Aa
Xifaxan
Has anyone tried this . I am starting this med this week .
COMMUNITY LEADER
Lactulose is a non-absorbable sugar used in the treatment of constipation and for the prevention and treatment of hepatic encephalopathy including the stages of hepatic pre-coma and coma.
When the liver has been damaged by cirrhosis, it may not be able to filter poisons from the bloodstream, especially substances in the blood produced by bacteria in the large intestine. As a result, these substances (which include ammonia) may build up in the bloodstream and cause problems in your brain called encephalopathy. High ammonia levels are a sign of encephalopathy.
Other things that can contribute to encephalopathy include use of sedatives or narcotics, gastrointestinal bleeding, abnormal levels of electrolytes in the blood (especially low potassium levels), excess protein in the diet, infection such as peritonitis, dehydration, and constipation.
I would suggest reading his hospital discharge papers to understand why and what he was treated for.
Hector
When the liver has been damaged by cirrhosis, it may not be able to filter poisons from the bloodstream, especially substances in the blood produced by bacteria in the large intestine. As a result, these substances (which include ammonia) may build up in the bloodstream and cause problems in your brain called encephalopathy. High ammonia levels are a sign of encephalopathy.
Other things that can contribute to encephalopathy include use of sedatives or narcotics, gastrointestinal bleeding, abnormal levels of electrolytes in the blood (especially low potassium levels), excess protein in the diet, infection such as peritonitis, dehydration, and constipation.
I would suggest reading his hospital discharge papers to understand why and what he was treated for.
Hector
COMMUNITY LEADER
I am not sure why he is experiencing more HE now that he is on treatment. That doesn't add up. While HE can't be totally eliminated. it can mostly be controlled enough to prevent its extreme affects of stupor and coma which can be life-threaten. While people can develop strange behaviors abuse of others is rare. Something doesn't sound right to me.
First, what is his MELD score. While not everyone's symptoms are MELD based at least I will understand how advanced his cirrhosis is.
Are you sure it is his HE causing his behavior?
Have you told his liver doctor of this behavior?
Is he having his ammonia levels monitored?
Are you sure he is compliant with lactulose dosing? 2-4 bowel movements per day is required for effective use of lactulose?
TIPS unfortunately can make HE worse in some people, At least temporarily as less blood flows through the liver to be filtered.
Having a new, fully functional liver with transplant usually stops all complication of liver disease literally overnight. Although occasionally some people can have post transplant complications with ascites and more rarely some HE.
I think you really need to figure out exactly what is going on. Abuse of any kind is wrong and not a normal sign of advanced liver disease. For many of us we hardly had the strength to even speak when we were very ill before transplant.
I am sorry you are going through this.
Hector
First, what is his MELD score. While not everyone's symptoms are MELD based at least I will understand how advanced his cirrhosis is.
Are you sure it is his HE causing his behavior?
Have you told his liver doctor of this behavior?
Is he having his ammonia levels monitored?
Are you sure he is compliant with lactulose dosing? 2-4 bowel movements per day is required for effective use of lactulose?
TIPS unfortunately can make HE worse in some people, At least temporarily as less blood flows through the liver to be filtered.
Having a new, fully functional liver with transplant usually stops all complication of liver disease literally overnight. Although occasionally some people can have post transplant complications with ascites and more rarely some HE.
I think you really need to figure out exactly what is going on. Abuse of any kind is wrong and not a normal sign of advanced liver disease. For many of us we hardly had the strength to even speak when we were very ill before transplant.
I am sorry you are going through this.
Hector
My husband also just started this medicine a few weeks ago. He's also on lactalose 3 times daily 30 ml is his dosage. I would like to say it's helped but I don't know, he's just been struggling with HE attacks more often. I understand this is a terrible illness but I am barely hanging on by a thread myself from losing my mind. The verbal abuse has gotten so bad, atleast 3 times a week now I am screamed and cursed at and called horrible names. I feel like I'm walking on egg shells everyday not to say anything to possibly set him off. I've never ever felt like he would harm me physically in the past but lately I'm scared of him. I love him and know that if I leave he will never make it without me but do any of you have suggestions if it ever gets better? Will he get somewhat better after the TIPS procedure or only when he receives his liver transplant? I'm just about to lose it.
