End Stage Liver Disease

Autoimmune Hepatitis is a disease in which the body’s immune system attacks the liver cells. Like Ulcerative Colitis, and other autoimmune diseases, Autoimmune Hepatits causes inflammation of the affected organ. If left untreated over time, this disease can lead to cirrhosis pf the liver, and eventually liver failure. This chronic condition is potentially fatal. Type 1 Autoimmune Hepatitis, in, many cases, also occurs with other autoimmune disorders such as Ulcerative Colitis, type 1 diabetes, autoimmune anemia, Graves’ disease, Sjgren’s syndrome, thyroiditis and proliferative glomerulonephritis. Type 2 Autoimmune Hepatitis is less common and mostly affects girls ages 2 to 14; however this type can also be found in adults.

Symptoms of autoimmune hepatitis range from mild to severe. The symptoms may include fatigue, abdominal discomfort, joint pain, skin rash, enlarged liver, jaundice, itching, nausea, vomiting, dark urine, loss of appetite, abnormal blood vessels on the skin, fatigue and pale or gray colored stools. Mental confusion and fluid in the abdomen can sometimes be found in patients with advanced stages of the disease. Please note that the symptoms of viral hepatitis and other forms of hepatitis that are caused by a drug are very similar. With this in mind, other tests may be needed by a physician to rule out these other forms of disease, and to confirm Autoimmune Hepatitis.

Diagnosis of autoimmune hepatitis is based on symptoms as well as a liver biopsy and blood tests. For a liver biopsy, the patient goes to an outpatient surgical center or to a hospital. The doctor will take a small sample of liver tissue to examine under a microscope. This examination will accurately diagnose autoimmune hepatitis and it’s seriousness. While a routine blood test can reveal a patterns that are typical in a hepatitis case, further blood test are needed to diagnose autoimmune hepatitis especially for autoantibodies. The pattern and the level of antibodies in the blood help define if the disease is a type 1 or type 2 classification. These tests will also help distinguish autoimmune hepatitis from other forms of hepatitis.

Treatment for autoimmune hepatitis is most effective when the disease is diagnosed early. Treatment consists primarily of medications that suppress the immune system. To treat the disease, the doctor may prescribe prednisone, which is a corticosteroid. Prednisone, or other corticosteroids may have some unpleasant side effects. These side effects increased acne, filling or rounding out of the face, weight gain, thinning of bones, thinning of hair and skin, high blood pressure, diabetes, cataracts, glaucoma, depression, anxiety and confusion. Athzathioprine (Imuran) is another medication that is prescribed in the treatment of autoimmune hepatitis. Like prednisone, this medicine is also used to suppress the immune system as well as helping lower the doses of prednisone needed while reducing it’s side effects. Once the disease is under control, the physician may prescribe azathioprine, in addition to prednisone. Possible side effects of azathioprine may include lowered blood cell count, nausea and poor appetite. Rare side effects include an allergic reaction, pancreatitis and liver damage. The duration of treatment varies from individual to individual in that some may eventually stop treatment followed by close monitoring or in some cases it may be necessary to contintue the treatments for life. However, for those whose treatment has been stopped, it is possible that the disease may return even worse than before, especially during the first few months after stopping treatment. Within 2 years of starting treatment, 7 out of 10 people will have the disease go into remission. However, the symptoms will return within 3 years, so treatment for autoimmune hepatitis is an ongoing process. Other treatments are also possible for those patients who do not respond to standard immune therapy or who have severe side effects. These include medicines such as tacrolimus, cyclosporine or mycophenylate mofetil, which are also immunosuppressive agents. Liver transplants are needed for those with cirrhosis and or end stage liver disease.

Frequently Asked Questions

  1. QUESTION:
    What treatment’s are available for end stage liver disease?
    My uncle has been diagnosed with end stage liver disease, he has been told that he has less than 6 months to live by two out of three doctors. One doctor has given him hope, what treatment’s are out there? Herbal, or otherwise. Are there any recommendations on specialist to treat this anywhere? Would like to hear of any experience’s good or bad, all comments are welcome.

    • ANSWER:
      Hi Desiree

      Here are some remedies regarding liver disease. I believe the liver can be cured, but it wont be easy. Doing a liver cleanse (colon cleanse as well) is a must. A lot of different cleanses out there, so do your research. Here are some remedies and testimonials.

      1.Castor Oil Fomentation: to draw out poisons and flush them out of liver etc. In order to get rid of hardened mucus in the body, which may appear as cysts, tumors or polyps, the following fomentation is to be used:

      Soak a piece of outing flannel or baby’s diaper in castor oil, squeeze slightly so it won’t drip much, then place over entire frontal torso (neck to groin and side to side). Place a hot water bottle (over the castor oil application) over the liver area (the liver is on the right side just above the waist). It should be noted that a heating pad is not too highly endorsed here, unless a wet towel is placed between it and the skin–but even then, a wet heat (such as the hot water bottle) is best. Leave all this on for 1 1/2 hours; the hot water bottle may have to be refilled with hot water several times, because it cools rapidly. The next three days, over the same area covered by the outing flannel and castor oil, massage in circular motion toward the heart with olive oil for 5 to 10 minutes.

      The seventh day is a day of rest, not only from the fomentation, but every part of the program, drinking only water the entire day–and every seventh day thereafter will be done the same way. On the eighth day then, begin again with the castor oil for three days and so forth, along with the mucusless diet. the herbs, etc., until healing is accomplished. In the use of the fomentation, the castor oil goes through the skin into the liver area and lymph glands and starts drawing out the poisons and flushing them out, while the olive oil goes in and heals and rebuilds new tissue. This procedure may have to be carried on between six weeks to six months to properly clean up the system, depending on the case.

      2.Dr. Christopher’s Liver-Gallbladder Formula: To speed up the blood purifying process, it is good to have a good clean liver and gall bladder area. When the liver does not function properly, the bile does not excrete freely into the intestinal tract, and so it passes off into the blood stream and throughout the rest of the system, causing a toxic condition called cholemia, causing indigestion, sluggishness, fatigue, constipation, upset stomach, chills, vomiting and fever. Why wait until it gets to this condition? A combination of barberry (or Oregon grape root), wild yam, cramp bark, fennel seed, ginger, catnip and peppermint–will help relieve this condition.

      Suggested dose: 1/3 Cup or one or two capsules or tablets, 15 to 20 minutes before a meal.

      3.Castor Oil: This oil can be obtained commercially and is used for the liver fomentation to open the capillaries of the liver. It is an excellent external healing oil for discomforts of windburn and is good for massage. But we never use castor oil internally or for a laxative. We often suggest opening up the capillaries of the constipated liver by applying a cotton or flannel cloth which has been soaked in hot castor oil over the area of the liver (on the right side of the body under the rib cage). Place a wet, wrung out hot towel over this cloth and a hot water bottle over that. Keep the fomentation warm for 20 minutes and then alternate with a cold towel fomentation warm for 20 minutes and then alternate with a cold towel fomentation for five minutes. Repeat the hot fomentation and then the cold. This can be continued for about an hour and a half. This has relieved pain of congestion in the liver and other organs such as the gall bladder and the pancreas.

      4.Juices for Liver Trouble: Carrot-beet-cucumber, apple, dandelion, grapefruit, lemon.

      5.Cayenne: There are safer ways to stimulate the gall bladder. One is by taking cayenne pepper orally. This has been reported in medical journals to trip the gall bladder reflex and promote the flow of bile naturally. As we mentioned before, bile is concentrated toxic material recycled by the liver. It acts like a natural laxative. The gall bladder (known in certain surgical circles as “the gold bladder”, as we mentioned in an earlier newsletter, because of the tremendous amount of money spent on yearly gall bladder operations), is a reservoir which stores the bile for timed release into the digestive tract where it mixes with other digestive aids. When this organ is removed, the caustic bile drips directly into the duodenum and can cause duodenal ulcers. Dr. Christopher’s Liver and Gall Bladder Formula, composed of barberry, wild yam, cramp bark, fennel seed, ginger, catnip and peppermint, can safely rebuild the diseased liver and gall bladder and help them to function normally because this formula is a specific food for these organs. The liver is recognized by medical science as a highly regenerative organ. it can rebuild itself even if there is only one-tenth of it functioning.

      Testimonials
      1.Carrot Juice: One of the most common misconceptions regarding carrot juice is that one will start to develop orange or yellow colored skin after steadily drinking the juice because of the carotene content in the juice. This is not true. The development of yellowish skin is due to the fact that carrot juice is a great liver cleanser and the toxicity within the body is coming to the surface. Keep up with the carrot juice and the symptoms will soon disappear. The formerly constipated liver is reconditioned once again to experience a free flow of bile the excess of which is eliminated through our largest eliminative organ, the skin. I have personally experienced this phenomenon during a time when we prepared hundreds of gallons of carrot juice a week for sale. Because the juice was so abundant and available, I drank it for nearly every meal…sometimes instead of meals. My wife soon commented upon the yellow cast which my skin began to take on. I continued drinking the juice, however, and within a week my skin color was back to normal. But my liver had gone through a wonderful cleansing! It is often a surprise to me that the most learned of health authorities will try to sell you the carotene theory without any sort of proof, personal experience or background.

