the same?
    I am a 29 yrs. old female. I drink only occasionally (of course there are times when I gotten drunk when I hang out) I don’t do drugs or smoke. I had a gastric bypass last year and lost a lot of weight. On february this year I was complaining of abdominal pain and they did a sonogram, a HIDDA scan (to check if it was my gallbladder) but everything was ok. After that they did an abdominal CT scan to check. In the CT scan everything was ok but it said:

    ” the liver is somewhat heterogeneous in attenuation without discrete biliary tree dilatation or masses. There is subobtimal examination due to lack of IV contrast. The underlying coarse atrenuation may be related to fatty changes ”

    and in the area of impression it said:

    1. CT of the abdomen without contrast demostrates attenuation and coarse underlying hepatic parechyma which may correspond to chronic hepatic disease.

    When I read this I was scared as hell thinking I might have something irreversible on my liver so I went to my internist so he could interprete the results. He send me a liver profile and everything was fine and he also send me a coagulation lab test and everything fine. He told me that he was sure it was fatty liver and with diet modification everything was going to be normal in no time. After visiting my doctor I was relieved but I still can’t stop thinking why did they write on my CT chronic liver disease if its just fatty liver? My internist told me fatty liver is a liver disease but its reversible. What do you think?

    • ANSWER:
      Fatty liver disease is caused by:
      weight gain, obesity, fast weight loss, malnourishment,
      diabetes, insulin resistance, high cholesterol/triglyceride
      levels, and others.

      Simple Fatty liver doesn’t usually cause a problem in
      the liver. Diet or changes to medications can reverse
      the problem. (It would be best not to drink any
      alcohol and not to take any medications that are
      not approved of or prescribed by your doctor now)
      However, if the fat continues to build
      up inside the liver, it can lead to damage to the liver
      cells. The liver is surrounded by a tight membrane
      capsule. When the liver cells become damaged,
      the immune system of the body can respond to this
      damage and cause inflammation to also develop
      inside the liver. This is then known as
      Steatohepatitis. Steato stands for fat, hepat stands
      for liver, and itis stands for inflammation.
      This is, then, much more serious as the inflammation
      can lead to death of the liver cells and scar tissue
      formation inside the liver that will block the flow of
      blood.
      Apparently, the one that looked at your
      scan could not determine the cause of the problem
      or wasn’t sure how far advance this would go later
      on without treatment being done…only your doctor
      could do that. He said it “may” correspond to
      Chronic (ongoing) hepatic disease.

      Your doctor feels that this can be reversed, since
      he knows your medical background. It would be
      best to follow any advice he gives you. Don’t
      be afraid to ask him any questions about this.
      If he deems it necessary, he may refer you to a
      gastroenterologist.

      Best wishes…Hope this information has been of
      some help.

      Here are a few links, you can click on, to read
      more about this disease:

      http://www.aafp.org/afp/20060601/1961.html

      http://yourtotalhealth.ivillage.com/fatty-liver.html

      http://en.wikipedia.org/wiki/Fatty_liver

      http://www.gastro.com/Gastro/liverdisease/fatty_liver.aspx

      http://www.medicinenet.com/fatty_liver/article.htm

  30. QUESTION:
    The VA claims I need a liver from drinking too much, but I don’t believe them. Why do they lie so?
    They say I have cirrohis, hep b, hep c, chronic liver disease, and are threatening to keep my new liver unless I capitulate to thier unreasonable demands. Beer is a part of me. I can’t imagine the NFL without beer. They don’t care. THEY ARE THREATENING TO KEEP MY NEW LIVER! Besides, the jail doctor said my liver is fine.

    • ANSWER:
      Let’s tear this apart. The VA would not withhold treatment even if you are stupid enough to go against all recommendations so that must be lie number 1. The jail doctor said your liver is fine – that must mean you are in jail so you cannot be drinking beer. That’s lie number 2. Threatening to keep your new liver – organs can’t be ordered or placed on hold, an organ donation comes from someone who had died who also is a close match to you and is somewhat rare so that must be lie number 3. If you have cirrohis, hepititis B and C plus chronic liver disease (and how is that different than hepititis) then you are dead or much too sick to use a computer so that must be lie number 4. As far as not having the NFL without beer – granted that being plastered makes the game look better if certain teams are playing but it is possible to watch without drinking – yup lie number 5. Do us all a favor and wipe your hard drive.

