Can a decompensated liver become compensated?

[Meadowbank]

Sorry if this has been asked before. I have only just found this community and have read a lot but don't know the answer to that question.

I was diagnosed with cirrhosis 3 months ago. It wasn't a shock as I had drank heavily for years. The doctors have said it is decompensated as I had ascites and jaundice. The ascites was drained, the jaundice has mostly gone although I do look strangely tanned, not yellow.

I gave up alcohol straight away, follow a Dieticians strict low salt diet and also eat every 2-3 hours to try and get my weight back up.

I am on 25mg of spironolactone.

Is there any chance my liver can become compensated if I stick to the diet and my sobriety?

[beebeebumblebee]

We are at our wits end trying to deal with my husbands cirrhoses the doctors told us four weeks ago he had two years to live Friday we got a letter now they have said 1 year to live my motto is where there is life there's hope so like yourselves take care of himself reading this forum we don't feel alone he has diabetes as well which I am sure does not help he has ascites they drained 17 litres last week he is being referred to kings but don't gave any hope of him having a transplant . I would love to hear our doctor say well we will try this and that and whether tat will help to maintain a healthy life as much as possible but what we get is going and do a bucket list don't waste time trying to find something thankyou guys for your posts keep going X

[ralph2014]

Yes a decompensated Liver can return to being compensated, how ever it will remain scarred.  A Liver is classed as decompensated when it can no longer carry out its functions and all the horrible symptoms show up, ascites , jaundice etc.  If you stop drinking the Liver has a good change of atleast gaining some small amount of function back and returning to a compensated state, where the ascites and jaundice resolve.  But cirrhosis is generally considered progressive so over time the benefits gained from stopping alcohol will slowly be taken back by the progressive scarring.

[Jancharlie]

Finding this forum was a god send, I haven't been disagnosed yet but I have the symptoms of alcoholic cirrhosis. I started having symptoms a week ago but can't get an MD appt until next Wednesday. I have spent the last week crying and thinking of making final arrangements. My husband has not been very supportive, he has an whatever it is you did it to yourself attitude but he drinks as well. I have no one to talk to and feel very alone. reading through these posts have given me a glimmer of hope. Thanks

[lusal]

My husband was diagnosed with cirrhosis in March 2012 following 2 years of very poor health;severe rectal and oesophageal bleeds requiring several transfusions, gall stones and acities...he was abstinent since diagnosis and in April 2014 was told his liver was compensated even though he the consultant has said he only has 10% liver function. If he continues to abstain hopefully his liver will continue to compensate. He has not been hospitalised for one year now and is relatively well. Good Luck to everyone...think of others as its not only the patient who suffers.

[Meadowbank]

Interesting pugdaddy. I will Google.

[Meadowbank]

Very nice to 'meet' a fellow Uk person Taz. Well done on your sobriety!

Your story really gives me hope that I can continue to live a good life for a fair few years yet. Last year I thought it was goodbye Vienna, I really did. Now everyone I meet tells me how well and happy I look.

Best wishes.

[pugdaddy]

There is a drug presently in second phase of human clinical trials here in the USA - it has been proven to reverse liver scarring (fibrosis and cirrhosis) - and has generated much excitement, as you can imagine.  You can Google the term "GR-MD-02" and read all about it.
I'm told (by reliable sources who are actively involved with the trials) that it has been granted an FDA 'Fast Track' status - and will likely be available within the next approx. 3 years.

[taz54]

Hi Meadowbank , I live in the uk,you can improve your liver and live a longer life,I have in 2008 ,I was admitted to the hospital with liver failure through alcohol abuse they gave me 20% chance to live,my eyes all over my body was yellow I look like I was 8 months pregnant with ascites, which they drained,portal hypertension,hepatic encephalopathy,they did a ct scan and said my liver has shrunk in size and was badly scarred, and a  Transjugular liver biopsy because I was so ill,was referred to a dietician, when the ascites went,I look like a bag of bones, I have alcoholic cirrhosis stage b-c, when I left hospital I was told never to drink alcohol ever again,6 years on, I have not drink alcohol,I am on a low salt diet, no processed foods,the only meds I am on are vitamin b,I walk every day I can't run no energy but that's the cirrhosis it don't store glycogen (a carbohydrate that produces short-term energy)I have to eat small but often every 2 hours, I don't have to see my specialist at the hospital anymore just my GP,I have a Ultrasound scan every 6 months and my bloods done to check for cancer, my doctors are very pleased with me my liver is now smooth and normal in size, I said to my doctor has the cirrhosis gone he said no the damage is in side but I've improved my quality of life and can live to a old age I never thought I could live this long but we all can just keep away from the alcohol it's hard but you can do it one day at a time I have bad days but  I am thankful for every day I stay sober!

