ESLD

[Pugsley1628]

my husband has ESLD and ammonia levels go way up. He takes lactulose and zig axon amongst other meds but it still goes up. If they give him a general I've antibiotic it comes completely down to the 30's. Is there something they are missing. They say there is no infection and then they pull him off the antibiotic

[HectorSF]

There are a wide variety of causes that can trigger a Hepatic Encephalopathy (HE) episode. The liver transplant center doctors must figure out what the root cause of his HE is first (a proper diagnosis), only then they can address the cause and properly treat it.

Some things that can trigger an HE episode…
* Constipation
* Dehydration
* Infection
* Gastrointestinal bleed
* Overdiuresis (too much increased excretion of urine when using diuretics)
* Hypokalemia (lower than normal potassium level )
* Non‐compliance with HE therapy
* Excessive protein intake.
* Post TIPS procedure complication
* Portal vein thrombosis
etc....

If the cause of his HE is an infection (bacterial, viral or fungal) then the infection must be treated and cured to get the infection and resulting HE under control. Treating a bacterial infection with IV antibiotics is a common way to treat infection in cirrhotics who have comprised immune systems and are prone to infections. Infections in people with advanced cirrhosis can be a life-threatening situation and therefore needs to be diagnosed and effectively treated.

As in all case of cirrhosis only by talking with the treating doctors will you really understand what is going as cirrhosis and its complications. Everyone’s cirrhosis and how it manifests itself at any particular time is individual and must be treated on an individual basis.

Talk with his liver transplant doctor to understand better what is going on or at least what they are currently thinking may be having and how they are trying to address it.

Best of luck to you and your husband.
Hector

[Pugsley1628]

Thet admit him and automatically start an antibiotic till they run test to see if he has an infection and the amonia level comes down in the 30 to 40 range.  After a few days and all test come back and no infection they remove the IV antibiotics.  With in a week it shoots back up.  He is taking lactolose and Xifaxin, amongst other water pills does anyone know why the IV antibiotics  bring the ammonia down?

[Pugsley1628]

Let me try this again, my phone did autocorrect   My husband has ESLD,  his ammonia level goes in the 200-300 range