  31. QUESTION:
    My boyfriend has liver disease caused by Hep C & chronic alcoholism – What can I expect? (symptoms, etc)?
    He was told about 3 years ago that he had hep C, chirrosis and he is a chronic alcoholic. Dr told him to quit or he would die. He has tried and failed several times ( I know he’s not trying hard enough…. ) . I just want to know what to expect. He is tired all the time, has headaches, and is depressed – Is this part of it? Also I have heard that mood swings are common to this, is that true? I posted a similar question earlier but felt I needed to clarify…. I appriciate any info I can get! Thanks!
    I appriciate the replies but I am looking for real answers not opinions on the relationship….. we have been together for many years, it’s not something simple to walk away from…..

    • ANSWER:
      Hepatitis C is the inflammation of the liver cells
      caused by a virus. Cirrhosis is death of the
      liver cells. His disease can be brought on by
      the Hep C or his drinking problem. Trying to
      quit drinking on his own is extremely difficult.
      He needs to go into a detox program at a
      hospital in order to do this. The symptoms
      he has from trying to stop drinking may be
      too much to handle…they can give him drugs
      to lessen these symptoms and help him get
      through it much better. The symptoms that you
      stated are normal. You have to realize that
      he is now facing death straight on and he has
      to make decisions on what he can do now.
      Depression is normal now, because of having
      to live with all these hurdles to go over to
      save his life. Waking up everyday knowing
      that you may die is very hard.
      Liver patients are usually in shock when they
      first hear they have a terrible disease like this.
      The first reaction is unbelief…then it moves
      where they try to do something to help
      themselves, if it is possible…it leads from
      there to either coming to terms with the
      disease and trying to fight it or just giving up.
      They need alot of support and understanding
      at this time. They get mad and they feel
      helpless and they feel like someone cheated
      them or played a dirty trick on them or they
      feel like saying “why me”. Others people drink and they don’t have this. Cirrhosis can be caused by many different things.

      Your boyfriend doesn’t have a rosey future and
      he knows that. He also knows that if he wants
      to spend time with the people he loves he has
      to do it now. I’m going to explain a few things
      to you. Once there is death of the liver
      cells it forms scar tissue in the liver…this blocks
      the other normal healthy cells from receiving
      nourishment and oxygen and causes them to
      die also. This is a progressing disease and
      the only real option he has now, if he has
      cirrhosis, is being evaluated and placed on the
      transplant list for an organ. But, first he has
      to overcome his addiction of alcohol which
      he needs to get care in order to do. A
      person has to be free of alcohol for at least
      six months before he can be placed on the
      list for transplantation.

      There are symptoms that may start to develop
      with this disease that he may or may not
      show signs of. Some of them are listed in
      this short article.

      http://www.nlm.nih.gov/medlineplus/ency/article/003895.htm

      If he wants to stay with his loved ones longer,
      than he needs to stop drinking now. He is
      causing his liver much more damage faster
      and it will lead to a much much earlier death.

      Having others around him who truly care about
      him, will make whatever course he decides on
      alot easier on him. You cannot make decisions
      for him, but you can be there to support him
      with all he does. Best Wishes

  32. QUESTION:
    Wisdom Teeth Extraction with those with Liver Disease — Any way to reduce risk of death and complications?
    I have already made a post, a while back, in regards to having oral surgery to remove damaged wisdom teeth, but that I was concerned about the pain medications used afterwards (considering I have liver disease ). I would like to know now, after hearing about more potential risks involved with dental surgery on those with chronic diseases and health problems, including the recent death of a young girl from improperly delivered anesthesia, what there is exactly that could be done to reduce the risks involved with oral surgery and anesthesia administration. And if there is not much that can be done to reduce the risk, is there any way to perhaps not have anesthesia during oral surgery. Constructive, but honest opinions would be greatly appreciated. Thank you.
    I would appreciate any professional advice, as well as laymen’s advice.

    • ANSWER:
      Emma,
      there are many problems associated with treating your case outside a hospital or atleast an oral surgery department within a hospital. If you are actively treated by a physician the oral surgery department or surgeon must be in consult to go over your current disease stauts, medications, lab values, and other contraindications to medications, surgery, etc…If you haven’t seen your physician in several months, the oral surgeon will need key lab values like CBCw/diff, AST, ALT, platelet, Thrombin time, prothrombin time before any invasive procedures. The best thing is to talk to your oral surgeon and have them treat you in a hospital setting with full consult of your Gastroenterologist or Hepatologist. In this situation bleeding diatheses, infection spread, or unpredictable drug metabolism can be treated promptly.

