Is this beginning of end stage liver disease

My brother has Hep C and cirhossis from needle use and alcoholism.  He went through his last interfuron treatment in 1997.  Two years ago the doctor told him his cirhossis was getting worse.  He today presents with severe back pain, ascites, swollen testicles and now blood in his urine.  The doctors" are treating all of these separately.  My question is, am I out of line in thinking that these might all be related and that it is indeed the beginning of end stage liver disease?

[Bill1954]

Some of the symptoms you mention could certainly be related to cirrhosis, although it’s obviously difficult to determine over the internet. End stage liver disease (ESLD) can be assessed using ‘MELD’ score; this can help determine morbidity/mortality to some degree. Sorry hear of your brother’s problems; is he still using or drinking? Has he been referred to a transplant center for evaluation?

http://www.mayoclinic.org/meld/mayomodel6.html

Good luck to him and the family-

-Bill

[mikesimon]

Symptoms of cirrhosis can include ascites, swollen testicles and back pain. I have not heard of blood in the urine as a symptom of cirrhosis but I do not know that there isn't an association.

I agree with Bill that getting him evaluated at a transplant clinic is a good approach. That assumes that he is no longer abusing drugs and/or alcohol. If he is then getting sober is obviously the first step for him.

It's not unusual to attempt to treat the symptoms because the underlying disease in your brother's case is cirrhosis caused by HCV and alcohol/drug abuse. The only viable treatment for cirrhosis is to eliminate the underlying cause. In your brother's case that means he has to stop drinking and investigate his HCV treatment options.

Treatment for HCV has improved a lot since 1997 and it should improve significantly soon with the imminent availability of new treatment drugs - within this year in all probability. People with cirrhosis have treated successfully with interferon and ribavirin although it is a difficult road. He really needs to be clean and under the care of a good hepatologist if not a transplant center.

Good luck,
Mike