Parent with Cirrhosis

[dklp]

I am wondering about the immediate future for my mother.  She has been diagnosed with Cirrhosis and kidney damage (high LFT, etc) back in early July of this year.  She told us the doctor said "Significant damage to both" and that they felt it was cirrhosis.  My mother refuses to talk about it, their reports or anything else about her condition.  We cant get all of her information but her symptoms are getting terrible. When she innitially went in back in July she complined of a bloated stomach and ankles, "gas like pains", and nausea.  Since that time she has lost over 45 lbs. her ascites appears to be worse and in a matter of a few weeks her mind has gone from sharp to the inability to remember simple things.  She seems confused all the time and has prnounced slurred speech. I have notice her skin is growing pale (not yellow) and her face is drawn to the point that her teeth are begining to stick out beyound her lips. She refuses to go back to the doctor leading us to believe she was told something she doesnt want to deal with.  I am aware that her life expectancy cant be exactlly determined, but given the speed in this progression and the obvious symptoms, could one come to the conclusion that she may not last another 2 weeks? 3 months or a year?  We havent even been able to determine the exact cause of it.  She was told 17 years ago she had Hep C, but yet recent blood work said that wasnt the case.  She has always been obese and we know that fatty liver may have caused some of the issues.  I suppose those issues are not as important to us right now as to what we should expect in the future and what that time line may be.

Thank you

[Kevin Pho, MD]

End-stage liver disease can present this way.  In severe cases, there can be mental status changes (due to elevated ammonia levels) as well as resulting kidney disease (hepatorenal syndrome).  

The definitive treatment would be a liver transplant.  If there is consideration of hepatorenal syndrome, the combination of midodrine and octreotide can be considered.  A TIPs procedure can also be considered.  This is a shunt that can be considered to relieve refractory ascites.  

At this time, a referral to a liver specialist can be considered for further treatment options.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[Sandal]

My husband was diagnosed with cirrhosis in November 2004 after having several severe bleeding episodes.  He had the TIPS procedure, which helped stop the bleeding, but not the progression of the cirrhosis.  In April 2005 he was so bad off he went into a nursing home (at age 52) and only made it until July 26, 2005.  His symptoms were exactly like your mother's, the forgetfulnes, the weight loss, the swollen legs and abdomen. She definitely needs Lactulose for the ammonia build up in the brain, it can get very bad.

No doctor would ever come out say how long he had, even an estimate, but I always knew it was just a matter of months. Best of luck to you.