      Good luck

  33. QUESTION:
    Would overdosing on OTC pain killers, but not have to go to the ER from it cause liver damage / liver disease?
    I use to take alot of aspirin (more than the recommended amount) for a chronic pain which turned out to be gallbladder infection. Could this cause liver disease / damage? How would I be able to find out if I have liver damage / disease?

    • ANSWER:
      Aspirin is safe. Even in moderate overdosages.

      Tylenol (acetaminophen) is not safe, and it very easy to overdose and destroy your liver.

      A physician can talk with you about your concerns.

      A common sign of liver disease is jaundice, the whites of your eyes turn yellow.

  34. QUESTION:
    Just found out I have a chronic disease?
    I just found out yesterday I have hepatitis (not a, b, or c, just inflammation of the liver) and I haven’t been fully diagnosed, but whatever happens it will be serious. It is most likely nonalcoholic fatty liver disease.

    I don’t know what to do. I know the depression will pass eventually, but right now I am writing this from my iPhone because I don’t even want to get out of bed. I feel sorry for myself because I’m only 19 and have tried to take care of myself…

    How can I make myself feel better? I want to run and hide but the problem is stuck inside of my body.

    • ANSWER:

  35. QUESTION:
    What does it mean when I have a sharp pain in my right ribcage?
    The reason I ask is because I have a chronic liver disease. Where is the liver located?

    • ANSWER:
      Based on your description and that you say you have chronic liver disease, it is most likely your liver that may be causing you pain. If the pain is very sharp and does not go away, then I would strongly suggest you see your doctor about it sooner than later! It may be a lot of things, but it’s better not to chance it when it could be from such an important body organ!

      Here is a picture to look at where the liver is in reference (generally) to your ribcage (it’s the one colored in purple):

      http://images.google.com/imgres?imgurl=http://www.dkimages.com/discover/previews/832/20113049.JPG&imgrefurl=http://www.dkimages.com/discover/Home/Health-and-Beauty/Human-Body/Respiratory-System/Lungs/Lungs-91.html&h=768&w=572&sz=87&hl=en&start=1&um=1&usg=__ANu6mJxF2OpRMBtzsF_Dx1YUQ9g=&tbnid=w2kzstyDJ8EKiM:&tbnh=142&tbnw=106&prev=/images%3Fq%3Dliver%2Bribcage%26um%3D1%26hl%3Den%26safe%3Dactive%26client%3Dfirefox-a%26rls%3Dorg.mozilla:en-US:official%26sa%3DG

      I hope this helps and that you feel better soon!

  36. QUESTION:
    Liver Transplantation?
    1. My mother is a patient of chronic liver disease. I want to clarify following questions for my further information / dicision:-

    (a) Sir please would you apprise us that is there any age specified for liver transplantation?

    (b) Is it possible to trasplant a liver of 64 year old lady?

    (c) What are the expenses of liver transplantation?

    2. I would be highly appriciated for the earliest response in this regard.

    Best Wishes

    Abid Aziz

    • ANSWER:
      I am in the USA…so my answers can only
      reflect it here.
      In the USA, they have transplanted liver organs
      to the age of 65.
      Transplantation is very expensive. The patient
      will not receive a transplant unless they have
      the financial means to pay for it. This means insurance or asking for help with a social worker.
      of the transplant team, to learn how to obtain the funds for it through contacting organization that will contribute to it, etc.
      On average, you may be looking at about
      0,000 or more.

      I am posting links, you can click on, so that you can learn more about the transplant process and also learn more about the financial help and what may be required:
      Organ Procurement and Transplant Network…

      http://www.optn.org

      This is a Patients guide to liver transplantation
      from one of the transplant centers in the USA..
      very good info:

      http://www.surgery.usc.edu/divisions/hep/patientguide/index.html

      This is Transplant Living where there is
      info on all transplants and also on organ
      donations from live donors:

      http://www.transplantliving.org/

      This is the United Network of Organ Sharing
      where they decide what transplant center
      will receive an organ once it becomes available:

      http://www.unos.org/

      It is best to contact the “Transplant Center where
      you live and talk to them. Other countries
      don’t always follow the same rules and also
      are sometimes cheaper than the surgeries
      in the USA.

      I hope this has been of some help to you.

  37. QUESTION:
    my father is not well for past 7months….some liver problem:plz tell what these reports says……< his current reports are:
    GGT 311
    SAP 164
    SGOT 51
    SGPT 66
    ISB .50
    DSS .20
    TSB .70
    PLATELETE COUNT:177000

    diagnosis::autoimmune chronic liver disease with acute HEV
    Abdominal koch's
    PCR for koch's :positive

    now can any one help me writing in detail abt wt these reports say.......what is the position of liver???
    is something very serious??
    how it cud be cured??
    is it fully cureable<>???