      2.Dandelion: A classic story about the use of Dandelion is often repeated. Around the turn of the century, A Dr. Sparks wrote,”Fifteen years ago I was afflicted with the liver complaint. I used all my skill trying to cure it but failed. I then tried two physicians, Doctors Wilson and Jordan, but without success. An old nurse told me that Dandelion was an effective folk remedy for this disorder, so I decided to try it. Using Dandelion promptly restored me to health. It then became my favorite prescription for liver complaint, either by the simple extract of the herb or by taking a teacupful of a strong decoction of it twice a day. In almost every instance I have succeeded in restoring those who have used this plant.”

      There are plenty of answers to solution, so keep exploring.

      Best of health to you and your uncle.

      Cheers

  2. QUESTION:
    Can someone help, does any one know anything on end stage liver disease?
    My mother is in end stage liver disease and I believe she hs Hepatic encephalopathy. I was wondering what the stages are because to me she seems really bad. Once this starts how long do I have with her.

    • ANSWER:
      Unfortunatly Hepatatic Encephalopathy is a serious complication of Cirrhosis (inflamation of the liver). It can be treated up to a degree, but organ transplantation is the only real treatment. Once she’s admitted into an ICU, mortality rate increases to over 50% (but still almost half of the people admitted into intensive care units with this diagnoses have a chance for recovery – especially if they can find a donor liver, I believe even a living-donor’s partial liver transplant can help). Improving this chance is when malnutrition is addressed quickly and aggressively:

      “… early intervention in replenishing the nutrient deficit can prolong life expectancy, ameliorate quality of life, diminish complications and prepare them for a more successful liver transplantation.[5,7]

      http://www.medscape.com/viewarticle/575158

      good luck!

  3. QUESTION:
    What to know about End Stage liver disease?
    Looking For any information, of what to expect, how long people have lived, ANYTHING,
    What if you don’t get a transplant
    Living and or Caring with someone with End Stage Liver Disease

    • ANSWER:
      A lot of times, people don’t know they have liver problems until they are in the end stages of the disease. I imagine you are talking about cirrhosis in its end stage. If that is the case, a transplant is your only hope of getting better. Cirrhosis is scarring of the liver to the point where it can longer do its job.

      Common problems with end stage disease is ascites (fluid build up throughout the abdomen), varices (unwanted veins that are at risk to leak and bleed internally), encephalopathy (high ammonia levels that can cause confusion), extreme fatigue, edema or swelling with fluid in the legs and feet, and jaundice (yellow skin and yellowing in the whites of the eyes caused by high biliruben). These are just some of the symptoms of the disease.

      How long can a person live when in the end stage? That varies as to what caused the disease and how damaged the liver might be. Example: If liver failure is caused by alcohol, if a person stops drinking, then the disease will usually slow down in its progression. If one continues to drink, it will be much quicker to being in complete failure.

      I was given 5 years when told I was in the end stage of my disease which was caused by my auto immune system attacking the bile ducts inside my liver which eventually destroyed it. That was just an average they gave me, but it turned out to be pretty accurate. I had my transplant about 2 years later. The surgeon told me that I probably had 1-2 years left at most before it would have been in total failure. I had about 10% function of my liver when first diagnosed. The liver is an amazing organ that can function even when there is little function left. Medications, good doctors, and good treatment kept me alive till my transplant.

      Cirrhosis is permanent damage, and it’s a progressive disease which will only get worse. If not given a transplant, it’s only a matter of time before it reaches total failure. Everyone is different as to how long it takes to get to that point.

      There are countless websites that can give you all the details of the disease process. Just do a search on cirrhosis. The bottom line of ESLD (end stage liver disease) is that there is no cure except a transplant. I would suggest that anyone with this disease go for a transplant evaluation at a transplant center to see if they would qualify to be listed if they want to fight this disease and get well again. If the person got the disease from drinking, most if not all centers require at least 6 months of proven sobriety in order to be even considered for a transplant.

      Hope this helps you some.

  4. QUESTION:
    My mother has been diagnosed with End Stage Liver disease, what should I expect next?
    My mom is only 56, but has had a really tough life (drugs, alcohol, hep-c), now she has been diagnosed with End Stage Liver Disease. What should I expect next? I know she has to have a transplant, but I am weary that she will even last that long………..Im afraid, and ignorant about this type of situation

    • ANSWER:
      I assume your mother has ESLD (end stage liver disease) due to having hep C which is a virus that has attacked her liver causing scar tissue to replace healthy cells. This is called cirrhosis of the liver. They call it end stage when cirrhosis has formed in the liver. It could be a small amount of cirrhosis (scar tissue) or a large amount since they are not specific when they call it end stage. Since the doctor has apparently told her she will need a transplant, she probably has quite a bit of cirrhosis present.

      If she hasn’t done it already, she should go to a transplant center and get evaluated to see if she could qualify for a transplant. Maybe she has already done this and is already listed. I hope that is the case. The evaluation consists of a lot of medical tests, talking with psychiatrist, social worker, financial people about insurance coverage, etc. Then after she is through doing all this, a board of doctors will go over her case and decide whether or not she can be put on the national waiting list to receive a liver transplant.

      Once a person is on the list, they will be given a MELD (model for end stage liver disease) score. It goes from 6-40. The number of your score is from the results of 4 blood tests that show how sick you are and about your liver function. The higher your score, the more sick you are. Those with the highest scores goes to the top of the list since they need the transplant the most. When an organ becomes available, the transplant center will call the person at the top of the list who is a match to the donated organ. To be a match for a liver, all that is needed is to have a compatible blood type and similar body size. They are easier to match than a lot of other organs.

      You should educate yourself on the disease of cirrhosis so you know what happens as the liver continues to fail more and more. Having cirrhosis is not an automatic death sentence for many people. I have talked with many people who have had successful transplants who have hep C which is the number 2 reason for needing a transplant in this country. I believe alcohol abuse is the number one reason for liver cirrhosis. I don’t know how much damage your mom already has and what symptoms she is experiencing right now from her disease, but this disease slowly progresses. This is especially true with hep C. Since she needs a transplant, that should be her focus right now. Giving her a lot of love and support is so important and try not to be negative especially if she is listed and waiting for them to call her. There is no cure for cirrhosis other than a transplant.

      I was 45 when diagnosed with an autoimmune disease that caused my cirrhosis. My liver was already 90% destroyed with scar tissue when I found out. Even with that much damage, they still gave me an estimate of 5 years left to liver before total failure would occur. I got my transplant and am doing just fine today.

      Your mom should be seeing a gastroenterologist or a hepatologist to treat her disease. She should avoid ALL alcohol, that mean none at all. She should also avoid salt as much as possible since water retention is usually a problem and salt makes it worse. Bleeding problems are common due to unwanted veins that form with cirrhosis that can leak, burst and cause internal bleeding. Tell her to talk to her doctor asking about getting an endoscopy done to see if she has any of these veins (called varices) that need banded. It’s a procedure they can do that will greatly reduce the risk of internal bleeding quite a bit. I used to have mine checked every 3-6 months. They can give her diuretics (meds) for water retention problems. High ammonia levels are common due to the liver not working well anymore. This can cause confusion, memory loss, behavior changes, and if left untreated can lead to coma. They usually give a med called Lactulose for this. They also have Xifaxan if she can get the insurance to cover it. Both will help keep the ammonia levels down. This is why she needs a good doctor to deal with all the problems that come with this disease and know how to treat them and adjust meds as needed. You want to keep her safe and well as possible until transplant.

      I hope this helps you some. You can always email me if you have any other questions.

  5. QUESTION:
    What is the most common thing for someone with end stage liver disease to die from?
    My father has been diagnosed with end stage liver failure since September 25, 2006 and just yesterday his doctor called me saying that i needed to bring him to the hospital his kidneys are failing and then today he had a heart-attack, his potassium levels are really high too, anyone have any idea how long i have left with my dad?

    • ANSWER:
      You need to speak with his doctors.
      They have all his medical records and also
      his test results. They can give you an
      estimate, based on all this, of how long your
      Dad may have.

