Reason of the cirrhosis not identified

Hi,
I am the patient of liver cirrohiss.my sgpt remain increased all the time since one and half a year.my gestro.examined all blood necessary tests,ultra sound, endoscopy and liver biopsy for diagnostic reason of cirrhosis.My LFTs shows abnormal.now my sgpt 135,total bilbirubin1.2,sgot 59,alk. phos;234, gamma gt32.
ultra sound shows liver small in size showing coarse ecotexture with labulated nodular margins.no focal lesion no intra extra heptic biliary dillation. spleen shows normal ecotexture & normal size.multiple  varices in the splenorenal ligament.my EGD,Biopsy & other reports indicates stage 4 fibrosis liver cirrhosis.**But my gestro. can not identified the reason of cirrhosis.now I am using these drugs Esso 40 mg,carvedol 6.25 mg ursodeoxycholic acid250 mg & folic acid 5 mg per day.So please suggest me what shold I do for my prolem

[HectorSF]

Taking ursodeoxycholic acid is for gallstones or primary biliary cirrhosis a condition that slowly damages the bile ducts in the liver, and as the disease progresses, it can damage the liver..
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Primary biliary cirrhosis is a disease in which the bile ducts in your liver are slowly destroyed. Bile, a fluid produced in your liver, plays a role in digesting food and helps rid your body of worn-out red blood cells, cholesterol and toxins. When bile ducts are damaged, as in primary biliary cirrhosis, harmful substances can build up in your liver and sometimes lead to irreversible scarring of liver tissue (cirrhosis).

Primary biliary cirrhosis is thought to be an autoimmune disease in which the body turns against its own cells, but what triggers primary biliary cirrhosis isn't clear.

Women account for about 90 percent of PBC cases. It is most commonly diagnosed in patients between the age of 35 and 60.

Primary biliary cirrhosis develops slowly. Medication can slow the progression of the disease, especially if treatment begins early.

Blood tests to check for signs of autoimmune disease. An analysis of your blood may reveal anti-mitochondrial antibodies (AMAs) if you have primary biliary cirrhosis. These antibodies almost never occur in people who don't have the disease, even if they have other liver disorders. For that reason, a positive AMA test is considered a very reliable indicator of the disease. At the same time, a small percentage of people with primary biliary cirrhosis don't have AMAs.

Because no cure exists for primary biliary cirrhosis, treatment focuses on slowing the progress of the disease, relieving symptoms and preventing complications.

Treating the disease
Treatments aimed at slowing the disease and prolonging life include:

Ursodeoxycholic acid (UDCA). Also known as ursodiol (Actigall, Urso), UDCA is a bile acid that helps move bile through your liver. Although UDCA doesn't cure primary biliary cirrhosis, it may prolong life if started early in the disease and is commonly considered the first line of therapy. It's less likely to help people with advanced liver damage. Side effects of UDCA may include weight gain, hair loss and diarrhea.

Liver transplant.
When treatments no longer control primary biliary cirrhosis and the liver begins to fail, a liver transplant may help prolong life. A liver transplant is a procedure to remove your diseased liver and replace it with a healthy liver from a donor. Most donated livers come from people who have died. But in some cases, it may be possible to remove a portion of a liver from a living donor. Primary biliary cirrhosis often recurs in the transplanted liver, but it may take several years to develop.

Treating the symptoms
Your doctor may recommend treatments to control the signs and symptoms of primary biliary cirrhosis to make you more comfortable. Treatments may help control symptoms such as:

Fatigue. Treatment for fatigue involves trying to determine what may contribute to your symptoms. Treating the underlying causes may help relieve fatigue. Medications have been studied for fatigue. One medication that has shown promise in studies is modafinil (Provigil). More research is needed to determine its role in primary biliary cirrhosis.

Itching. One option for controlling itching is cholestyramine (Locholest, Prevalite), which is a powder that must be mixed with food or liquids. Though cholestyramine works for most people, the taste is unpleasant. Another option is rifampin (Rifadin), which is taken in pill form. Rifampin doesn't work for everyone. Itching that can't be controlled may be treated with a liver transplant.
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Carvedilol? - Treats high blood pressure and congestive heart failure (CHF). Also reduces the risk of death from a heart attack. This medicine is a beta-blocker.

