I'm sorry that your doctor can't give you a more specific answer about what is causing your liver disease. One thing I would suggest is that you ask for copies of all your medical reports and test results - blood tests, ultrasounds, MRI reports, liver biopsy reports. Even the best of doctors can sometimes overlook things if they are very busy, and it is very common for doctors to only discuss some of the results with the patient. If you keep copies of all results you will be able to study them at your own pace and can ask more specific questions here and get more precise and detailed answers. Patients In the U.S. have a legal right to a copy of all their own tests, although some doctors and hospitals charge a small fee per page of paperwork. I have no idea if Pakistan has this kind of law, but even if they don't you can still ask and they might give them. Or they might allow you to at least read the papers in their office, and then you could take notes on the results. Once you have your own test results you can do research on the web and learn more about all of the tests and what the different results mean. This will help you to ask better questions of your doctor (always ask very respectfully, especially if they are not accustomed to the idea of patients learning enough to ask serious questions) and in the end it will help your doctor do a better job of taking care of you.
In your case the first things I would want to know are:
1. Was your cirrhosis diagnosed by liver biopsy, or by what other test? Exactly what did the report say about it?
2. What are your complete blood test results?
3. Have you been tested for hepatitis B and hepatitis C?
To increase your own odds of long-term survival with cirrhosis the single most important thing you can do is to remove any sources of additional damage to the liver. The most obvious is to try to remove whatever caused the cirrhosis, and the two most common causes are viral hepatitis and alcohol. You must avoid drinking any alcohol with cirrhosis, and if you have Hepatitis C you should try to treat it and get rid of it. If the antibiotic you took has any record of causing liver damage in large doses then you should try to avoid it, probably forever now that you have cirrhosis. You should follow the usual rules for living healthy - regular exercise, eating lots if fresh fruits and vegetables, keeping your weight at normal or slightly lower levels. You should check with your doctor and/or online resources first before taking any kind of medicine or nutritional supplement.
What food you eat will not make much difference to your illness. With a platelet count of 97,000 you probably have early cirrhosis (stage 4 liver disease) without many symptoms.
There is no food that will stop your liver disease from getting worse. Whatever is causing your liver disease must be treated if possible to stop what is damaging your liver from causing more damage.
The only foods you may want to limit is salt (sodium) to 2,000 mg per day. This will prevent fluid from building up in your abdomen and lower legs.
The other food to limit or eliminate is red meat. Red meat can cause hepatic encephalopathy which is a symptom of advanced cirrhosis which can cause confusion, memory loss, the inability to sleep properly.
Stage 4 liver disease is serious liver disease. Please if you can find a doctor who can determine the cause of your liver disease. If the reason for your liver disease can be found then many times further damage to your liver and be stopped.
Here are 2 articles about cirrhosis in Pakistan.
"FREQUENCY OF DIFFERENT CAUSES OF CIRRHOSIS
LIVER IN LOCAL POPULATION
Fahim Ullah, Sheema Khan, Ayesha Khan Afridi, Sadiq ur Rahman
Department of Medicine, and Department of Surgery, Khyber Teaching Hospital, Peshawar, Pakistan
Background: Cirrhosis liver is a common cause of morbidity and mortality in developing countries. The objective of this study was to find out the frequency of different causes of cirrhosis liver in patients admitted to
Material & Methods: A prospective study of 95 patients already diagnosed with cirrhosis liver or diagnosed as such during current admission was performed in the Medical B Unit of the Department of Medicine Khyber
Teaching Hospital, Peshawar from January, 2009 to December, 2009. Both male and female patients above 15 years of age were included in this study.
Results: Of the 95 patients meeting the inclusive criteria 49(51.6%) were male and 46(48.4%) female patients.
The commonest affected age group was 40-60 years.
The most common cause of cirrhosis liver in our study was hepatitis C virus infection responsible for 74(61.66%) patients followed by hepatitis B virus infection, hepatitis B and C viruses co-infection and hepatitis B and D virus super infection in 18(18.94%), 5(5.3%) and 4(4.2%) patients respectively. Other causes found were alcoholic liver disease in 3(3.2%) patients, primary biliary cirrhosis in 2(2.1%) and 1(1.05%) patient each had Wilson’s disease and haemachromatosis while in 3(3.15%) no
cause for cirrhosis liver was found.