      Let me explain what takes place in liver failure.
      There are many different causes of liver
      problems. These causes can damage the
      liver cells. When this happens, the immune
      system of the body responds to this damage and
      can cause inflammation to develop inside the
      liver which will cause the liver to enlarge in
      size. If the cause of the problem can be
      removed, and the inflammation treated…then
      the cells may heal. If this doesn’t take place…
      it can progress to death of the liver cells and
      scar tissue forming inside the liver that blocks
      the flow of blood to any healthy cells that are
      left and also block the flow of blood through
      the liver on its way back to the heart. This disease is then known as cirrhosis of the liver.
      It is progressive and there is no cure.

      The liver handles toxins that come into the
      body, to convert them to a non toxic form.
      The liver is no longer able to do this efficiently and the toxins build up in the blood. The
      kidneys then try to remove these toxins on
      top of the job they normally do. This puts
      added stress on the kidneys and they are next
      in line to go into failure after the liver does.

      With having end stage liver failure, the kidneys
      not functioning well, and the fact of having
      a heart attack…the prognosis is not very good.
      They can try to stablize him…putting him on
      a dialysis machine to help the kidneys function
      better…to bring the electrolytes into balance.
      It will depend on how far advanced he is in
      the end stage liver failure, kidney problems, and how his heart responds to therapy.

      Wish I could be more uplifting…

  6. QUESTION:
    what age does end stage liver disease usually affect?
    i am doing a report and need to know about end stage liver disease. i need to know who it affects and at what age. also i need to know any cultural backgrounds or socioeconomics that may influence food choices for a person who has end stage liver disease.

    • ANSWER:
      Usually end stage liver disease has a lot of causes to mention: infections (viral, including HAV, HBV, HCV (rarely), HDV, HEV, bacterial, rickettsial, parasitic), drugs and toxins, ischemia (shock), Budd-Chiari syndrome,idiopathic chronic active hepatitis, acute Wilson’s disease, microvesicular fat syndromes (Reye’s syndrome, acute fatty liver of pregnancy). For all the mentioned diseases, if they are left untreated and not given full attention they will lead to END STAGE LIVER DISEASE. So it purely depends on what age the individual contracted the disease. For instance if that individual took a medication that is toxic to the liver at a very young age,then develop the signs and symptoms of liver pathology and neglect it then there is a likelihood that the individual will further go into complication leading to end stage liver disease. So its important for you to know what is the causes of every disease I mentioned earlier. For that it will give you an idea what are the factors involved leading to it. I hope I have given you enough information and if you have more feel free to ask me. Good Luck…

  7. QUESTION:
    What chemical causes dementia in patients with end stage liver disease?
    My friends mom has it and we are trying to figure out what the chemical was that causes it. The doctors said it but we don’t remember. Real medical answers from people who actually know would be greatly appreciated.

    • ANSWER:
      High ammonia levels can cause confusion, forgetfulness, hallucinations, and can cause a person to even become belligerant and violent. They are just not themselves. This is a condition called encephalopathy.

      The common drug used to treat this condition is Lactulose.

  8. QUESTION:
    What is the life expectancy of someone with end stage liver disease?
    Jaundice present, low blood pressure, ascites present (1L removed, addtional amount to be removed), kidney function deteriorating (improves with IV medication, but cannot sustain higher function without medication), MELD scores unknown.

    • ANSWER:
      about 7-10 days after kidneys deteriorate to end stage 4. coma first, then you go

  9. QUESTION:
    How long does a person live with end stage liver disease?
    my husband has been in the hospital for the last three months and has just come home. He is living on lactulose and suffers from severe nausea. his kidneys failed but with dialysis they have opened up but are not functioning fully. His meld score is 17 does anyone know how long someone usually lives like this?

    • ANSWER:
      Well, first off here is some info on how I know the answer.
      My dad was diagnosed with stage 4 liver cancer in July 2007. It was metastatic (meaning it began somewhere else). At that point the doctors gave him 9 months to live… at the beginning of the 8th month he was having a hard time breathing… so we figured we would take him to the ER so that they could put him on oxygen… 3 days later he was returned home and passed away about 24 hours later…. This does not mean that your husband won’t live longer… all people are different…

      However, I believe that hospice killed my father from mercy killing…. after all…. he ONLY went to the ER because he couldn’t breathe normal (he could still breathe and had an oxygen lvl of 92). They gave him enormous amounts of morphine and ativan… so… I really don’t know how much longer he would have survived if it wasn’t for those IDIOTS on the cancer ward…. anyway… Good luck and God bless… you and your family will be in my prayers!!!!! If you have any other questions feel free to ask!

      Edit….
      Sorry I just went back and re-read your question… liver disease is probably different from cancer… I missed that part… so probably disregard my answer….

  10. QUESTION:
    For someone with End Stage Liver Disease, how high does their MELD score have to be to get a transplant?
    Have a friend who is in End Stage Liver Disease, cirrhosis, who refuses hospice care, I need to know how high his MELD score has to be before they will “bump” him up on the donor list.

    • ANSWER:
      Not to discourage you. Not everybody with End stage Liver disease qualifies for a transplant. The doc’s have to consider why his liver has cirrhosis. If that is a possibility for the transplant as well, the chances are low.
      If they are already mention hospice care it does not look good.
      Sorry to say this, but my prayers are with him.

  11. QUESTION:
    Could someone tell me what happens to you with end stage liver disease?
    Please be as specific as necessary, I’m a realist and it won’t shock me.

    • ANSWER:
      I want to clarify first of all to anyone reading this that ESLD (end stage liver disease) is not referring to cancer. It is a medical term used for liver failure from cirrhosis (when healthy tissue in the liver is replaced by scar tissue).

      The term ESLD can be misleading because it just sounds so terrible. It means that at least some cirrhosis is present in the liver. It can be just a little bit or it could be a lot. As long as at least some cirrhosis is present, they call it end stage. It’s the last stage in the progression of liver failure, but a person can live a long time with it if there is just a small amount of cirrhosis present. As the disease progresses, everything just keeps getting worse with liver failure until it can be fatal. There is no cure for cirrhosis other than a transplant, but not everyone having cirrhosis will need a transplant depending on a number of factors such as what caused it, can it be treated and possibly slowed down or even stopped from progressing further, etc. It’s a very slow progressive disease that is permanent damage that will not go away. The liver can regenerate, but not when it comes to scar tissue.

      I’m guessing you are asking what happens to someone who has reached almost total failure and death is near. At the end, a person might or might not have pain. I had ESLD and never had any pain from it. They would retain a lot of fluid in the abdomen that might make them look pregnant. Their abdomen would be hard and swollen. Their skin and whites of eyes will be yellow with jaundice. They would probably be confused, maybe even hallucinate, have behavior changes due to high ammonia levels. They would be very weak and tired and can sleep 16 hours or more a day. Eventually, they would not be able to care for themselves and probably just slip into a coma and die. Not everyone with cirrhosis goes like this, but I’m just giving you the more common way it reaches the end. Some people can have a life threatening crisis that is fatal. They have trouble with their blood clotting and unwanted veins form inside that can leak and even burst causing a major hemorrhage. In other words, they could quickly bleed to death if a large vein suddenly bursts. Also, the fluid that typically builds up can become infected which can also kill the person. There are a number of ways that liver failure can be fatal.

  12. QUESTION:
    What vitamins are potentially harmful to the human liver during end stage liver disease?

    • ANSWER:
      All medications (over the counter, herbs, vitamins,
      minerals, and supplements) should be approved
      of by the doctor. Most all medications go through
      the liver first, to be broken down, before going
      to the rest of the body. Therefore, if the liver
      cells are damaged, all medications have to
      be adjusted and prescribed according to how
      much damage there is. The liver cells are what
      performs this function and because they cannot
      do these functions efficiently now or not at all…
      it is best to be safe. What once was okay for
      a person to take when healthy, can easily become
      toxic to the remaining functioning liver cells if
      taken in that same amount.

      Vitamins are water soluble and fat soluble.
      Water soluble ones leave the body faster.
      The fat soluble ones are the ones that the
      liver may store (Vitamin A,D,E,K,B12, etc)
      These are the vitamins that should not be
      taken in excess.

      It is best to have the doctor do blood testing
      and then tell you which vitamins the patient is
      lacking or whether it will be okay for them to
      take a multiply vitamins if needed. If they
      are not eatting well, he may recommend a
      supplement drink to help the patient get
      nourishment.

      I hope this information is of some help to you.
      Best wishes

  13. QUESTION:
    My dad has End-stage Liver disease/ liver failure (Cirrhosis) How long does he have?
    My family seems to be keeping a lot of information from me about his illness. I went to the hospital a few days ago and I really didn’t find out much. We are working really hard to get him a transplant and I just moved out of state to be with him during this ordeal.

    I may not want to know..but, how long do people normally live when they have Cirrhosis/Liver failure?