    • ANSWER:
      Beings that you don’t have any units with your numbers I can’t for sure say what they mean but here are the normals for a male and what an abnormal value COULD mean (some of them were not listed in my lab book):

      Gamma-Glutamyl Transpeptidase (GGT)
      -liver enzyme sensitive to biliary and liver disorders, including alcoholic liver disease. Normal value 9-50 International Units/Liter (IU/L) I can’t tell if this is high since you didn’t add the units his lab values were measured in.

      -Platelet Count: Normal 150,000-450,000 cubic millimeters (mm3) (his is normal)

      As for his diagnosis Autoimmune Chronic Liver Disease: Basically, chronic means it is long term. Liver Disease is very vague. There are many different types. Find out what type he has and google it.

      HEV is Hepatitis E Virus which is an infection spread through the feces (stool) of an infected person. It is acute, meaning it will last less than 6 months.

      I will give you a website where you can go and find information. Also just googling in “Chronic Liver Disease” or “HEV” should turn up with quite a few websites.

      I do not know what Abdominal Kochs is.

      As for the position of the liver: if you divide your stomach into four quadrants with the belly button being the very center, your liver is in the right, upper quadrant. It is a very vascular organ, filtering your blood at 1500 mL per minute. (L. White, 2000) Your liver also secretes bile which breaks down the fat you eat. Among many other things, it produces prothrombin and and fibrinogen, which are necessary for blood clotting. Poisonous toxins (e.g. alcohol) are detoxified in the liver.

      I hope I helped a little bit. There is quite a lot of information in your question. What did the doctor tell your dad? That is probably the best info you’re gonna get. I’m sorry to hear about your father, I hope he is doing well.

      you can go to http://www.webmd.com and just search for his diagnoses in the search box.

      or just go to http://www.google.com and type in either one of his diagnoses.

  38. QUESTION:
    Do I possibly have leukemia or some other blood disease? ADVICE FROM EXPERIENCED/ or DOCS?
    my symptoms are, and noted beggining about a year ago, disapearing and reapearing regulary but not serious, but recently symptoms have returned elevated and much more serious then past experiences, symptoms include…

    bleeding gums, paleness, red dots on skin that are itchy, patchy red palms,, white fingernails under nail, yellowing at tip of fingures, fatigue, joint pain. wrestlessness, trouble waking up. (sleep long hours) sometimes bed at 8pm and up at 4-6pm the next day. and swallen lymph nodes in my lower neck and under my jaw…. (SINCE THIS NIGHT I HAVE DEVELOPED BUMPS UNDER MY LEFT ARMPIT AND CHEST PAIN) I also am beggining to feel ill, feels like the flu, but rather strange as my headache will go and come back in a different area…

    Here is my doctors summary from saturday night. when i attended the emergancy dept…

    (Jaime Waters presented to Box Hill hospital Emergancy Department on 07 Aug 2010 at 15:40

    ED Diagnosis: Bleeding disorder for investagation
    History of presenting Complaint: 20 y.o male presented with 2 month histroy of bleeding gum and joint pain with no significant background histroy.

    Patient first noticed gum bleeding at least 3 or more months ago after brushing, since then bleeding has become more consistant, bleeding lasting now upto 10 minuts after brushing. also noticed incease of joint pain mainly on MCP joint and knee joints over this period of time.

    Bleeding has worsened over the past 5 days and become consistant in the past 2 days. patient now also complains of lethargy and weakness in this time frame.

    smoker since 14

    heavy drinker; usually 2-4 bottles a week.
    Last alcohol yesterday 1/2 bottle bourben.

    No family history of bleeding disorder, auto immune disease or leukemia.