[hepcandme]

That's great Meadow. Good for you

There are very few times that I actually miss alcohol. Maybe when out with friends for dinner and they are all enjoying a nice pinot noir that I recommended. Or, I have thought, on a Really hot day, wouldn't a beer taste great right now?

But then I think, you drink and you will die in a very unpleasant way, and order a lemonade instead

Or sometimes when I'm out I ask for a nonalcoholic beverage in the fanciest glass that they have. It's fun to see what they come up with

So many other things to enjoy about life that giving up drinking seems like a small price to pay for the chance to be healthier

I do realize that this is much more difficult for some people so thanks for sharing your experience

Now, let's figure out a way to reverse liver damage!

[Meadowbank]

Update

Hi. I thought I would update you on how I am doing. I no longer focus on the compensated/decompensated issue. I take each day as it comes.

I am still sober :-)
One year, one month and one week of sobriety.

I am off all meds apart from vitamin B. I have regained weight and have a normal BMI. My liver function tests are normal. The more detailed tests show slightly raised levels but nothing alarming.

I still keep to the low salt diet.

I am thankful for every day I stay sober.

Thank you for reading.  And thank you for the support and wise words.

[nan535]

Amazing story.  Your story will give hope to many.

Thanks
Nan

[SmokedBrisket]

In the first sentence it should read decompensated to compensated.

[SmokedBrisket]

It is possible and rare for a liver to change states from compensated to decompensated.  I realize this is tantamount to heresy when discussing cirrhosis. I was hospitalized ~8 times 2 years ago and given 6 months to live and then less than 5 weeks to live. Cirrhosis was diagnosed by CT showing regenerative nodules followed by a biopsy showing fibrosis but not bridging fibrosis. I chose to live every day as it came. In the beginning I was on 12+ meds and supplements. I could not even walk , was yellow to pumpkin orange and I had several  bouts of hyponatremia (with swelling of the brain, plus a unusual and rapid response when my doctor prescribed Prednisone, white blood cells spiked with very rapid swelling). My MELD score hit in the 50's .I had multi-organ failure and thrombosis of the hepatic artery and veins. I was not a candidate for transplant. In every statistical analysis there will be an outlier. Do your best to stay positive, I freely admit that this is difficult. I turned to faith and prayer. This was my experience, I also found that changing from decompensated to compensated is rather unusual even heretical, if one searches the web or PubMed. You are in my thoughts and prayers. Will things stay this way for me, maybe so?  My bilirubin is now 2 down from a high of 29 and the other typical blood work is normal(no ascites, take low doses of  spironolactone/Lasix combo every other day). One doctor tells me to stop taking these and monitor things while another insists on the every other day diuretics.For now I try to enjoy all that is around me and keep to a low salt (under 2g) and low iron diet..

[pickaxe]

it is possible for ur liver to come bak do not drink

[skeptigal]

Hi, Went from near death to compensated liver for last 3 yrs.  Had nerve disorder and immune disease that had quietly attacked my liver (surprise!).  I chose to drink heavily for 4 yrs (self medication and stupidity) and boom. Stopped drinking but had jaundice, acites, a liver stent, esophageal banding  and hepatic coma. On transplant list, but MELD 11 meant no transplant. Docs' treatment was meds and putting out fires. I became proactive and ate a cancer fighting type diet (massive amounts of produce), with virtually no salt or processed foods. Exercised daily (even in bed) took meds and did 2500+ hrs of research on liver/nutrition/ body systems. I learned a lot and used my knowledge to lower MELD to 7, don't need stent, port-o-cath or transplant. Still take meds and supplements prescribed/ok'd by doc. Some are for the Sarc and RLS. My liver numbers have been steady for years and most are normal or near normal. If I do mess up with diet and my numbers change, I can fix it usually in a week. I do have some complications due to the cumulative effect of my medical problems.