    • ANSWER:
      The timing can be tricky. It depends on how bad he is or how bad he is treated in the hospital. I would fight and fight for the transplant before he is no longer allowed one. When they get too sick they normally think the patient can’t survive and they don’t want to waste a liver on them. Sucks, that happen to my dad after his newer liver started failing. To learn more, I would search it online on Wikipedia.com. When everything was happening to my dad no one would tell us details about his illness and that totally sucked. I only learned once I was in Sonography College in great detail. Good luck it can be a long bumpy ride.

  14. QUESTION:
    My father-in-law has end stage liver disease. What is happening to him now?
    Last week they drained over a gallon of liquid from his abdomen while he spent two days in the hospital. Today he was non-responsive and taken to the hospital by ambulance. He’s in ICU and the family has learned his liver is no longer functioning. My son just went into Army boot camp and I am wondering if I should contact the Red Cross to let him know or wait. So many emotions with this one!

    • ANSWER:
      Unfortunately, a grandfather is not considered an immediate relative by the armed forces for purposes of emergency leave. You can call the Red Cross but I would not be hopeful about getting your son leave–especially since he’s in boot camp. I wish you well and I am sorry for your father-in-law’s grave illness.

  15. QUESTION:
    when someone With end stage liver disease falls into coma how long will they live?
    My mother in law has end stage liver disease and has had encepalapathy and last night she fell into a coma didn’t awake. 16 hours later she opened her eyes and is back asleep. How long will it be until death for her? I read that first person goes into coma before death happens.Is that usually a day,days, hours or week. I just want to know how much longer she will be with us?What next..

    • ANSWER:
      She probably has a day or two but less than a week. Things are now in God’s hands and she will die in her sleep.

  16. QUESTION:
    Is there any hope for an HIV POZ person with end stage liver disease from alcohol? Does anyone have experienc?
    I can’t find anything about the lives of alcoholics and HIV+ and their hope for life. Or even what the end is like? Please, I need some help other than “stop drinking” – did that already but it is too late…. thanks.

    • ANSWER:
      End stage liver disease is a bad diagnosis without being HIV positive. Add the HIV status and it is not a great scenario. The only treatment for end stage liver disease is a liver transplant and if the HIV is not under control the patient (you?) will probably not be stable for such a huge procedure. Medical management of the symptoms is probably the only feasible choice. A hepatologist should be involved.

  17. QUESTION:
    how long does someone live with end stage liver disease?
    she has Hep C, and is goherent one day and not the next, she hears alot of voices, and jerks alot. any estimate would be appreciated.
    she cat have a transpalnt, she is too week. she has hep C, CIPD, MS, cellulitis, vasculitis, and more…

    • ANSWER:
      it just really depends on the person. the only other thing i can tell you as at one point she will be in a light coma stage and wont be in any pain and will not know what is happening. it is usually a peaceful way to go.

      god bless.

  18. QUESTION:
    Is there anyone out there going through “End Stage Liver Disease”?
    I really need to converse with someone that is going through the same thing that I am going through right now. I am getting too many “different” answers to my questions, and research on the web is a nightmare.
    I am suffering from Hep C and I know everyone’s symptomatology is different, but could we please converse?

    • ANSWER:
      John, you have had no answers so far, and I don’t want you to receive none. I do not have liver problems, but I have great concerns for anyone facing a progressive disease. I feel for you, my man. I really do! I’m in Panama, now, and you can contact me at doncrisp99@yahoo.com. May God shine his grace upon you.

  19. QUESTION:
    end stage liver disease, being kept alive with lactulose?
    My mom has end stage liver disease from Hep C and drinking. she can not have a transplant she is to weak to undergo surgery. she is kept alive with Lactulose, it is keeping her ammonia levels down, the DR said if it wasnt for Lactulose, she would be gone. BUT, she was SO skinny before she went in, now with the lactulose everything runs right through her, she is now down to 85 LBS. she has her good days and her bad. she has encepholopathy, from the liver failure. any help would be appreciated.

    • ANSWER:
      Your mother would benefit from a high-calorie, high-protein diet. Calorically dense liquid nutritional supplements (such as Boost and Ensure) come in high protein formulas. She may also benefit from Benecalorie, a calorically dense food additive and Beneprotein or ProStat, both high protein supplements. And yes, Lactulose is used to treat hepatic encephalopathy does decrease ammonia but also is a laxative. Either you or she should speak to her hepatologist about the supplements I mentioned here and she can omit fiber from her diet. Your mother needs nutritional guidance and help now.

  20. QUESTION:
    How long does someone with end stage liver disease (non alcoholic, non hepititis) have to live?

    • ANSWER:
      There are no accurate ways to estimate prognosis in many disease processes, including liver disease, as there are too many factors to consider, including severity of illness, co-morbidities, adherence to therapy, lifestyle, age, ect. Also the term ‘end stage liver disease’ has no exact definition, it is one used by practictioners with great variance. Measurable indicators such as Childs class or MELD scores are more accurate and useful, but even these only give percentages such as 5 year mortality or surgical risk. It also depends on the cause, and you have ruled out the two most common causes of liver disease.
      Liver disease in and of itself does not cause death, it is the complications associated with it. The most life threatning of these are esophageal varices resulting in massive GI bleeds. However there are many other complications possible due to blood clotting abnormalities, opportunistic infections, encephalopathy, and kidney failure. There are many symptomatic treatments for the complications of liver disease that may substantially increase survival and the liver is a remarkable organ that can improve if the underlying cause is treated. Also in true end stage liver disease in a non alcoholic, liver transplant is an option.
      There is a very large population of people with the diagnosis of ‘end stage liver disease,’ the severity of their illness is variable, as is their survival. However there is currently good medical options for those who seek treatment and adhere to recommendations. It is however a devastating disease and I wish you luck and hope for the best of scenarios in whatever situation has prompted this question.

  21. QUESTION:
    Can anyone give me alternative resources for end stage liver disease or where they can be located.?
    Doctors have no compassion!!! Just take another pill. If you have Medicare or Medicade just let them die, so there is one less person the government has to pay thier expences!!!

    • ANSWER:
      You have not given any symptoms or details about the patient, I am a Homeopathic practitioner, can you please tell me what exactly is the patient feeling in the mean while I can tell you these three remedies with which I have had almost miraculous comeback where liver disease are concerned including Hepatitis Liver cancer and Cirrhosis of the liver all nay sayer will tell you Homeopathy is nothing but placebo well i have cured people whom were considered incurable by our conventional doctors get cured and walk away 100% fit as a fiddle, The three remedies are SULFUR in 30 or 200 potency BRYONIA ALBA in 30 or 200 potency and CARDUSS MARIANUS in Q(mother Tincture ) potency. 3 drops of SULFUR 30, 3 drops on BRYONIA 30 and 20 Drops of CARDUSS MARIANUS in about a sip of warm water three times a day if you are using SULFUR and BRYONIA in 200 potency just one dose of both are enough in 24 hours but keep giving CARDUSS MARIANUS 20 drops three times a day try them for three days and let me know the results, A person who had Hepatitis C with liver cirrhosis which deleloped into liver cancer and was rejected by our local hospital after being treated for two months and they told him he had no more then a week is under my treatment taking the above remedies for the last 6 months and getting better everyday he does not have Hepatitis anymore all his tests have come out totally cleaned and now the doctors have changed their statement and they say maybe he was not diagnosed right and he never had Hepatitis C. The decision is yours you can let him die or you can take my advise and maybe cure him. i would be happy to be of help if you can give me the exact symptoms of the patient exactly the way he or she is feeling them.
      Homeopathy treats the patient not the disease, all I am asking you to do is give these remedies a chance for just three days and if you don’t see any gradual improvement in the patient you are free to discontinue them. These won’t cause any side effects or complications and won’t react with other conventional medication in any way just take these remedies on an empty stomach half an hour before or after meals.
      It is my duty as a healer to try and help you with the best of my knowledge and expertise and I am trying to do exactly that i am not trying to sell you anything just trying to make a difference and save someones life which is my only objective.
      Feel free to email me if you need to know anything or clarify anything and I will be more then happy to help you anyway I can.
      And remember life and death are only in the almighty’s hands and we are no one to predict when someone is going to die and our doctors are No Gods and hence cannot predict anyones death.

      Take Care and God Bless you and Your loved ones. Amen

  22. QUESTION:
    How does end stage liver disease manifest?

    • ANSWER:
      Acute liver failure is distinguished by a breakdown of the organ’s synthetic and detoxification processes—which can occur within two weeks in a liver that previously was functioning normally.

