what happens stage 4 cirrhosis of the liver???

[nikki_d32]

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

[Bill1954]

Ok, you’re getting familiar with the landscape already :o); good for you. A Gastroenterologist is a “gut” doctor; they deal with everything digestive, including the liver. A hepatologist is a liver specialist; their primary focus is livers. She may want to schedule a visit with a hepatologist down the road.

In the meantime, take a look at the Janis and Friends site I mentioned above; it well answer many of your question. Your mother and father might want to look in there too. If you want to, you can look in this list for an explanation of the acronyms used frequently in here; it will help decipher our conversations:

http://www.medhelp.org/health_pages/Hepatitis/Common-Hepatitis-C-Acronyms/show/3?cid=64

Again, most of us in here will suggest she not drink anything alcoholic at all until this is resolved; she doesn’t want to put anything in her body now that might cause her liver harm. She’ll also want to discuss any medications she’s currently taking (including milk thistle, vitamins, etc,) with her doctor *prior* to taking it; some meds can be very hard on our liver.

Good luck, and stay in touch—

Bill

[jmjm530]

our last posts must have crossed, and I see that your mom missing a gastroenterologist.

Without being overly repetitive, the best thing you can do for your mom is to make sure she gets evaluated by hepatologist as soon as possible. Without going into details, and given the fact that there has been no biopsy, she very well may be getting incorrect and outdated advice, if her case is at all representative of many who are posted here. Indeed, she may not even have cirrhosis, or she may have cirrhosis but need treatment versus transplant. Of course I'm just speculating, but just seen too many screw ups by gastroenterologists here.

[jmjm530]

very sorry Nikki.

I'm assuming the diagnosis of cirrhosis, and the advice you've gotten, is from hepatologist, as opposed to a gastroenterologist.   If not, your next step should be to see one, because they are best equipped to make this kind of diagnosis and to advise you of next steps.

But assuming you're already seen a hepatologist who you have confidence in, then yes, sometimes the diagnosis of cirrhosis is made without a liver biopsy, and in some cases a biopsy is not necessarily desirable.

As to what to expect, a lot depends on how much damage has been done, because cirrhosis is not just one category, but actually multiple categories. Simply, it's divided into compensated and decompensated. something you should ask your doctor. Depending on the damage, treatment may take different directions. But again, both the diagnosis, and treatment recommendations, should be from a hepatologist (liver specialist) who are usually found in your larger, teaching hospitals.

keep positive. We've had many here diagnosed with cirrhosis, and they're functioning quite well.

All the best,

Jim

[nikki_d32]

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...

[kickboxingmom]

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,
Tammy

[Bill1954]

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?

Bill