    Resting tremor noted, no heptic flap, no obvious brusing/petechae
    No sign of chronic liver disease
    No conjuctiva pallor, no scleral jaundice

    chest clear
    abdo soft tender, no oragomegaly

    Oral examination – no active gum bleeding, no obvious gingervitis, tonsil not enlarged.

    tender submental lymph node bilaterally R>L
    Palpable R cervical lymph nodes
    Thyroid not enlarged

    stiffness of mcp joint both hands no tenderness on palpation and movement

    Managment: FBE/U+E/Coags/LFT/CRP
    may need medical refferal for bleeding disorder

    Results/outcome: Neutrophilia and increase WCC
    Normal LFT and Coagulation profile hb166

    Refferals and followup: Need LMO follow up for investagation of autoimmune disease and thrombolic screening,

    patient wil need new LMO for follow up and observation of progression.)

    in this letter not all my symptoms are noted. but i hav put as much as i can think of before i added this letter, also the doctor told me im developing a little bit of anemia but was nothing to be concerned about at this time and that i needed to be observed over the next few weeks for a diagnosis of whats happening. and refferd me to a GP.

    can anyone offer me advice?

    since seeing the doctor my under left armpit has become sore and stiff, my left hip bone upper left beg bone has began to ache with worsening bleeding of gums. and consistant taste of blood in mouth. im very confused and worried about whats goin on… advice?

    • ANSWER:
      When you go to that referral, ask them to test you for Lyme’s disease. I have a friend with similar symptoms and it turned out to be Lyme’s disease. Have you been camping or in the woods lately? Even if you haven’t, deer tics can be in tall grass and you don’t even know they are on you. It doesn’t sound like cancer to me
      I hope you find out what this is. Be well

  39. QUESTION:
    I know my kidneys are scarred and damaged. Do I have chronic kindey disease?
    Hi I am 29 and I have had kidney damage for over 4 years. My left kidney is the one that’s scarred and damaged. I have kidney infection every 2-3 months if I take care of myself by drinking lots of water. My kidney function test showed that they are still functioning normally at this point. I also have liver disease and hypothyroid.. although my thyroid probably has nothing to do with it. I am getting tested to see if I have bladder reflux. I think thats what it’s called. I always have protein in my urine also.

    What I am wondering is: Is kidney damage the same thing as kidney disease?
    Because I need to know if I need to follow the kidney diease diet or not. My doctor says I don’t but I fell much worse if I eat processed foods or drink pop. I drink about 64oz of water each day and some cranberry juice every week. Any help would be appreciated!!
    Okay thanks for the response. I have permanent kidney dmage due to too many kidney infections. I’ve had this for 4 years. It’s irreversible as I said the left one is damaged I have had blood tests as well as been to radiology for some tests.
    As far as the liver goes I had lost 30% of the finction of my liver when it was diagnossed. I have permanent liver damage also. It’s from an overdose of tylenol (about 300) and about 200 other pills. Yes I was ill but because I was in a coma 4 days before being taken to the hospital my liver couldn’t be saved.

    So both are permanently damaged I know for a fact. What I want to know is: “Is kidney damage the same as kidney disease?”
    Thanks

    • ANSWER:
      There are two blood tests that check for kidney
      damage: creatinine and Bun (blood urea nitrogen)…If these are in normal range…then
      there is a could chance that the kidneys will
      heal. Protein in the urine is not good however.
      Protein checked by a urine test, doesn’t show up
      much unless the kidney has been damaged.

      You said you have liver disease but do not
      mention what caused it. The kidneys are
      second in line to fail after the liver fails. The
      reason for this is because the toxins that
      the liver no longer handles, the kidneys try
      to dispose of and it taxes the kidneys sometimes
      beyond what they are able to handle. This only
      occurs when the liver is damaged to the point
      that the cells have started to die and form
      scar tissue inside the liver…also known as
      cirrhosis. Hypothyroid trouble can also be
      connected to the liver problem.

      There is acute kidney disease and chronic
      kidney disease. Acute means that it may
      comes and then leave, chronic means that
      it is ongoing. Damage to the kidneys, to
      me, means that it is a disease. But, the
      problem with the kidneys may be only a
      result of another problem you already have
      had and that is the liver problem. Once the
      liver problem clears up…the kidneys may
      return to normal also. Infections can occur
      in many people with no damage to the kidneys
      because of using antibiotics to fight it off.

      Most people who are having problems with
      their kidneys are told to limit the amount of
      sodium, potassium, phosphorus in their diets.
      Sodas have alot of phosphorus and
      processed food contain alot of sodium.
      However, a certain amount must be maintained
      in the body since sodium and potassium are
      needed for the heart to beat in rhythm and
      for water retention. It is best to get the
      advice from your doctor about what you stated
      here. He has your blood work and can tell
      you what you should or should not do.
      He can tell you if there are any limits to the
      amount of Sodium, potassium, phosphorus or
      proteins you should be taken in or refer
      you to a nutritionist. He can also inform you
      how much fluid you should drink a day.
      Most people who have had kidney stones are
      told to drink alot…but too much fluid can also
      overwhelm the kidneys if they have liver problems also. In cirrhosis of the liver,
      sodium is retained in the body by this disease
      and fluids have to be adjusted accordingly, to
      keep things in balance.