      Hemodynamic instability. The liver synthesizes albumin, along with other major blood proteins. Albumin helps keep circulating fluid in the blood vessels. Without albumin, colloid osmotic pressure is lost. Fluid seeps into the interstitial spaces, causing hypovolemia, generalized edema, and ascites. Hypotension results. The systemic vascular resistance plummets, and cardiac output rises

      All patients in liver failure will have blood clotting problems because the liver cells are responsible for making all but two of the body’s clotting factors. Bleeding is common in liver failure, Patients may have upper GI bleeding or bleed from their nose, lungs, retroperitoneum, or subcutaneous tissue

      Metabolic problems. Hypoglycemia develops because the liver can no longer store glycogen or manufacture glucose out of fat or protein. Triglycerides can’t be used for energy, either

      If you suspect impending liver failure in a patient with vague complaints, take a detailed history. Ask about their intake of medications that are hepatotoxic, such as acetaminophen (Tylenol) and phenytoin (Dilantin), and of hepatotoxic substances like alcohol or cocaine. Investigate recent travel. Patients who’ve been visiting China or the Pacific Islands may have been exposed to hepatitis B. Abuse of drugs administered intravenously and occupational exposure to blood/body fluids or other hazards suggest a viral toxin, too.

  23. QUESTION:
    My mom has end stage liver disease and her teeth are deteriorating.Is this common? Does anything help?Thanks.?
    mom has end stage liver disease (meld score of 7), is on the transplant waiting list..her teeth were fine in november..now they are loose and will fall out soon, or have to be pulled. She is only 55 and has always taken very good care of her teeth.

    • ANSWER:
      This is a quite common problem, fortunately not the most serious. It is necessary to cure all possible sources of infection before liver transplantation and dental granulomas are very frequent. Your mom needs a liver graft ASAP and she for sure prefers to save her life, not teeth.

  24. QUESTION:
    Diet for end-stage liver disease?
    My mom has end-stage liver disease & we’re both wondering if there’s a diet that will reverse liver damage, repair liver damage, or atleast keep her where she is – currently a MELD score of 16.

    • ANSWER:
      I’ve heard about some luck using a vegetarian diet, but I have no more information. It used whole grains and no processed foods, cooked slowly (not nuked). Hope you can find more.

  25. QUESTION:
    end stage liver disease?
    how long does a person with end stage liver disease have left to live???? my mother in law is sick with it:(
    she has end stage liver disease and congestive heart failure plus renal disease and asthma! and her lungs are messed up
    and shes also on dialysis 3 times a week

    • ANSWER:
      Let me explain a few things to make this
      easier to understand. Someone who is in
      “End” stage liver disease can develop fluid
      in their lungs. They can also develop
      kidney failure? Why, because when the
      liver is not functioning well enough to remove
      toxins from the body, then the kidneys work
      harder to try to rid the body of all these
      toxins which puts a strain on the kidneys to
      keep up and they can also go into failure.
      The dialysis is helping remove these toxins
      from the body and helping the kidneys to
      function better. If the kidneys are not
      functioning well because of this, this can
      effect the heart and how it is beating.
      It is like a chain reaction in what happens to
      the organs in the body when one fails.
      You did not say whether she had these
      conditions before her liver problem developed
      or as a result of her liver problem.
      If she had “serious” heart trouble and kidney trouble before having this liver problem, it is highly “unlikely” she would be able to have a
      liver transplant, because she may not be
      strong enough to make it through such a
      long surgery.
      With what you have posted here, only her
      doctors would be able to tell you an
      estimate of how long she might have.
      End stage can mean the last few stages
      of the disease or it can mean the very
      last stage of the disease. It sounds like
      the very last stage…so I don’t need to
      say anymore.
      I hope this will be of some help to you.

  26. QUESTION:
    End Stage Liver Disease – Prognosis?
    hi, my mum has end stage liver disease. she is being released from hospital today after only 4 days in there. She has had her varicies banded, (3 in total, she was throwing up blood and lost a lot of blood) and is badly jaundiced. They have been pumping her body with everything and have drained over 5 litres from her abdomen. They have said he liver will never repaired it self and has failed. I’m a bit concerned she is being released so early, as previously she has been in for a couple of weeks. Is she being released because there is nothing more they can do for her and its likely she will pass soon? Also how long can the body function with a failed liver? If anyone has any personal experience on this or is a doctor i’d be very grateful for your responses. The doctors will not answer my questions due to patient confidentiality. Her blood doesn’t clot and her eyes are very jaundiced. Many thanks for your help.

    • ANSWER:
      Your mother is showing all the signs of end stage liver failure. Her liver has not failed completely yet because if it did, she would not be alive. She still has some function but it is very poor and will only get worse in time.

      The hospital has did what they could for her which was make her comfortable and stabilize her. There is nothing more they can do for her at the hospital unless she goes through another bleeding crisis or some other life threatening problem that comes with liver failure. When someone has liver failure like your mom, their body will grow these unwanted veins called varices. These are not like the veins we are born with. They can grow very large, leak, and even burst which causes internal bleeding. If the vein is very large and bursts, the person can actually bleed to death in a short time. Your mother got to the hospital in time to save her life. The do a procedure called “banding” which will destroy the vein. Apparently, they have found 3 on your mom even though there could be more. Sometimes they will only band a few of them at a time and the person has to go through several visits to get all of them done. I had liver failure and used to get mine checked every 3-6 months. Banding will greatly reduce the risk of further bleeding episodes.

      Draining the fluid from your mom is called a paracentesis. Again, the liver is not working right, so fluid is able to accumulate especially in the abdominal area. It can be quite uncomfortable and also be a risk to her life if it gets bad enough. This will probably always be a problem for her and will only get worse over time. It is not unusual for people to get this done routinely when their liver is near total failure.

      I’m sorry to say that the prognosis for your mum is very poor. The only cure for this kind of liver failure is a liver transplant. Has anyone talked to her about this? Not everyone can get one and there might be some reason this has not been mentioned to your mum, but that is what she really needs to save her life. Without one, the liver will eventually completely fail and take her life. How long will this be? Only her doctor could give an estimate. It sounds like she is in the very advanced stage of liver failure, but no one knows for sure how long that might be. Liver failure is usually a very slow progression so it’s hard to tell. Many factors come into play as to how long it could take such as the reason for having the failure in the first place.

      Your mum has made it through another crisis and you can be thankful for that. Anyone with advanced liver failure can have a crisis at any time. I don’t know the circumstances surrounding your mum and her liver failure, but if there is any way she can get a transplant, she should work her hardest to get one if possible. That is the one and only thing that will save her life. I’m sorry your mum is so sick. I went through this myself and received a liver transplant 5 years ago.

  27. QUESTION:
    Living and Caring For Someone With End Stage Liver Disease?
    I don’t even know where to start… But I need someone to talk to…

    My grandmother has end stage liver disease… I known for awhile she had liver problems but she has kept them from us or just not told, She always taken care of us.

    Lately she been in and outta the hospital these past few months, with some really good scares in there, I guess i just been playing blind to the fact of all her medical problems, because there a whole whack of them, but as the time goes by, I can no longer play blind to the fact of what is inevitable.

    She is the End Stage Liver Disease, I’m sure it just the beginning ( i think) i Google it and read some of the article online, the most things that come up are about Kidney Failure and it being down hill from there and she not there at that stage,

    I don’t wanna dance around the question, but what kinda of life expectancy are we looking at, without a transplant, and I pretty sure we are a far ways from evening being fit to be a candidate, and even if she was fit, the wait cant be unbelievable long, ( I know this from another family member waiting for a liver transplant and she been waiting forever)

    There been so many hospital visit in the past months, and there so many other things wrong with her, I just don’t know… and I haven’t really asked the doctor too much yet… I want know what is coming my way, I am crazy to be thinking the worst is starting… ( As much as I wish I was I don’t think I am )

    I’m in the role switching spot, where I am know the caregiver, A caregiver to a women has done so much for e in my life… she been my rock… I don’t expect to get the answer im looking for here… I’m not even sure of all the detail … this Liver disease ( and actually taking a look at it ) is all very new to me .

    The Basis of all this is… I dont wanna play blind to the fact…. waste the time do have with her, thinking ahh she be ok…. because visit and visit seem to get worse… maybe im rambling for nothing…. but i hope someone hears me ….

    ~Feeling Scared and Alone ~

    • ANSWER:
      Kiddo, first and foremost you need to be a part of her medial care which means asking questions. Make a list of the ones you already have for her doctor. Knowledge is key.

      As well, you can look at getting some outside help… a nurse to come in a couple of times per week to look in on her and help you with concerns you may have as well. You will also need a break now and then.

      I would also talk to a counselor. Emotionally this is going to take a toll on you. As it would anyone in your situation.

      Have her friends over for tea sometime. Visits are important and will make everyone feel good and up lift spirits.

      Keep your chin up.