Hector, my mister was given lactulose while in the hospital a couple of weeks ago and he didn't/doesn't have HE. Do you know why they might have given it to him a a prophylactic?
He has a decompensated liver due to alcoholic cirrhosis.
(This is my first post.)
MeanOldHag
He has a decompensated liver due to alcoholic cirrhosis.
(This is my first post.)
MeanOldHag
Thanks Hector
I have had a neurologic exam and everyone tells me that I would know if I had HE and so would everyone around me!
Ammonia levels fine
I do sleep too much but that could have all sorts of reasons and I am going to try to just go to bed early and see if I can get to sleep and then wake up at a normal hour - without having to take a nap in the middle of the day
That's just what I need - a universally loathed drug that makes me crap all the time.
Grasping at straws, Kaiser docs?
I have had a neurologic exam and everyone tells me that I would know if I had HE and so would everyone around me!
Ammonia levels fine
I do sleep too much but that could have all sorts of reasons and I am going to try to just go to bed early and see if I can get to sleep and then wake up at a normal hour - without having to take a nap in the middle of the day
That's just what I need - a universally loathed drug that makes me crap all the time.
Grasping at straws, Kaiser docs?
COMMUNITY LEADER
Lactulose is a liquid laxative that is only prescribed to cirrhotics who have been diagnosed with hepatic encelpalopathy (HE). Lactulose is used to manage the symptoms of HE by causing the person to have regular and often bowel movements which prevents the buildup of digestion toxins in the blood and then traveling to the brain were they cause the symptoms of HE.
HE can cause sleep problems, typically day-night reversal were a person is wide awake all night because they can't sleep and then they sleep all day. It that cause if the HE is treated then they could have less fatigue because they are getting proper sleep.
For someone who doesn't have HE (not all cirrhotics have HE or any other complication of cirrhosis for that matter) all that te lactulose would do is make them defecate a lot more than they probably normally would.
So the simple question to the doctor is..."Do I have HE?" If so lactulose is a proven, effective, inexpensive treatment for HE.
Latulose is universally loathed med. It is a super sweet, foul tasting syrup which can also cause some nasty bowel problems as well, especially for the inexperienced user. I don't know of anyone who would take it for no reason if they didn't need it.
All of us who have taken lactulose for years before our transplants were happy the day after our surgery when we learn we would never have to take it again.
After SVR even a early cirrhotic liver will heal itself over time. But it my take many years for full recovery. Also it should be keep in mind that the elevated risk for the development of liver cancer (HCC) still remains for years after SVR, so regular surveillance for HCC (ultrasound & AFP blood test) should continue to be conducted as outlined in the AASLD/IDSA "Recommendations for Testing, Managing, and Treating Hepatitis C".
Hector
Hector
HE can cause sleep problems, typically day-night reversal were a person is wide awake all night because they can't sleep and then they sleep all day. It that cause if the HE is treated then they could have less fatigue because they are getting proper sleep.
For someone who doesn't have HE (not all cirrhotics have HE or any other complication of cirrhosis for that matter) all that te lactulose would do is make them defecate a lot more than they probably normally would.
So the simple question to the doctor is..."Do I have HE?" If so lactulose is a proven, effective, inexpensive treatment for HE.
Latulose is universally loathed med. It is a super sweet, foul tasting syrup which can also cause some nasty bowel problems as well, especially for the inexperienced user. I don't know of anyone who would take it for no reason if they didn't need it.
All of us who have taken lactulose for years before our transplants were happy the day after our surgery when we learn we would never have to take it again.
After SVR even a early cirrhotic liver will heal itself over time. But it my take many years for full recovery. Also it should be keep in mind that the elevated risk for the development of liver cancer (HCC) still remains for years after SVR, so regular surveillance for HCC (ultrasound & AFP blood test) should continue to be conducted as outlined in the AASLD/IDSA "Recommendations for Testing, Managing, and Treating Hepatitis C".
Hector
Hector
But not commonly recommended for those who are not experiencing HE?