You are on very little medication. If you keep clean and watch your Tylenol consumption (plus meds with added Tylenol), eat right and read all you can. Good luck.

[pugdaddy]

Well said, Karen.  Howie IS da BOSS!...in the most positive and flattering context of that word.  I'd like to think that we all have at least a portion of Howie's determination, persistence, grace and (even on occasion...) humor.  And of course perhaps the most obvious...his generosity.  I cannot imagine being in his present state of health - and yet always making time to help the rest of us.  We love ya, Howie - and are believing for a new liver for you soon, before the arrival of the New Year -

[crossroadsec]

I'm with you too Howie. Thanks for setting me straight on that. I'm smiling. You're like a Boss. xoxo Karen:)

[pugdaddy]

Howie, I'm believing with you for it to all work out...and for the timing to be perfect!!  

[HectorSF]

Yes, my AFP dropped 1,320 points (!) after PEI treatment. Just have a ways to go to get under 500 long enough to get a transplant. I will find out tonight what the plan is going to be. Hopefully another treatment of ethanol injection in the same area to kill any remaining tumor even though the MRI says no tumor found. MRI are limited in what they can see so it may be missing it. Obviously this tumor is a super AFP generator for only a 2.0 cm tumor.

In September my MELD score will be 35 which should put me very near the top of the list except for critical cases so maybe the timing will all line up for a transplant for me?

Ciao
Howie

[pugdaddy]

Howie, your AFP of 600 is one heck of a lot closer to the 'magic number' of 500 than you've been in awhile.  Believing with you that #6 will be the charm!!  Many thanks for the knowledge and generosity of spirit that you so consistently share -

[HectorSF]

The decompensated liver can't regenerate because most of the liver cells are dead and the liver consists of scar tissue. When the liver tries to regenerate it creates more growth of nodules throughout the liver. This is not functioning liver scar tissue build up so no new functional liver cells are regenerated. Meanwhile the blood is routed around the liver through collateral veins and finds it way back to the heart. This is how varices and collateral veins around the abdomen are created. All caused by scarring with caused portal hypertension and the resulting complication of complete cirrhosis.

Each patient is different so no one can say what will happen to a particular individual be we can speak in general about the progression of liver disease and liver failure. Liver transplant is for that exact situation.

Liver cancer number 6 coming up soon for me. AFP still 600 and not eligible for transplant.

Hang in there.
Howie

[crossroadsec]

Hector - you always put the word out... Meadowbank - I felt the same way. I was drained, put on diuretics. Crazy ninja diet. I had hep c and treated for it, but Cirrhosis is NOT a death sentence. Even end stage. There could always be a portion of your liver that is carrying some of the weight. It is a huge organ that does try and regenerate.
My portal vein closed off and I'm back to flowing in the right direction now. I don't know how or why. I'm still limited. Always will be. If it comes down to it, I will try and get on a transplant list like Hector.

Decompensated liver or not? Who knows. I'm alive and that is what counts. I know it's scary business.
Hang in there. xo Karen:)

[HectorSF]

Sounds like a great plan. Since you have educated yourself about your children's disabilities you are experienced in knowing how to go about it. Knowledge is power. Remember it all takes time. As long as you consistently are curious about what is happening to you you will be amazed by all you will learn over a year. I was diagnosed with cirrhosis in 2007 and decompensated in 2009 to I have had plenty of time to experience the complications of advanced cirrhosis and its treatments, navigating the health system and reading all I can in the hepatology literature to learn what is happening to me.

We must all advocate for ourselves. No one has an easy job managing their advanced cirrhosis and the complexities of the health system.

Keep advocating for yourself. Just do it diplomatically as possible so you not alienate the very people you are dependent upon to help you. A patient that advocated for themselves will get the time and respect of the doctors.

Hector

[Meadowbank]

Thank you Randy for your comments and links. I will read the threads.

Take care.