  28. QUESTION:
    My father has end stage liver disease – how much time does he have left?
    My father is 53 years old and has just been diagnosed with end stage liver disease. Unknown to the family, he had been diagnosed with Hepatitis C nearly 10 years ago and never sought treatment. He was in ICU on a ventilator and bleeding from his nose and mouth for about a week, he is now at home. His abdomen is very swollen (he looks 9 months pregnant), and his bloodwork and ammonia levels are all out of whack. When he was in the hospital, they said in order to be put on the list for a liver transplant he had to be alcohol free for 6 months. He can’t be put on the list because the doctors said he doesn’t have 6 months left to live, but this is the only sort of time frame we’ve been given. I moved out of state in February and it is hard for me to get up there to visit him, as it’s either a 14 hour drive or a very expensive plane ticket. I just wish I could know how much time he has left. Any input or help at all is much appreciated . . . feel free to email me as well. Thanks.
    FYI – it has been about 3 weeks since his initial diagnosis.

    • ANSWER:
      No one can actually give a specific time frame. Drs. can only give an educated guess. Im a hospice nurse. I would suggest referring your dad to a hospice agency nearby, if he isn’t already on services. The nurses work together with his Dr. to make sure he is comfortable and instruct the patient and family on signs and symtoms of approaching death. Taking care of a very ill person is very overwhelming and this really helps to allow family members spend more quality time together. I still think if at all possible, placement on the liver donor list would be a good idea, because like I said Drs. can only give an educated guess. I have seen patients, given the medications and diet needed able to hang in there for even a year longer. I do not want to give you false hope, I do not know what exact condition your dad is in. I hope that this helps.

  29. QUESTION:
    How much longer with end stage liver disease?
    my mother 63 and has end stage liver disease. she does not want to have a liver transplant. she is also on about 10 different meds. she all the sign that go with disease, yellow skin, retaining water, ect. i talked to her today and she is throwing up and try to drink water and dry heves. she does not want help and wants to die. she also has not eaten in days and sleeps alot. Whats next… i know no one really know how long but any ideas would be a good help.
    she alo says she has a fever.

    • ANSWER:
      you need to take her to hosp. with out help she may have about a month to live

  30. QUESTION:
    if someone is in Early End stage liver disease, what is the likely hood that they will end up on the?
    transplant list? Does it always get to that point if you stick to the diet and meds?

    My fiance was just diagnosed with Early End Stage Liver disease. I’m sure that it is due to his alcohol consumption since he also had alcoholic hepatitis. I need some encouraging words to get him back on his feet. We do not know if this is definitely a liver is dying situation as of yet, but given the diagnosis and that his liver counts were fine, I can only hope for the best. Can anyone tell me what to expect and if the Hepatic diet with the meds will help.

    They did not do any type of biopsy, but the did drain 4 liters of fluid out of his abdomen. I am really nervous and am trying to stay positive about the outlook and outcome.

    • ANSWER:
      They really need to do a biopsy to determine how much damage is present in his liver. The most important thing he can do is to stop drinking ALL alcohol. That is more important than anything else and will help him more than anything else such as diet. You don’t say whether or not they have told your boyfirend he has fibrosis or cirrhosis of the liver. There is a big difference. In the fibrosis stage, if he stops drinking and takes care of himself, then his liver can actually heal itself and he should be fine.

      When you say “:early end stage” they are usually talking about cirrhosis since that is true end stage liver disease. They probably mean that he has just a small amount of cirrhosis present right now. Cirrhosis occurs when scar tissue replaces healthy tissue in the liver. This is permanent damage that will never go away. If he continues to drink, more and more scar tissue will form until the damage is severe and total liver failure will eventually occur. I had cirrhosis and my first symptom was fluid in my abdomen that needed drained like your boyfriend. I was eventually sent to a transplant clinic for an evaluation. Everything right now depends on the amount of damage and whether or not he continues to drink. Everytime he takes a drink, inflammation to the liver continues and more damage is done. The good news is that a person can still stay alive even with a significant amount of damage since the liver is a pretty tough organ. If he stops drinking and it’s in the early stage, then he might be able to stop the progression of his cirrhosis to becoming total liver failure. Once the damage gets severe enough, there is no stopping it from progressing. It will continue no matter what you do. That’s why it’s so important to not drink alcohol. Even if he stops and starts doing better healthwise, he still cannot go back to drinking because the scar tissue is still there forever. The disease would just pick up where it left off at if he starts drinking again.

      The meds and diet will help control the symtpoms. If the cirrhosis progresses to being much worse, the meds stop helping and that’s when you know total failure is near. He could live a very long time as long as he starts doing the right thing, but if not, his prognosis is very poor.

  31. QUESTION:
    End Stage Liver Disease w/HepC, looking for help, hope?
    My husband’s cousin has had HepC for decades, and had a transplant last year. The new liver is infected, and she’s been told she’s end stage, level 3?, and may not live to see 2010. I’m looking for any alternative treatments in this situation…

    • ANSWER:
      Sorry about your husbands cousin but there is probably nothing that alternative medicine can do to help you . Alternative medicine is usually much milder in action than allopathic (regular) medicine so is unlikely to be effective at this late stage. You can go to your local health food store and the people there should be able to tell you of alternative medical practitioners in your area.

  32. QUESTION:
    Does cirrhosis cause itching BEFORE ‘end stage liver disease’?
    My consultant actually started shouting at me that I was foolish and that there was no connection between liver disease inc. cirrhosis and a problem with itching skin (unless I was in ‘End Stage’ and actually dying (I’m not). Has actually now refused to see me as I am ‘difficult’ and says my appointments in future will be with a nurse!!! I have read lots of references to itching with liver disease and experience it myself every day – why can they not believe anything other than what they were told in Medical school however many years ago. I think I am actually being barred because I display insufficient gratitude when dealing with her, i.e. I don’t necessarily believe everything she says automatically – experience has taught me they don’t know everything, or anything like it.

    • ANSWER:
      Very unprofessional. I would not feel comfortable seeing this doctor or his staff again. Please seek another specialist.
      I’m not sure if this can cause itching in stages less than ESLD. Cirrhosis is stage 4 of liver disease, and while you may not be in the decompensation stage, you still have significant scarring. So I would imagine that due to that fibrosis or scarring, your liver is probably not functioning efficiently like it should. It may not be processing the bile correctly, and that build up can cause itching. Doctors often tell us one thing based on research, but in reality, patients often feel otherwise. Another case in point is that people say they feel pain in the area of the liver, but doctors will tell you that there are no nerve endings to feel pain in the liver. However, the sac that surrounds the liver can stretch with inflammation and can cause pain.
      That being said, you’re right. They don’t know everything. I hope you find a doctor that listens to your symptoms and respects you as a patient. Best wishes.

  33. QUESTION:
    End stage liver disease w/Hep C, looking for help, hope?
    My husband’s cousin has had HepC for decades, and had a transplant last year. The new liver is infected, and she’s been told she’s end stage, level 3?, and may not live to see 2010. I’m looking for any alternative treatments in this situation…

    • ANSWER:
      I have provided some links that you might find useful. It is called the Gerson Therapy. Hopefully you will find the answers that you seek. The last 2 links deals with spiritual matters. I hope you will find some comfort in them.

  34. QUESTION:
    what medicines can you take if you have end stage liver disease?

    • ANSWER:
      I disagree with the guy up here. There are pain medications that bypass the liver like Numorphan [morphine in suppository form] and Fentanyl Transdermal patches. No need to have your friend go through more pain and suffering than he has already endured. He has the right to to live what is left as pain free as humanely possible.

  35. QUESTION:
    Could narcolepsy be related to end stage liver disease?

    • ANSWER:
      No, they are two totally different medical conditions and not related to one another.

  36. QUESTION:
    would a person throw up blood if they were in end stage liver disease?
    my sister has hep c she is now throwing up with what looks like dried blood, also a bit of confusion, she has ascites and is getting drained approx every 10 days

    • ANSWER:
      Any throwing up of blood is a medical
      emergency!
      Let me explain…
      People who are in the end stages of liver
      disease usually have portal hypertension.
      This is because the blood no longer goes
      through the liver and backs up into other
      vessels that are not used to handling
      this amount of blood. The vein that usually
      carries this blood through the liver is
      known as the Portal vein. Portal hypertension
      is the pressure building up there that is
      forcing this to happen. These other vessels
      will have weak spots in them. These weak
      spots can balloon outward and burst open.
      When this happens, she may be bleeding
      internally or can bleed out completely.
      It is very important that she be checked out
      immediately. These vessels are located
      mostly in the esophagus, but are also
      located in the belly button area and also
      the rectum. If they catch this in time,
      they can go into the esophagus and place
      a band around the varies and stop the bleeding.