My doc has suggested it as a way to combat fatigue. I am wary of taking another pill that I probably don't need
I do have portal hypertension and an enlarged spleen, some depression but none of the other symptoms that you mentioned and that are common to peoples with ESLD
I may have reached SVR (will know tomorrow!) so it seems from what I hear others say, that cirrhotics, like other Hep C patients, tend to get better once some time has passed and their livers and accompanying ailments continue to improve
I sure hope so
My doc has suggested it as a way to combat fatigue. I am wary of taking another pill that I probably don't need
I do have portal hypertension and an enlarged spleen, some depression but none of the other symptoms that you mentioned and that are common to peoples with ESLD
I may have reached SVR (will know tomorrow!) so it seems from what I hear others say, that cirrhotics, like other Hep C patients, tend to get better once some time has passed and their livers and accompanying ailments continue to improve
I sure hope so
COMMUNITY LEADER
Fatigue is the the most common symptom of cirrhosis (along with many other conditions and diseases) which can impair a person's quality of life. There are many contributing factors to the fatigue in a person with cirrhosis. Some of those factors are... cirrhosis severity including the presence of ascites and hepatic encephalopathy in more advanced cirrhosis, anemia, impaired renal function, hypocortisolism, psychological distress resulting in anxiety and depression
Lactulose is an oral indigestible sugar and therefore a laxative. It is broken down in the large intestine into mild acids that draw water into the colon, which helps soften the stools. It is prescribed for persons diagnosed with cirrhotic Hepatic Encephalopathy (HE) to help them manage their HE symptoms.
HE is poisoning of the brain caused the inability of a cirrhotic, failing liver, to filter toxins from the blood created during the digestive process. These toxins then flow through the bloodstream and enter the brain causing mental and behavioral affects. Some of the affects of HE are confusion, problems with memory or thinking, sleep problems, behavior changes, tremors, loss of coordination, stupor and in the worse case... coma. A HE coma it is a medical emergency as it can result in death. The comatose person should be immediately taken to the nearest Hospital ER.
The dose of lactulose must cause the production of 2-4 soft bowel movements per day in order to be effective and prevent the symptoms of HE. It keeps the digestive system moving and thus prevents the buildup of toxins in the bowel. Typically about 30 to 45 mL orally 3 times a day will produce the desired effect. Both constipation and diarrhea can trigger a HE episode so regular bowel movements are important.
Cheers
Hector
Lactulose is an oral indigestible sugar and therefore a laxative. It is broken down in the large intestine into mild acids that draw water into the colon, which helps soften the stools. It is prescribed for persons diagnosed with cirrhotic Hepatic Encephalopathy (HE) to help them manage their HE symptoms.
HE is poisoning of the brain caused the inability of a cirrhotic, failing liver, to filter toxins from the blood created during the digestive process. These toxins then flow through the bloodstream and enter the brain causing mental and behavioral affects. Some of the affects of HE are confusion, problems with memory or thinking, sleep problems, behavior changes, tremors, loss of coordination, stupor and in the worse case... coma. A HE coma it is a medical emergency as it can result in death. The comatose person should be immediately taken to the nearest Hospital ER.
The dose of lactulose must cause the production of 2-4 soft bowel movements per day in order to be effective and prevent the symptoms of HE. It keeps the digestive system moving and thus prevents the buildup of toxins in the bowel. Typically about 30 to 45 mL orally 3 times a day will produce the desired effect. Both constipation and diarrhea can trigger a HE episode so regular bowel movements are important.
Cheers
Hector
Hector
Have you ever heard of Lactulose being prescribed to counter fatigue?
It's a laxative, right?
Have you ever heard of Lactulose being prescribed to counter fatigue?
It's a laxative, right?
COMMUNITY LEADER
Yes, I took Xifaxan (rifaximin) for many years in combination with lactulose to manage my Hepatic Encephalopathy (HE) before having my liver transplant.
It seemed to have no side effects, unlike lactulose, and studies have shown that it reduces the number of hospitalizations for HE. The only downside to Xifaxan is that it is under patent (there is not generic version) and so very expensive and not all health insurance plans cover its cost.
Cheers,
Hector
It seemed to have no side effects, unlike lactulose, and studies have shown that it reduces the number of hospitalizations for HE. The only downside to Xifaxan is that it is under patent (there is not generic version) and so very expensive and not all health insurance plans cover its cost.
Cheers,
Hector
Have an Answer?
You are reading content posted in the Cirrhosis of the Liver Community
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