Conclusion: The most common cause of cirrhosis liver in admitted patients is hepatitis C virus infection followed by hepatitis B virus infection in our local population."
DR. S. MEHTABULLAH KAKAKHEL, MBBS, FCPS Dr. Mohammad Haroon, MBBS Registrar Post Graduate Trainee
Department of Medicine, Medical B ward, Department of Medicine, Medical B,Khyber teaching hospital, Peshawar. Khyber teaching hospital, Peshawar.
DR. MOHAMMAD TARIQ, MBBS, MCPS DR. SADEEQ-UR-REHMAN, MRCP Post Graduate Trainee Professor, Department of Medicine, Medical B ward, Department of Medicine, Medical B ward, Khyber teaching hospital, Peshawar.
Objectives: To know the frequency of HCV in patients with cirrhosis and to know the mean age of patients with cirrhosis.
A descriptive study. Setting: Medical Unit Khyber Teaching Hospital Peshawar Period: From Jan 2007 to Jan 2008.
Materials & Methods:
100 consecutive cirrhotic patients or those with signs and symptoms of cirrhosis, admitted to the medical units. They were either known cirrhotic or
having signs and symptoms of chronic liver disease and diagnosed as cirrhotic during their stay in the hospital on the basis of ultrasound
findings. The routine investigations including liver function test (LFTs), prothrombin time (PT), activated partial thromboplastin time (APTT),
serum albumin were carried out in all patients. Ultrasound was the main tool for the diagnosis of cirrhosis liver. The hepatitis C virus (HCV) status
was diagnosed by detecting Anti HCV Antibodies by enzyme linked immunosorbent assay (ELISA). Polymerase chain reaction (PCR) for HCV
RNA was done only in affording patients.
Results: The overall frequency of HCV was 52 in 100 patients. Out of these 52 HCV positive patients, PCR for HCV RNA was positive in 20 patients (38.15%) and the rest of the patients were not able to afford the test. Out of 52 HCV positive patients the number of male were more (1.8:1) as compared to female. The age of the patients ranged from 45-65 years, the majority being from 45 to 65 years with the mean age of 52 years. The stratification of risk factors was not the objective of this study. However, a note was made of exposure to various risk factors. Most of the patients had the history of receiving injections in the past from quacks.
Conclusion: It is concluded that chronic HCV infection is the commonest cause of cirrhosis leading to chronic ill health, great economic burden on family and health care system and mortality. As there is no treatment for cirrhosis so prevention, early detection of HCV infection and prompt treatment of HCV infected patients will undoubtedly lead to a decrease in morbidity and mortality from this silent epidemic."
"Cirrhosis is a common disease and is responsible for 10% of hospital admission and over 30% of chronic illnesses in our area.
Please get tested for hepatitis C and B if you can. There is treatment that can cure hepatitis and stop your liver disease from getting worse.
If you could be treated at Khyber Teaching Hospital in Peshawar I believe the most knowledgeable doctors are there.
I wish you all the best.
San Francisco, California USA
lot of thanks for guiding me,I am getting treatment from one of the best gestro of Pakistan, but after too much tests he can not identified any reason.i am working on Amonia production plant and about two years ago I was suffered in a testis infection resulting blood in urine 4 months and then worst in epidedino orchatics during these days a physiologist given me a lot of anti biotics like augmenton sipraxin ciproflaxacin and others like this.My gestro assumes that this cirrhosis may be the due to my previous medical condition or anti biotic high and too much dose or due to my working conditions where I have to expose ammonia, other gases and chemicals.but he says now he is not in position to say any thing to specify the reason.now what should I do?
Thanks Respected Madam,
As you asked me about my test reports copies, Here in Pakistan same law about reports as in US.I have all my test report copies.My Gestro repeated LFT, CBC,and USG after every three months.
the answers of your questions are as under:
1.No, I think it was through ultra sound and after too much blood tests.liver biopsy was planned later on for identifying the reason of disease.
2.In last two years history platelets remained 50000-60000.some time decreased too much down to 20000.but in last month test it was above lake 100000.R.B.Cs and WBCs were also little low from lower limit but last test shows a little improvement.but alfa feto protein and sgpt shows increasing trend
3:Yes,Hepatitis B and C are negative
Respected Mam. I can send you my test reports if you allow or want to review
First I have to make it clear that I am not a doctor, just another cirrhotic patient. I've been soaking up lots of knowledge from reading a lot and from a number of other very well-informed people on these forums and am just trying to give back whenever I feel I can help. HectorSF is one of the people who have taught me the most, and I always recommend his advice.