      The confusion she may be having is known
      as encephalopathy. This is cause by
      the ammonia, that the liver usually converts
      into a non toxic form so it can be disposed
      of in the urine…isn’t being converted now and
      is staying in the blood and going pass the
      blood brain barrier and into the brain. It cause
      confusion, unclear thinking, and if not treated…
      can lead to a coma. There is medications
      that the doctor can give someone who has
      this that will bind this extra ammonia and
      remove it from the body, known as lactulose…
      there are others also, but this is the main one.

      The blood can look bright red (oxygenated)
      darker red to purple (lacks oxygen) or even
      coffee ground (starting to form clotting or
      drying up).

      If you want to learn more about your sister
      disease…here is a site:

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

      Cirrhosis of the liver is death of the liver
      cells which forms scar tissue inside of
      the liver. The functions that the liver once
      did deteriorate.

      Here is a link to explain Portal Hypertension:

      http://www.webmd.com/digestive-disorders/digestive-diseases-portal

      Here is a link to explain about encephalopathy and how it effects the
      brain:

      http://www.hcvadvocate.org/hepatitis/hepC/hepatic_encephalopathy.html

      This site is the best on the web for people
      who have Hepatitis C:

      http://www.janis7hepc.com/

      I hope this information is of some help to you.

  37. QUESTION:
    End stage liver disease?
    Is anyone out there living with an end stage liver patient? Having trouble getting along with them after the personalily change?

    • ANSWER:
      in liver disease this is common (whether or not it’s end stage or not)
      more than likely the person doesn’t really remember doing or saying much. the whole body is toxified and this influences the brain as well and how it relates. the mental disease associated with liver disease is not an easy one to deal with.
      try not to take anything to heart….if you need to talk -heppystephy (yahoo.com)
      sounds like your mom is nearing the end. she will eventually end up in a light coma-most pass on peacefully and aren’t aware of their issue.

  38. QUESTION:
    Who can help with answers about end stage liver disease?

    • ANSWER:
      The liver can become damaged by a number of reasons:
      (1) Alcohol abuse (2) medications toxic to the liver
      (3) hereditary conditions (4)bile duct blockage
      (5) autoimmune disease (6) bacterial or viral hepatitis
      (7) fatty liver (8) chemical exposure (9) mushroom poisoning
      And there are others. All this usually starts out as
      inflammation of the liver cells. There may be no symptoms
      at all during this time.

      However, to continue to end stage liver disease.
      With end stage disease, the liver cells die off. These dead
      cells form scar tissue inside the liver. Once this happens,
      it can cut off the blood supply to the healthy cells that may
      be left. In which case, when the cells do not receive
      enough oxygen and nourishment from the blood…they die
      also. The cells that are left, try to reproduce to replace the
      dead ones. But, because the scar tissue is there…instead
      of the cells connecting to each other…the bunch up against
      the scar tissue which forms the appearance of a cirrhosed
      liver. This is the appearance of nodules, or lumps you
      see on the liver. When all this takes place, the cells can
      no longer do the functions that liver once handles to keep
      the body working well. This is usually when the symptoms
      start to appear.

      Usually, the first thing the patient notices is
      Jaundice…which is the yellowing of the white of the eyes,
      skin and mucus membrance because the liver isn’t able
      to convert the bilirubin into a soluble form that the body
      can dispose of.
      Now other things you may notice are:
      (1) red palms and red soles of the feet
      (2) spider like veins on the chest, neck, and shoulder areas
      (3) extreme tiredness

      As we continue to the end stages, symptoms become
      more severe:
      (4) there is confusion and the inability to concentrate.
      This is known as “encephalopathy”. This occurs because
      the liver is no longer able to change the by product of
      protein…which is ammonia, into urea to be disposed of
      by the body. The ammonia goes into the blood and pass
      the blood brain barrier and effects the brain.
      (5) there is fluid developing in the abdominal area.
      This is known as “Ascites”. This occurs because the
      liver isn’t able to make the protein Albumin well anymore.
      The albumin is what holds the fluids inside our vessels.
      When it goes low in the blood, the fluid can seep out and
      gather in the abdomen.
      (6) Since the liver isn’t able to make protein well, the
      body will start to use the protein it already has….this
      leads to muscle wasting.
      (If you look at a patient with cirrhosis: they look like a
      pregnant skeleton with skin. This is just an idea of what
      you will see. )
      (7) The patient may develop varies, usually in the esophagus…but they may also occur in the rectum or belly
      button area. These are varicose veins that form because
      the damage liver blocks the blood flow through it now and
      it backs up into vessels that don’t usually handle that
      much pressure or blood load. So they tend to balloon
      out in weak spots like this and can easily break open and
      the patient can bleed internally. This pressure that
      builds up is known as “portal Hypertention”

      To learn more about cirrhosis, which is death of the liver
      cells:

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

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

      http://www.emedicinehealth.com/cirrhosis/article_em.htm

      To learn about transplantation:

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

      When a person reaches end stage liver disease, they need
      someone there who can help them with everything. It is
      best for the family to see about getting an advance directive
      or durable power of attorney so they can handle their
      affairs and talk to the patients doctors.
      No one is able to tell you how long a patient “may” have to
      live except for the doctors. The doctors will do blood tests
      and film testing and maybe biopsies to see how far
      advanced in the disease they are. It will depend on how
      far along the cirrhosis is in the liver and if it covers the
      whole liver or just part of it. It will also depend on how well
      the liver is still functioning.

      The best doctor to have when a patient is in the end stages,
      is a hepatologist that is connected to one of the
      Transplant Centers’ hospitals. The best test known to
      see how far advanced the disease is, is the liver biopsy
      where they can look directly at a tissue specimen and not
      just films.

      If you get in contact with the transplant center closest to
      your home, they may have support groups there…seminars
      on transplantation, and may even give you information in
      pamplets, etc.

      Here are some sites if you are considering a transplant:

      http://www.unos.org/

      On the Unos site, there is a link in orange which says:
      Transplant living…this is also very good.

      I hope this is of some help to you. If you have
      questions: there is a group on Yahoo known as
      “Liver Cirrhosis Support Group” that is free to join.

      http://health.groups.yahoo.com/group/livercirrhosissupport/

  39. QUESTION:
    Are there any other common treatments besides liver transplants for treatment of end-stage liver disease?

    • ANSWER:
      When a diagnosis is given such as ESLD (end stage liver disease), it doesn’t necessarily mean it is fatal and will require a transplant. There are three stages.

      A. Compensated meaning not too sick
      B. Beginning to decompensate (complications beginning to appear)
      C. Decompensated (significant liver failure that will require transplant)

      In the earlier stages, if the reason for liver failure is able to be eliminated, then these people can often stop the disease altogether and might never require a transplant. Example: An alcoholic quits drinking, and if the damage is not too severe, they can get better and will be able to live with the amount of damage already done.

      If the reason for the disease cannot be eliminated, the doctors just routinely treat the problems that come with the disease as it progresses. Meds can help get rid of the excessive fluid in your body, meds can help control ammonia levels, banding can be done through endoscopy to get rid of the unwanted varix (veins that grow trying to get blood supply to your liver that can leak and bleed), and low sodium diet to help control fluid retention. These are just some of the typical problems that are treated for those with cirrhosis.

      There is little they can do except treat the symptoms once the damage has been done.

  40. QUESTION:
    how long does my mother have? She has end stage liver disease…?
    I just need to know because I the doctors arent saying anything much. I need to know the truth. I am not ready to lost my mother, but she is very bad. She is home with us, but she cannot get out of bed on her own and can’t walk anymore. SHe says she is fine, but it seems like everytime she has to go to the hospital she gets worse and now sometimes we have to beg her to eat. HELP!!!

    • ANSWER:
      No one can tell you how long someone has. They can respond well or not respond well to treatment from day to day. It’s critical that your Mother take her lactulose – we were megadosing my brother toward the end (right before transplant) just to keep him sane. Mark was in a coma, as well, before we learned how critical this medication is. The lasix and spironolactone are also very important – she needs to take both. One raises potassium and the other lowers it, which keeps down those complications.

      Are they giving your Mother Epoetin injections? It helps her body produce red blood cells. What about FFP and albumin? These help keep the fluids in the venous system, instead of in the abdomen (ascites) where it can cause problems with breathing, etc.

      Do you know your Mother’s MELD score? It’s an indication, on a scale of 6 to 40, of how far the disease has advanced.

      Your family is in my prayers!

  41. QUESTION:
    Do you know any one who has end stage liver disease?

    • ANSWER:
      exactly what u want ot find out ? let it know.

  42. QUESTION:
    my mum is 56.has end stage liver disease.black stools, jaundice and blood levels very low.what to expect next?
    now she had and angina attack took to the doctor and he said she got water in her lungs and her pressure is low.what can we expect after this.is it going to get worse

    • ANSWER:

  43. QUESTION:
    what is the life expectancy of a person with end stage liver disease (cirrhosis)?

    • ANSWER:
      from experience in my own family it only took about 8 weeks give or take a few days.