      Sorry that I cannot be of more help…just
      giving you some things to think about and
      maybe discuss with your doctor.

  40. QUESTION:
    Anyone else have enexplained liver pain?
    I have chronic liver pain that i have had for 2+years. I have had tons of ultrasounds that show nothing to be concerned with, and have slightly elevated liver enzymes. they have done MRI and cat scans, and still no answers to why i would be having PAIN. the only diagnoses they can give me is that i have “fatty liver disease” which is normally something someone would get if they were morbidly obese, or an alcoholic. Neither of which i am, not even close. I had my gallbladder removed 3 years ago, but i still feel like i am having gallbladder attacks, thats what the pain feels like: sharp, crampy, like someone is squeezing my organs and stabbing them. Its horrible and the pain can last anywhere from 20 min.-2 hours. Anyone know of anything that could cause this?

    • ANSWER:
      The liver itself doesn’t have nerves so most doctors don’t believe patients that complain of “liver pain.” However, my wife got Hep C from a blood transfusion at birth. Before she was diagnosed, she would complain of “liver pain”, not a severe as your description, but similar.
      You can only get Hep C from blood to blood contact. Maybe bring it up to a doctor next time. I don’t know if this is an answer to your question, but it’s good information at least.

  41. QUESTION:
    how can one die of chronic ethanol abuse and no damages to liver or other functions that ethanol would destroy?
    Just wondering someone close to me passed and on the death cet. it said that they died from chronic ethanol abuse, toxic effects of opiates and hypertensive cardiovascular disease. I just don’t get that ruling and the autopsy report says nothing about liver damges or nothing . Is it because the numbers were how with the ethanol.. or maybe he just died of high blood pressure…

    • ANSWER:
      It’s also possible that the liver damage, while indicative, was not so extensive as to be listed as a cause of death. Basically, this person slowly poisoned themselves on alcohol and pain killers.

  42. QUESTION:
    Would I qualify for medical marijuanna?
    I have colitis and I have a chronic liver disease. Marijuanna takes away the nasuea i get from taking pills for my liver disease. Also it helps my appetite. I live in Massachusetts by the way.
    By the way, there is a bill waiting to be passed for marijuanna to be decriminalized.
    what kinda doctor would I get the prescription from?

    • ANSWER:
      yea man, I know someone who had a hurt bone bruise in his arm and he got some, but that was in Cali and I know its stricter in other places. That sounds bad though, a lot worse than the bone bruise, so I would say you should be able to get some. Good luck, I hope that bill gets passed, I think we are on the way to decriminalization, and I cant wait.

  43. QUESTION:
    looking 4 a GP on the Gold Coast Australia, multiple problems, chronic pain – Diabetic,heart & liver, URGENTLY?
    looking 4 a GP on the Gold Coast Australia, multiple problems, chronic pain – Diabetic,heart & liver, URGENTLY?
    I am a 37 year old woman suffering from everything from a severely deranged liver & Kidney disease, 3 heart attacks, 2 T.I.A’s, Angina, CHRONIC PAIN for more than 8 years – requiring Morphine @ times daily & to top it off I’m a type 2 Insulin dependant Diabetic….PLEASE PLEASE GET IN TOUCH IF YOU KNOW OF A REALLY GOOD DR @ THE NORTHERN END OF THE GOLD COAST, I truly am desperate as my treating GP is retiring very soon, THANK YOU in advance, Yvette
    yvettebond2002@yahoo.com.au

    • ANSWER:
      Hey, I don’t live in Australia, but make sure you look into celiac disease. It is highly associated with diabetes and causes all kinds of health issues. There was a study I read recently where they found that almost 50% of people with diabetes have some adverse reaction to gluten and a good percentage of them have full blown celiac disease. Make sure to rule this out. It’s extremely common and wrecks havoc on your whole body. Many physicians don’t test for it unless you have digestive symptoms, but most patients don’t have digestive symptoms. definitely rule it out.

