First let me state the obvious. We are not doctors here. You have a disease that is fatal over time if not managed by a doctor properly. It is also a disease that has many life-threatening complication. Only a qualified doctor can properly manage your illness, symptoms and complications. So any information provided should be run by your doctor first because End-Stage Liver Disease is too serious to make assumptions based on another layman opinion. That said...
"Cirrhosis Grade B".
I assume you are saying you have been given a diagnosis of Cirrhosis Child-Pugh score B. More commonly known as End-Stage Liver Disease (ESLD) or decompensated cirrhosis.
Are you being seen by a hepatologist and a transplant center? You do realize that only a liver transplant can keep you alive once your liver fails or you develop liver cancer (HCC)? If you are being treated at a transplant center they would have you meet with a dietician that would instruct you on the proper diet for your condition plus any particular medical issues you might have.
Your liver is failing to function properly due to injury of its cells. I assume hepatitis C is what has damaged your liver of many decades. The liver is the largest internal organ for a reason. It performs many functions. One of its functions is processing the nutrients from food. Since your liver is no longer able to function properly, it is unable to properly process food. It is not food that is the problem; it is your damaged liver that is the problem. The ascites, hepatic encephalopathy, varices, portal hypertension and any other health issues you are experiencing are complications of your liver not being able to function properly and they will only get worse over time.
There is no food that will make you live longer but there are foods to avoid that will lessen the symptoms of ESLD.
* You should limit your sodium intake to less than 2000mg per day. This will help with any bloating you have. The foods highest in sodium/salt are processed and prepared foods, such as canned meats, soups, and vegetables, crackers, cold cuts and restaurant food. READ LABELS.
* Avoid all red meat. Chicken and fish are okay. Red meat in difficult to digest and creates a lot of toxins that flow through the blood and affect the brain causing encephalopathy.
* Avoid raw shellfish, which may carry bacteria called “Vibrio vulnificus” that can cause a fatal infection in people with cirrhosis.
* A proper balance of proteins, carbohydrates and fats are important.
* Any vitamins, supplements or herbs should be first approved by your hepatologist. Some of these substances are toxic to the liver.
* No alcohol.
* No NSAIDs over the counter pain relievers (such as aspirin, Ibuprofen, etc.). Only Tylenol. 2000mg or less per day.
Obviously there are too many things you should know as a patient with ESLD. We can only give you the basics and direction on how you can manage your hepatitis C and liver disease. Only a knowledgeable and experienced hepatologist can help someone as ill as you are. In time ESLD is a fatal illness and needs to be taken seriously if you value your life. You really need to be under the care of a hepatologist at a transplant center whether you plan on having a transplant or not. ESLD is a very complex disease and only a doctor can help you manage your illness.
Yes, it is a good idea to discuss this with your GI doctor. Gastroenterologist specialize on the entire digestive system. Some may know very little about hepatitis C or liver disease.
A hepatologist specializes on the liver. Since you have advance cirrhosis you should be seeing a hepatologist. Hepatologists work on a daily basis with patients that have various degrees of advanced liver disease. They are the only doctors qualified to evaluate, diagnose and help a patient manage their cirrhosis. They also work at transplant center and are the ones who can get you on the centers list for a transplant.
The waiting period for transplant:
The sickest patients get the transplant before others who are not as ill and have a better chance of living without a transplant. Patients are ranked by their MELD score. The MELD score is based on the patients chances of being alive in 3 months. The scale is from 6-40. Most patients need to be at least 15 to get listed. The MELD score is calculated from 3 blood tests. Bilirubin, INR and Creatintine. Also sometimes points are given to patients with certain circumstances who don't have long to live without a transplant. For patients like myself with liver cancer. The MELD score is used throughout the transplant community and has replaced the Child-Pugh classes. It depends also on where your transplant center is. Center can transplant at different MELD score.Northern California, New York City and LA have long waits. Many times a MELD score above 30. In Florida and Tennessee patients may be able to get a transplant with a MELD score of 20 and above.
Yes, at most centers you have to be very ill. Passing into what was called Child-Pugh Class C. The wait also depends on your blood type. If you have AB the wait is a lot shorter than if you have type O. As must people are type O so the most patients waiting are waiting for a liver from a type O donor.
Of course the patient has to be able to survive the transplant and that is why there is a MELD limit of 40. Although here in Northern California the wait list is so long a patient may have a MELD of 43-44 before getting a transplant. But these patients look more dead than alive. It is very scary but once they get that donor liver they start looking human with a few days. It is amazing if you have never seen a patient before and after a transplant. Sometimes it is hard to even recognize them.
So a transplant can give you a second chance at life. It is amazing.
So hang in there. Talk to your GI. (It is okay to keep your GI for simple tests and local support if the transplant center is further away). Have him refer you to a transplant center. Then you will find out all of the options that are available to you.
Best of luck!
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