I think your post will be better addressed in our cirrhosis of the liver community.
Hello and welcome to MedHelp.
I am very sorry to hear about your mom. The fluid is called ascites. Ascites is the build-up of fluid in the space between the lining of the abdomen and abdominal organs (the peritoneal cavity). Ascites results from high pressure in the blood vessels of the liver (portal hypertension) and low levels of a protein called albumin. Treatments for fluid build-up may include:
• Avoiding alcohol
• Lowering salt in your diet (no more than 1,500 mg/day of sodium)
• Limiting fluid intake
This is very important she adjusts her lifestyle to these standards since ascites can result in serious life threatening complications such as kidney failure or Spontaneous bacterial peritonitis (a life-threatening infection of the ascites fluid). Weight loss is also common.
Medicines from your doctor
• "Water pills" (diuretics) to get rid of extra fluid
• Antibiotics for infections
• Inserting a tube into the belly to remove large volumes of fluid (called a paracentesis)
• Placing a special tube or shunt inside your belly (TIPS) to repair blood flow to the liver
You mentioned “she looks drunk”. This is not a complication of cirrhosis and it is very important she isn’t. Her sobriety is the most important element in treating her cirrhosis, failure to maintain sobriety will cause her cirrhosis to advance more rapidly leading to death.
For some persons with advanced alcoholic cirrhosis such as myself it is possible to treat your decompensated symptoms and slow or halt the progression of cirrhosis. Those with alcoholic cirrhosis requiring a transplant must have 6 months of documented sobriety. Some centers also require rehabilitation such as AA.
It is important your mom receives the best treatment available. She needs to register for treatment from a transplant center. This does not mean she will need a transplant. Other doctors no matter how good their intentions cannot provide the quality of treatment she needs.
I wish you the best,
I am sorry for what you and your mom are going through. The "drunkeness" that it seems your mom is experiencing could be related to symptoms of HE.
See the link below.
Symptoms many begin slowly and gradually worsen, or they may begin suddenly and be severe from the start.
Symptoms may be mild at first. Family members or caregivers may notice that the patient has:
Breath with a musty or sweet odor
Change in sleep patterns
Changes in thinking
Confusion that is mild
Personality or mood changes
Worsening of handwriting or loss of other small hand movements
More severe symptoms may include:
Abnormal movements or shaking of hands or arms
Agitation, excitement, or seizures (occur rarely)
Drowsiness or confusion
Inappropriate behavior or severe personality changes
Slowed or sluggish movement
I agree strongly that she needs to see a liver specialist.
I agree with Randy and rivll.
It sounds like your mom has "decompensated Cirrhosis", which means that her liver is no longer functioning properly.
Can you describe for us what you mean when you say that she seems drunk? As Randy said, her compliance with doctor's orders will be critical. If she needs a liver transplant now or in the future, she will not be approved for one if she is drinking alcohol or not complying with other doctor's orders.
The sense that you have of her seeming to be drunk could very well be signs of Hepatic Encephalopathy, which can be treated and helped with medications. It's important to know if the symptoms that make it seem like she is drunk are in fact signs of Hepatic Encephalopathy or if in fact she is abusing alcohol, or any other substance. If it is Hepatic Encephalopathy, there are medications that help to increase the number of bowel movements the patient has daily to help prevent the build up of ammonia, which causes the symptoms of Hepatic Encephalopathy. Without medical treatment and monitoring, symptoms of Hepatic Encephalopathy can increase and can result in many problems. As Randy said, weight loss can be due to her advanced liver disease. The body has a hard time processing all of the nutrients from food when the liver isn't functioning properly. It is very essential for your mom to be seen by a hepatologist in a liver transplant center who can evaluate her overall status with regard to her liver disease and make recommendations and treat. A primary care provider or a gastroenterologist is not qualified to manage your mom's care.
Some things to consider: your mom should not take any medications (prescription or over the counter) or supplements or herbs unless OK'd by a hepatologist. She should reduce her sodium intake. She should avoid red meat and food items that are high in iron. She should not take a vitamin with iron.
Good luck. Let us know the results of the ultrasound and try to get her an appointment with a hepatologist as soon as possible.
Thanks so much for this info, as well as replying to my message. I'm positive shes not drinking anymore, and after reading more info above, I do think it may be a mild case of HE. I explained all of the necessary changes to her and she's adapting quite well. And as of today she has not had any pain from the ascites for 3 days now. Not sure if it comes and goes, but it has eased up over the last weak and seemed to be nonexistent over the past couple of days. I just got her insurance info and will be calling around to get her a hepatologist in our area. Can that be done on her own or does her Dr need to give her a referral? I'll be going with her on her Dr's visit on Thursday for her results of her Ultrasound. I'll be sure to get copies of al of her labs as well. Thanks again!
Thanks for your comment! Based on the info you provided, it does seem like she has a mild case of HE. Even though she only has the change in sleep patterns, it may be likely this is what shes experiencing. The thing is she's totally alert, not forgetful, active, living her normal life. Driving around, running errands, doing everything shes always done prior to her diagnosis. But her face, aside of the weightloss, just looks different. Has an appearance of being drunk/disorientated but she actually isn't. I dont know, it's kind of hard to describe. But I'm totally positive shes no no longer drinking. Is there any other ways for me to know if its in fact HE. Maybe certain tests? I even asked her about her bowel movements, and she stated those are regular as well. Would Lactulose or Xifaxan be helpful at this point just in case even if were not totally sure thats the issue? I'll be sure to ask her Dr as well.
Hello, thanks for your comment! Now when I say drunk, I don't mean acting like it. No slurring, or anything that a drunk person would display. I mean her face just has a different look to it. Sort of a tired, fatigued, drained, sort of disorientated look. But shes totally normal! None of the symptoms that was described above aside of the change in sleep patterns. I thought it was just me, but I had my husband pay attention, and he noticed it as well. I will be sure to bring this up to her Dr. And we're in the process of finding a Hepatologist as well. We're in the NYC area so if any recommendations please let me know! I have no idea of how to go about this process of finding one, but I'm sure a few phone calls will lead me in the right direction. I'm completely hands on with this whole experience and will try my best to keep her as informed as possible. She has the eating habits under control as of now. After tons of research I explained the no meat, no iron, avoiding any meds that aren't prescribed to her etc... She's really concerned with her weightloss at this point. Do you know of any tips to help her gain it back? We've been doing tons of juicing and having her eat healthy, but she says that's only going to make her lose more weight. Is there any healthy ways to go about gaining weight the right way? And lastly, what about sweets? Is she allowed to have a cookie or slice of cake here in there? She's had this urge for sweets lately and I stay on her telling her she's not allowed any. Thanks so much for your help Advocate!! And I'll be sure to post her results as well as labs once she see's her Dr on Thursday.
I think this link will help in your search for a TP center.