  44. QUESTION:
    Explain the effects of the following on glomerular filtration?
    1 Chronic liver disease
    2 kidney stones
    3 high blood pressure
    4 low blood pressure

    • ANSWER:
      I’m not sure about chronic liver disease, but…

      2. kidney stones lower the glomerular filtration rate because the stone is in there blocking the tubing, if it gets bad enough it can shut down the nephron/kidney

      3. high blood pressure increases the GFR becaues there is more pressure on the blood… if this happens things like blood cells and protiens that shouldn’t be filtered can get into the filtrate

      4. low blood pressure decreases the GFR because there isn’t enough pressure on the blood and it just passes by without being filtered. This causes problems because the ‘waste’ stays in the blood

  45. QUESTION:
    can someone be fired while taking medical treatment?
    emergency family medical leave absence is denied and employee gets fired. The employee is also under medical treatment that requires medical supervision and further tests with possible if not chronic disease (liver and lung)

    does the employee have any rights? can the person apply for workers compensation? will ssi give temporary disability?

    thank you

    • ANSWER:
      Depends on the State, for instance in TN you can get fired any day for any reason, the company doesn’t need to give a reason at all.

      Applying for SSI is easier said than done, because they will deny you the first time nearly a 100%. So then you have to run through all the red tape, which causes time and can cost you everything you worked for. Sorry but our “christian” nation is not very nice to it citizens once they need help.

  46. QUESTION:
    how long does one live after discovering chronic kidney failure?
    64 year old male. already has pancretitis, liver disease, gallballder trouble, and renal failure. has been treated medically to try and reverse kidney failure, and now does not wish to have dialysis, and has decided to stop treatments and wait to pass away. all conditions are caused by chronic alcholism. thanks for any input, personal experiences.

    • ANSWER:
      From a medical provider standpoint, you typically live as long as you feel like living, regardless of the disease.

  47. QUESTION:
    What multivitamins suitable for people with liver disease?
    26 years old female, was diagnosed with Hepatitis C and level 2 Fibrosis. She is now on Pegylated Interferon Alpha 2 b and Ribavirine medication. These drugs are really challenging and have a lot of side effects. The one side effect that is really bothering her is Chronic Fatigue. Doctor prescribed a multivitamin supplement called Centrum, the problem with this drug is that it contains Iron. Iron are known to be bad for liver patients. What vitamins does she need, and what multivitamins product (no iron included) is suitable for her? Help please!

    • ANSWER:
      If a liver patient doesn’t have hemochromatosis, which is a
      hereditary disease in which a patient body tends to hold onto
      too much iron…then this would not be a good idea to take more.
      However, other liver patients it doesn’t hurt to take some iron into
      their bodies because iron is needed. Iron is on the Red blood cells,
      it is what the oxygen molecules we breathe in, attaches to. Without
      some iron, the patient would become anemic…and this is not good.
      The doctors can do blood tests, like the hemoglobin, ferritin, transferrin,
      and TIBC to be sure that she doesn’t have a problem with this.
      Apparently, she may be lacking in certain vitamins or they would
      not of started her on them. I would contact the doctor office and
      ask them, if you are not sure. The nurse, there, can look up her
      file and tell you, from her lab work tests done, if the doctor does
      want her to have this. Liver patients do lack iron at times.

  48. QUESTION:
    I have NAFLD (Non Alcoholic Fatty Liver Disease). What are my chances of getting Cirrhosis?
    I went to the the ER the other day because I have had chronic diarrhea, dizziness, and abdominal pain for more than 3 months now. The Dr. found that I had NAFLD and said that I should be seeing a Dr. for this condition and said that I need MANY tests done to see what is causing it. She also said that I have to be on a vegan diet (I am not overweight) to see if it can reverse the Disease. My questions are: Is there a cure for this & What are the chances of it forming into Cirrhosis?

    • ANSWER:
      You should be seeing either a gastroenterlogist
      or hepatologist now.
      Fatty liver disease can be caused by many
      different things: alcohol consumption, certain
      medications like steriods, weight gain, hereditary conditions,
      diabetes, insulin resistance, high cholesterol/triglyceride levels
      and more.

      The cause needs to be determined.
      There are different stages of this disease….
      Simple fatty liver doesn’t usually cause a
      problem and can be easily reversed by
      stopping the cause. Alot of people are very
      thin and can still have this problem.

      The fat pushes on the liver cells and can
      even push the nucleus of the liver cell out of
      place. That is why it has to be treated immediately
      ….so the fat will disappear and not harm the cells.
      The liver is surrounded by a membrane capsule and
      the fat only adds to the pressure inside the liver.
      If the cells of the liver become damaged, it signals
      the immune system of the body to respond to
      this. The immune system then causes inflammation
      to develop inside the liver, also. This will cause the
      liver to enlarge in size. It then goes from simple
      fatty liver to steatohepatitis. Steato means fat,
      hepat means liver and itis means inflammation.
      This becomes more serious…the inflammation adds
      to more pressure inside the liver and the cells can
      more easily start to die off. When the cells die off,
      it becomes a progressive disease known as
      Cirrhosis of the liver. What happens now, it the
      cells die off and form scar tissue inside the liver
      that blocks the flow of blood through the liver on
      its way back to the heart and may also block
      the flow of blood to the other liver cells and they
      will continually die off.