  44. QUESTION:
    i am 39 with end stage liver disease–has anyone else been thru this?

    • ANSWER:
      Sadrina, I myself have not been threw this but know somebody who has. He had lung cancer and had taken radiation, chemo. but none of it was doing any good , he was close to death and hospice was called in and started giving him strong pain medication and in about 3 weeks he died, hospice said that liver failure is very painful disease and then moved him up to morphine. It was very sad for his children even though they were already grown and had children and they knew he had come to the dying stage and thought they were prepared for his death, they really were not and it hit them all pretty hard. Good Luck Rita V

  45. QUESTION:
    My mother has end stage liver disease. She was given 6 months 4 months ago.?
    4 months ago, my mother was sent home from the hospital with ESLD. Doctors never told her she was going home to die. A hospice nurse visited her (whom I tried to stop until my brother came home from Boston), and told her. It is 4 months later. She hasn’t drank any alcohol and is following the diet, meds, lactulose, to the letter. She seems to be improving. She takes long walks and has babysat my rambunctius 11 yr old. She has problems sleeping and pain in her left leg. Otherwise healthier than I have seen her in a couple years. Is this false hope or might she recover? She has less than 20% of healthy liver left, so I imagine recovery is not the right word, but with continnuing to follow the regimen might she live years? She is 57. The abdominal water retention she had has greatly receeded.
    This is NOT cancer. It is due to alcoholism. I clean for a woman who was given the same diagnosis 3 years ago. Though, I don;t know how typical that is. I am looking for more specific
    experiences.
    I call her every day and go to her house every day that I can. She loves Phantom of the Opera and I got her an autographed pic and personalized letter from Michael Crawford. I made a video for her on You Tube. I contacted Amvets who is sending her a citation for her work with the local America’s Hero’s Association. I spend every minute and every dime I have to make sure every minute counts.

    I am REALLY looking for someone that has had the same experience and some details on this particulat ESLD.

    • ANSWER:
      They say they get better before they get worse. When my step-father was dying of lung cancer, he improved a ton then it got really bad. I don’t want to dash all of your hope, though. Maybe since she’s taking better care of herself, she is buying herself a little time. Just be sure to spend as much quality time with her as you can. I’m really sorry you both have to go through this. It’s not easy. God Bless.

  46. QUESTION:
    MELD SCORE (model for end stage liver disease)?
    My friend has a Meld Score of 15, and he said the highest number is 23, but all the info I looked up said the highest number is 40…. why would his doctor give him the 23 number? Am I missing something?

    • ANSWER:
      The Meld score goes from 6 to 40. Those
      with a Meld score closer to 6 are the most
      healthiest and may not need a transplant
      as soon, as you go up the scale closer to
      40, then they are sicker, will die sooner if they
      don’t have a transplant. They go by what a
      persons blood work results show: the
      Bilirubin, INR, and creatine and also, now the
      sodium.

      Some doctors still use the old scoring
      system known as the Child Pugh Score:
      here is a link to that

      http://en.wikipedia.org/wiki/Child-Pugh_score

      Your friend, may someway been using that
      system instead of the MELD. Though, it
      still doesn’t make sense.

      He should be with either a gastroenterologist
      or a hepatologist. You did not state if he
      was on the transplant list or not. There are
      calculators on line that give a patient an
      approximation of what their MELD score might
      be by putting information in from their lab
      results.

      I believe I would ask him again about this.
      However, the farther up the transplant list
      he goes…there is a condition that shows
      up> it is known as Encephalopathy. This
      is where the toxins that the liver no longer can
      handle, go out into the blood and pass the
      blood brain barrier and into the brain. It
      causes unclear thinking, confusion, sleep
      pattern changes, extreme tiredness and
      other things. The doctors first line of
      treatment for this is a drug known as
      Lactalose.

      I hope this helps you understand more.

  47. QUESTION:
    l have been told l have end stage liver disease what does that mean..jan09puffy?

    • ANSWER:
      End stage of any disease means the disease is terminal and you don’t have too long left to live without serious treatment. Don’t panic, there are options. Nine years ago I had end stage pulmonary disease and less than a year to live. I recieved a double lung transplant and am doing well. I also have a brother, who like you is facing end stage liver disease and has been informed that he has no more than two years to live. He is at this moment being worked up for a liver transplant. Don’t give up hope, talk to your doctor about what options may be available ro you and very importantly what youcan do to otherwise maintain your health. Whatever happens you will need your strength. Good luck and if the transplant route is available to you and you want more information or moral support, please feel free to contact me.

  48. QUESTION:
    a weird medical question: what harm can viagra,orsomething similar do to someone in end stage liver disease?
    hospice has ask me if I have funeral arrangements. they have qualified my son. they want to put him on pain pump. my son’s girlfriend wants him to get viagra. hospice will not do it we are all in shock at her selfishness, as she must be nympho, for real. at a time like this, she is worried about that. i have been upset with her for many reasons, as she is interfering with his well being, but my son is wayy to sick to see it. he just seems glad to have her at all. i am keeping my mouth shut to him, as I don’t want him to know exactly how upset I am. he was real sick yesterday,and she told me they had sex. he was sick after the sex. real sick. what is going on medically??? does anyone know? hospice said his liver was about gone. not having the viagra, he or she will get illlegal something to substitute to satisfy her very selfish needs. should she not show him she loves him without all the pressure for that? just so upset, please forgive me. when he is more incompetent than now, i can make decisions. that is not now, as he is losing mind and does not really know what he is doing, he can still talk and walk. yesterday, he could barely walk after their sex. what happened? is a heart attack possible? this is a serious question about someone terminally ill, so please no jokes. she is putting something into him, but he is allowing it, but he is not in right mind. is she going to kill him if she does not get stopped? possibly? i hope not,as I pray for him to be surrounded by family and those who really love him at such a time. he is only 35, so i get some of it.
    thanks neuro, he is not really in last minutes, but will be if she stays around. he can not be cured, but the disease can be slowed down, or accelarated. that is just one example of girlfriend, there are many. she is harmful. excluding family in last days, or months, to be with someone who is abusive, is heartbreaking for family. she cheats, she does drugs, she steals from him, lies to him, and he is too sick to see it all. she is nympho, is not joke. if he does not give it to her, she gets it somewhere else. it is time to make peace with people, and allow real love into his life, not just sex. if it was from someone who really loved him and treated him right, i could deal with it better. but,that is not case. sex can be draining for man, especially someone with cirrhosis and end stage. end stage can be days, months or a few years. she makes sure he has some drug to help him have sex, meth a very toxic substance. thanks

    • ANSWER:
      Cialis appears easier on the body.

      Try not to judge her for her many shortcomings, she may not know better or comes from a situation where values and integrity were non-existent. He cares about her, at least for the sex. He probably knows all her shortcomings but does he care when his life is slipping away? He’s just happy to have any attention or sensory gratification. Remember that is what got him on this treadmill and it isn’t going to change.

  49. QUESTION:
    re:end-stage liver disease?
    I was diagnosed with esld in march of 2009, and was given 3 months at the most to live. Through diet and exercise and being very specific about what goes into my body and abstaining from alcohol, I an still here and in great condition, non symtomatic whatsoever. But I have to have an EGD because I have vericous veins in my esophogus. How common is this? My left portal vein also had an effusion, but that is gone now. Is there any risk to removing, or however the procedure is done?

    • ANSWER:

  50. QUESTION:
    Question about end-stage liver disease?
    I ask a similar question a while back, but forgot to add more details. My husband has cirrhosis. His variecs bled all the time. Two years ago in May, he had the TIPS proceedure. He hadn’t bled up until 2 months ago, when he did for 1 day, due to an ulcer in stomach. He can’t sleep well, eats very little, but seems normal otherwise, except his breath has this wierd smell. Can you enlighten me about this mouth odor? The last person, (very informative), told me it was from bleeding, and probley needed TIPS proceedure. He is on Transplant List and a year ago he was at level 13. Haven’t been back except for other tests. Does anybody know what this smell could be, he’s had it off and on for about 6 months, it isn’t continuous. Thank you

    • ANSWER:
      google around on “Fetor hepaticus”…

      a condition seen in portal hypertension where portosystemic shunting allows mercaptans to pass directly into the lungs. It is a late sign in liver failure. Other possible causes are the presence of ammonia and ketones in the breath. The breath has a sweet, faecal smell to it.
      The compound dimethyl sulfide has been associated with it,[1] raising the possibility of an objective noninvasive measure of liver failure.

      Hope he gets his transplant soon!

      Good Luck and GodSpeed