So far the info we have on you is that your doctor has diagnosed you as cirrhotic, but with unknown cause, and without use of a biopsy. It is more common to say things like "possibly" or "probably" cirrhotic when diagnosing without a biopsy, but cirrhosis can sometimes be obvious without biopsy when the other tests show bad enough results, as in an ultrasound showing a markedly heterogenous nodular texture, very low platelets, or signs of varices and/or ascites. Your platelet levels are quite low, and one possible cause of low platelets is cirrhosis. There is excellent and fairly easy to read information available on this subject at this link: http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis/
I'm sorry I can't make that link live - it is a restriction of the medhelp website that only links within their own site can be live, and all others require copying the link and pasting it into your browser. I strongly recommend reading a number of good resources on cirrhosis, to help you become a truly active partner in your own health care.
As you will read in that article, the most common causes of cirrhosis are alcohol, Hepatitis C and Hepatitis B. I've been unable to find and documentation linking cirrhosis with exposure to either ciproflaxin or to ammonia in the environment (doesn't mean its not possible, just not well documented). You probably know if it is alcohol, but the viruses require blood tests to confirm. If you have either if these viruses it is really critical information, and it makes little sense to worry about anything else until you know whether or not you've been infected. If you don't already know: HCV is not sexually transmitted, and is only passed from blood to blood. Most commonly it is through contaminated needles, which can mean IV drug users, or in some cases it can mean poorly trained medical personnel with inadequate supplies or inadequate training. Much less commonly it can be transmitted via careless barbers, manicures or tattoos. HBV on the other hand is transmitted sexually , as well as being transmitted in all the same ways as HCV. Either virus can first cause an acute infection which the body may or may not succeed in fighting off. If it doesn't succeed, the virus becomes chronic. With HBV it is very likely to become chronic if one is exposed as a young child, but if 5 or over the risk is only 6-10%. With HCV the risk of becoming chronic is far higher, about 75-80%. On the other hand, HCV is now quite treatable. New drugs are now available that can cure most (about 90%, or maybe higher) cases of HCV. This is why it is so very important to know if you've been tested for HBV and HCV, and if you show positive antibodies to either then you must also have further blood tests to show whether you have active viral infection or merely leftover antibodies from an infection that was successfully fought off. It hardly makes sense to pursue any other lines of inquiry until you've figured this out first. Well, this AND looking at your alcohol consumption.
You mentioned alpha fetoprotein rising. This test is for a marker for liver cancer (HCC). It is not a conclusive test but one that tells a warning to look more closely with ct scan or MRI. Hector can tell you much more about this test and how to interpret results, as he has been through liver cancer until he finally got a new liver last fall. I can tell you that HCC is rarely a problem until cirrhosis has been present for many years, and that slight elevations in AFP are generally just an indication to watch things more carefully. It usually rises really rapidly and persistently in cases of actual HCC.
With a dx of cirrhosis you should be getting a pretty thorough exam, including complete blood tests and an abdominal ultrasound, at least every six months (3 months if things seem to be accelerating at any time) for the rest of your life. You are always welcome to ask questions on these forums, but you get more responses, and more specific ones, if you include appropriate test results with the question. As in those actual platelet numbers, the actual AFP numbers, the actual wording of US reports. For your original question I think Hector gave you the best answer. Individual food items are unlikely to help and not very likely to harm either unless they are toxic in some way. Knowledge is key because the number one concern should be in eliminating whatever is causing the current damage to your liver. No amount of healing effort is going to get very far while the original source of damage is still working at causing more damage. Learn all you can and keep asking questions of your doctor too. Good luck!
I want to tell you that my liver biopsy has also done in august 2012.Report describes the chronic and fatty liver and class iv cirrhosis and evidence for early fibrosis, but it can't tell any reason.HCV HBV ave satisfactory results active antibodies are slightly higher but in range. Madam I never drink not even smoking.As you guide me I will consult with Mr.HectorSF.
Thanks Madam keep guiding and helping others.