Esomeprazole (as magnesium trihydrate) 20mg/40mg.
Esomeprazole is in a class of drugs called proton pump inhibitors (PPIs) which block the production of acid by the stomach. Proton pump inhibitors are used for the treatment of conditions such as stomach and duodenal ulcers, gastroesophageal reflux disease (GERD) and the Zollinger-Ellison syndrome which all are caused by stomach acid.

What is your diagnosis?
If you can you should see a hepatologist (liver specialist). They can determine if you have Primary Biliary Cirrhosis (PBC).


Good luck to you!
Hector

[HectorSF]

Taking ursodeoxycholic acid is for gallstones or primary biliary cirrhosis a condition that slowly damages the bile ducts in the liver, and as the disease progresses, it can damage the liver..
-------------------------------------------------------------------------------------------------
Primary biliary cirrhosis is a disease in which the bile ducts in your liver are slowly destroyed. Bile, a fluid produced in your liver, plays a role in digesting food and helps rid your body of worn-out red blood cells, cholesterol and toxins. When bile ducts are damaged, as in primary biliary cirrhosis, harmful substances can build up in your liver and sometimes lead to irreversible scarring of liver tissue (cirrhosis).

Primary biliary cirrhosis is thought to be an autoimmune disease in which the body turns against its own cells, but what triggers primary biliary cirrhosis isn't clear.

Women account for about 90 percent of PBC cases. It is most commonly diagnosed in patients between the age of 35 and 60.

Primary biliary cirrhosis develops slowly. Medication can slow the progression of the disease, especially if treatment begins early.

Blood tests to check for signs of autoimmune disease. An analysis of your blood may reveal anti-mitochondrial antibodies (AMAs) if you have primary biliary cirrhosis. These antibodies almost never occur in people who don't have the disease, even if they have other liver disorders. For that reason, a positive AMA test is considered a very reliable indicator of the disease. At the same time, a small percentage of people with primary biliary cirrhosis don't have AMAs.

Because no cure exists for primary biliary cirrhosis, treatment focuses on slowing the progress of the disease, relieving symptoms and preventing complications.

Treating the disease
Treatments aimed at slowing the disease and prolonging life include:

Ursodeoxycholic acid (UDCA). Also known as ursodiol (Actigall, Urso), UDCA is a bile acid that helps move bile through your liver. Although UDCA doesn't cure primary biliary cirrhosis, it may prolong life if started early in the disease and is commonly considered the first line of therapy. It's less likely to help people with advanced liver damage. Side effects of UDCA may include weight gain, hair loss and diarrhea.

Liver transplant.
When treatments no longer control primary biliary cirrhosis and the liver begins to fail, a liver transplant may help prolong life. A liver transplant is a procedure to remove your diseased liver and replace it with a healthy liver from a donor. Most donated livers come from people who have died. But in some cases, it may be possible to remove a portion of a liver from a living donor. Primary biliary cirrhosis often recurs in the transplanted liver, but it may take several years to develop.

Treating the symptoms
Your doctor may recommend treatments to control the signs and symptoms of primary biliary cirrhosis to make you more comfortable. Treatments may help control symptoms such as:

Fatigue. Treatment for fatigue involves trying to determine what may contribute to your symptoms. Treating the underlying causes may help relieve fatigue. Medications have been studied for fatigue. One medication that has shown promise in studies is modafinil (Provigil). More research is needed to determine its role in primary biliary cirrhosis.

Itching. One option for controlling itching is cholestyramine (Locholest, Prevalite), which is a powder that must be mixed with food or liquids. Though cholestyramine works for most people, the taste is unpleasant. Another option is rifampin (Rifadin), which is taken in pill form. Rifampin doesn't work for everyone. Itching that can't be controlled may be treated with a liver transplant.
-------------------------------------------------------------------------------------------
Carvedilol? - Treats high blood pressure and congestive heart failure (CHF). Also reduces the risk of death from a heart attack. This medicine is a beta-blocker.

Esomeprazole (as magnesium trihydrate) 20mg/40mg.
Esomeprazole is in a class of drugs called proton pump inhibitors (PPIs) which block the production of acid by the stomach. Proton pump inhibitors are used for the treatment of conditions such as stomach and duodenal ulcers, gastroesophageal reflux disease (GERD) and the Zollinger-Ellison syndrome which all are caused by stomach acid.

What is your diagnosis?
If you can you should see a hepatologist (liver specialist). They can determine if you have Primary Biliary Cirrhosis (PBC).


Good luck to you!
Hector