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how to tell if my cirrohsis is progressing

How can I tell if my cirrhosis is improving
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683231 tn?1467326617
“How can I tell if my cirrhosis is improving?”

By working with your doctor and having your testing done as they have recommended.

Have you done something to stop your cirrhosis from progressing like stopping drinking if your cirrhosis is caused by alcohol, treating and curing your hepatitis c if that caused your cirrhosis, or losing weight in you have cirrhosis caused by fatty liver?

Depending on how much damage you already had the longer it will take for your liver to have an opportunity to improve with time.

For people who cure hep c with cirrhosis they say about 50% of people will have improvement with their liver over time. But even if your liver doesn’t improve if you remove the cause of liver injury at least your liver should not get any worse. But we will still need to be checked every six months for early signs of liver cancer because we will still continue to be at increased risk.
2 Comments
I quit drinking 1 year ago. My GI does labs every 6 months. I lost my Medicaid in November but my labs them were showing no more hep, but my liver enzymes are still through the roof
My symptoms are progressing everyday from delusions, memory loss, unbearable foot pain and more tired than ever. Some also have told me my jaundice in eyes is better but I still can't tell and don't even know what stage I'm in. I think it's stage 4
683231 tn?1467326617
Hi sorry to hear all this. Has your doctor looked for an additional cause for your elevated liver enzymes?

Once hep c is cured if that is the only cause of liver damage your liver enzymes normally return to normal range unless you have something else going on like fatty liver as an example.

If you are referring to F4 when you said stage 4 that is a liver fibrosis score of 4 which is the definition of cirrhosis. Everyone with cirrhosis has s fibrosis score of F4. Once you have cirrhosis it is further broken down by compensated where your liver even though damaged is still able to perform its important functions and decompensated where your liver is so damaged it can no longer keep up with its jobs and symptoms of decompensated cirrhosis begin to appear.

If you are referring to a different chart I’ve seen stage 4 liver cirrhosis that would mean you have experienced a varicial bleeding event and have marked ascities where you have a very swollen stomach that looks like you are pregnant and may have to go in to be periodically drained of this excess fluid or had a portosystemic shunt surgically placed to prevent this fluid build up.
683231 tn?1467326617
I hope you are seeing a doctor associated with a liver transplant center they are in the best position to follow a patient with advanced liver disease.

Have you had an upper endoscopy to look for esophageal varicies?

Have you discussed the delusions with your doctor have you been diagnosed with the cirrhosis symptom of HE (hepatic encephalopathy)? If you have HE are you taking lactulose?

Do you know your MELD score which is how patients are prioritized on the transplant. Even a patient with compensated cirrhosis will have a MELD score. Most transplant centers require a MELD of at least 15 to be elligible for the transplant list with most transplants occurring with a MELD of around 30 depending on the region.

Have you been evaluated for a liver transplant and are you elligible for a transplant?

Unfortunately, as I said originally about half of the people with hep c and cirrhosis will experience regression but the more damage that has occurred before cure the longer that may take. Also that depends if hep c was the only cause of liver damage and the persons liver enzymes return to normal after they were cured. It does seem as you still have something attacking your liver which is causing your liver enzymes to remain elevated.

I would suggest having a discussion about your prognosis. What is the cause of your elevated liver enzymes. Your doctor knows your specifics and I’m not a doctor just a patient who had hep c for 37 years and was diagnosed with cirrhosis 11 years ago after being infected for 30 years. I was cured 4 years ago.

I never have been jaundiced. I did have esophageal varicies that needed to be banded but never had a bleed. I also had my gall bladder removed because of gall stones which was probably also caused by liver disease.

You should see your general practitioner about your foot pain that is probably not related to your liver disease. I’m taking a wild guess maybe could be gout.

Your doctor needs to be a hepatologist associated with a liver transplant center if at all possible.

Having advanced liver disease you may qualify for social security disability if you have symptoms of advanced cirrhosis especially if you have HE. The medical social worker at a transplant center would be able to help you with that process.

Sending you my best hope you are able to find the help you need
2 Comments
Thank you for getting back to me. It started year half ago I had been drinking about 10 years straight and my stomach was big and I couldn't rid of gas and was incredible weak. Was sent to we where I spent a month half with chest tubes to drain fluid from lungs  almost had to get Tips. Been taking my meds since then. I've been sober 1 year. 1 am 40 now with long history of bulimia. As of Nov my he is no longer and I haven't had to have paracentis I 6 months. I've had 2 scopes throat enemia, 2 blood transfusions, scope up backside and I've been at my steady weight 6 months. I  lost my insurance in Nov and I'm in process of getting it back through decision on social security disability so I haven't seen my GI 5 months. I still haven't had a decent bowel movement without my lactulose. I don't know what else to do.
Is your GI associated with a transplant center? You really need to see a gastroenterologist or hepatologist associated with a transplant center.

Do you know your MELD score you can look up MELD score calculator and using  some of your test results you can calculate your score. The test results you will need are INR, creatinine, bilirubin, and sodium.

Are you eligible to be on the transplant list? One big hurdle for some is you need a support person to care for you post transplant.

Without knowing your medical situation and I’m not s medical person at all it does sound like you may need to be on the transplant list. From what I read about stage 4 liver cirrhosis your possibility of dying in the next 12 months is about 57% per the University of Washington liver department. But I’m not a doctor and don’t know your total health picture.

What you need to do is get that insurance back see a liver transplant hepatologist at a liver center. If your overweight and your doctor says it’s ok try to get some exercise as you can and try to lose some weight. Also exercise and weight loss if overweight will make you more likely to survive a liver transplant procedure.

The lactulose is to help you body remove excess ammonia from your blood stream which is caused by your failing liver. This blood ammonia is what causes HE. The goal is to take enough lactulose so you are having at least 3 soft bowel movements daily if that is not happening you need to increase the dose to prevent the mental symptoms of HE. But you don’t want to cause diarrhea either as that can lead to dehydration and cause HE.

Basically your fighting for your life here you need to get a physically healthy as you can, heat a healthy diet and maintain a healthy BMI weight if at all possible. And you have to be seeing a liver specialist associated with a liver transplant center as my assumption is you are looking at needing a liver treansplant.

But please don’t take my word for this see your doctor as soon as you can  
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