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754966 tn?1233880415

what happens stage 4 cirrhosis of the liver???

Hello everyone, this is probably the hardest gut wrenching thing I have ever had to discuss, but i need answers. My mothers doctor sat down with me today and told me she has stage 4 cirrhosis. I did't get really anything else out of him except she needs to lose weight before they will put her on the list also quit smoking, and eat healthier. They are gonna send me her lab reports in the mail. She has never had a biopsy just ultrasounds. Why is this? Is this normal. how do they know what stage she is if she has never had this done? What do I expect. She seems to be okay until she was hospitalized for pnemonia a few days ago. this all came so soon. normally she seems great besides the fact she dont have the energy she used to 10 years ago but she is 45, but that is still really young. I guess I am just hoping that someone will tell me there is meds she can take or other things to keep her healthy. I hope it's not to late...Thanks, Nikki
33 Responses
619345 tn?1310345021
so sorry to hear about your Mom I suppose the ultrasound can see some liver damage
not sure however if it can see stages of cirrosus you may want to consult with a heptologist in your area call for references to major hospitals near you may be a good idea to find one to speak with and get more tests done to see exactly your mom's conditio
I am assuming they want your mom to lose weight and quit smoking for her health or did they mean by list a transplant list? Does your Mom currently see a heptologist or GI?
More educated forum members  will chime in and have  suggestions for you
Your Mom is lucky to have you

427265 tn?1444080036
I am also a stage 4 (compensated cirrhosis) and I understand what a sinking feeling it is to hear those words, but alot of progress has been made in treating those of us with cirrhosis.

One thing I wonder is if you are seeing a liver doctor or at least should get a second opinion. If no biopsy has been done, I wonder how they came to the Stage 4 decision. Some blood tests and scans may "suggest" cirrhosis, or more importantly to determine if the cirrhosis is compensated or decompensated, but are usually followed up by the all important biopsy. Even in the case of low platelets I believe a biopsy can be run although it's often one that's less invasive than the standard biopsy. Someone else might be able to provide more info on that particular one.

Curious too if the recommended weight loss and quitting smoking is to pursue treatment in the future. Seems if a transplant was in the offing that more info would be provided.

Nikki, you are already  starting to put together a list of all important questions...things that haven't been answered to your satisfaction. Way to go!!  Keep a list of them ( and that list will grow!)

One more thing before I stop...it's good to get a copy of all labs and tests for your own records like they said they will send you. But labs without explanation are cruel....our minds can jump to all kinds of conclusions without some interpretation. So make sure any abnormal tests are explained to your satisfaction.

Wishing you both lots of luck and patience as you set out.....Pam

Avatar universal
Just want to reach out a hand to you so you know you are not alone. I have a daughter about your age, and I know how devastated she would be if anything happened to me. I can understand how you are feeling, and with such a young mother.

I am not that knowledgeable about cirrhosis, but your mother's low platelets gave me a clue that this might be what was going on. There are different ways of stating the platelets, so to compare them with the normal range you mentioned of 200,000 to 400,000 your mother's platelets probably translate to 68,000.

With hepatitis C it is common to have no symptoms until you have reached stage 4. There is treatment available for hep C, and there are those who treat with cirrhosis. Others have to get a liver transplant first and then treat afterwards since the hep C will not go away without treatment.

I hope the members more knowledgeable about cirrhosis will come along. I can ensure you that this is a very good place for you to find information and support.

754966 tn?1233880415
yeah to be on the transplant list she must lose weight and quit smoking, other than than that they will skip right over her. I don't know why though...
Avatar universal
I think it was FlGuy's doctor who diagnosed him with cirrhosis just on his outer appearance. There are clues which can make a biopsy redundant.
87972 tn?1322664839
Hi Nikki

Stage 4 cirrhosis is classified as to severity; using the Child-Pough scoring system, it can be graded as child-class A, B, and C. One major difference is whether the liver is compensated or decompensated. With compensated disease, the liver’s architecture is altered; but the organ continues to perform its vital functions. When decompensation occurs, it can lose its ability to filter, manufacture etc. We have many members in here with compensated cirrhosis; of itself, it’s not a death sentence, but it certainly needs to be managed.

Depending on the level of damage, she might not require a biopsy. There can often be enough evidence by blood test (low platelets, changes in serum bilirubin and albumin, etc) and US/scan to avoid an invasive procedure such as needle biopsy.

Make sure she is compliant with ALL doctor’s orders; this may be important should she require transplant down the road. No alcohol and be sure she follows doctors orders to a tee. Her doctor should ***** her and determine if she needs to be evaluated by a transplant center; and a MELD (Model End stage Liver Disease) score should be assigned.

She really needs more information to know where she’s at in terms of damage at this point. Janis and Friends has some fairly comprehensive info about Cirrhosis:


You didn’t mention if this is Hepatitis C related; this will be important info as well.

Good luck, and let us know how things progress—

754966 tn?1233880415
Yes it is hepatitis c related, My mother does not drink but probably 4-5 times per year I see her have a glass of baileys. I think she just thinks it is gonna go away or something. I know she takes milk thistle but thats it. I also want to know what genotype is? I just found out today that my dad has it also (just great i thought). The dr said he is like a carrier but has no signs or symtoms of it. I dont get that, So what he gave it to my mother and she is not doing well at all and he is just fine hmmm?
I also see no signs on her such as jaundice, but she does not heal well at all. She itches alot and takes zyrtec for that when she has an attack with that. She said you can tell a little by her neck, it kind of has red broken blood vessles which are very tiny but my mother said thats what it is from. Those are the only signs and symptoms she has.
87972 tn?1322664839
Grrr.... **** = assess.

754966 tn?1233880415
well i dont know if she really thinks it is gonna go away, or if she is trying to protect me by not telling me anything. So I took it upon myself to get to the bottom of it and Make her get better and healthier. I will do whatever it take to keep my best friend and my mommy! She is my whole world.
87972 tn?1322664839
Unfortunately, there’s often little outward sign of early cirrhosis; many people that are diagnosed are asymptomatic, and don’t realize they are ill.

If she has Hep C and has progressed to cirrhosis, her problems will not self correct; she needs to take action soon. If she can beat the virus, she stands a good chance of full recovery; this should be discussed thoroughly with her doctor. There is medicine that can eliminate the Hepatitis C (HCV); but she needs to take action; the liver disease *as well as* the medicine can cause a reduction in platelets… if they get too low, she will not be a candidate for treatment.

Regarding your father, not everyone develops progressive disease with this virus; he should be evaluated as well for treatment, and take appropriate action as necessary.

The genotype of Hep C is like the “strain” of virus; there are several different types, and each one has different response characteristics. Genotype 1 is the most prevalent in the U.S.; and the least responsive to current treatment. Other genotypes (2 and 3) are less common, but are more responsive to the meds, and require less time in treatment.

The red blood vessels on your mom’s neck might be spider nevi… this is one of the signs of cirrhosis. She should discuss this with her doctor. Has she had a referral to a hepatologist yet? Or is she being seen by her primary care doctor still?

439539 tn?1233469415
I'm sure you will find the answers your seeking.I just wanted to say good luck to you and yours .You are a very devoted daughter and it will help you, help your mom .
Good Luck,
754966 tn?1233880415
Yes that is what it was, spider nevi. She said she needs to watch them to see if they get worse. Also she is not seeing a hepotologist, he is a  Gastroenterologist, and internal medicine doctor. I dont know why she is not seeing a hepitologist? My father is genotype 1 but not sure of my mother...
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