      If the patient follows the doctor instructions and
      is treated for any inflammation that may have
      developed…then it may never go to the point of
      becoming Cirrhosis of the liver.

      Here are some links to help you learn more about
      this, that you can click on:

      http://www.medicinenet.com/fatty_liver/article.htm

      http://www.aafp.org/afp/20060601/1961.html

      http://yourtotalhealth.ivillage.com/fatty-liver.html

      http://en.wikipedia.org/wiki/Fatty_liver

      I hope this information has been of some help to you.

  49. QUESTION:
    If a native American is suffering from end state live disease due to chronic alcohol intake?
    is a liver transplant a option
    It is my step-daughter and she is on public assistance, and her doctors have not ofter her that option, should it be because she is a public charge
    or could it be because she has not taken the step to stop drinking

    • ANSWER:
      A person has to be evaluated and go through a series of
      tests to be placed on the transplant list. To be placed on
      the list, a patient has to be without any alcohol for a period
      of 6 months and willing to give it up completely. The
      shortage of organs for transplant makes it harder to
      be placed on the list unless the person, themselves, prove
      to others that they do want to live and will be compliant
      with following the rules to have an donor organ…which includes stopping bad habits so there is little chance, that once transplanted, the organ won’t go into rejection and the
      alcohol won’t react with the medication they need to take
      for the rest of their life.

      When you said, “is a liver transplant an option”…that is
      exactly what it is. The cost of a liver transplant is well
      beyond what anyone could afford…it can range from
      0,000 to 0,000 or even higher. A person
      needs to have insurance that covers transplant or find
      a way to raise the money….or they could be on disability
      and may receive help from the government or organizations.

      The system for the transplant is fair…people are placed
      on the transplant list according to how long they may live
      without having a transplant. In other words, if they are
      fairly well and may recover and not need a transplant…
      according to what their blood work shows…they will be
      placed lower on the list and may even go off the list and
      lead a normal life. As you go higher on the list, you are
      less well and if you are very near the top…you will either
      receive a transplant or you may die before an organ
      becomes available. This has nothing to do with sex,
      race, or any other similar thing. Blood type may be a factor…
      cause some blood types are rare and it is hard to find
      someone else who had the same blood type.

      The links below will give you alot more information about
      the process of liver transplant, organ donation, living organ
      donors, pre evaluation for transplant and many other things.

      http://www.surgery.usc.edu/divisions/hep/patientguide/index.html

      http://www.transplantliving.org/

      http://www.unos.org/

      So many people are trying to be placed on the list when they
      have developed the disease because of alcohol. Alcohol is
      only one of the reasons for this disease of about 20 others.
      Some people have no problem stopping their alcohol, but
      most need help and that help is there…the doctors can
      give them medication to help with the symptoms that may
      develop from stopping the alcohol. This is usually done
      in a hospital setting. It helps the patient cope alot better.
      It may be very scary for a person with alcohol cause they
      know what it feels like if they don’t take a drink and how much
      that can multiply if going cold turkey. They don’t just have
      one hurdle to cross…they now have two, overcoming
      the addiction and then having a transplant.

      It has been shown, that when people stop drinking alcohol,
      that their liver may heal if it has not progressed to the
      point where the liver cells have died, which is known as
      cirrhosis.

      To help you understand cirrhosis, here is another link:

      http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis/

      The best doctor that she could be with right now is a
      Hepatologist which is a liver specialist.

      Another thing that may help is for her not to use any
      medications except those prescribed by the doctor…
      this included herbal teas, herbs, or any over the counter
      medication (especially pain, NSAID)

      I hope that this information is of some help to you.

  50. QUESTION:
    hi! do you know any Hepatologist in Southern California?
    A close someone had chronic liver disease, and he doesn’t have a health insurance yet. it’s hard for me to buy one for him b/c most health insurance wouldn’t let him since he’s currently sick. I want him to be cured as soon as possible while it’s young. I’ll be paying out of the pocket. But i don’t know where to start consult. By the way, he still has no symptoms yet but his labs are already abnormal.

    • ANSWER:
      no good asking on yahoo uk and ireland is it! try US.