Posted by Sara on April 18, 1999 at 23:00:18
My husband has Hepc...He is decompensating..taking diuretics and lactulose. The Dr just added Flagyl to the mix. Is this a common addition and I can't quite understand his reasoning for this.
Thank you for your help.
Posted by HFHSM.D.-D.M. on April 23, 1999 at 18:27:06
I appreciate your question about your husband who has hepatitis C and is developing advanced disease. I am interested in your question about flagyl though I want to stress that it may be an appropriate time for your husband to be considered for liver transplant if this is an option. You might want to bring this up with your physicians.
Lactulose is the mainstay of treatment for a condition called hepatic encephalopathy. Hepatic encephalopathy is a condition that develops in advanced liver disease when chemicals build up in the blood that the liver would normally eliminate. Patients with hepatic encephalopathy typically become confused or lethargic. If lactulose alone does not control the hepatic encephalopathy, flagyl can be added as a back-up drug. Flagyl kills some of the bacteria that are responsible for creating ammonia which is one of the chemicals that causes hepatic encephalopathy.
You might want to ask your physician if this is the reason he is adding the flagyl. When I give my patients with liver disease, new prescriptions I try to explain what the new drug is for, though I have to admit, I am not always successful.
Good luck with your situation. It sounds as if your husband has advanced disease. I trust he is being seen by a liver specialist. If you have additional information or questions, I would invite you to post the material to MEDHELP or to contact us directly at Henry Ford (313) 916-8865. We have an active group of liver specialists.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
Posted by Sara on April 24, 1999 at 20:11:05
The drs have already ruled out transplant possibilities. He has been seen by Univ of Miami drs. There are additional medical complications that rule it out.
Another question would be...how does one know how long a person at this end stage can last. My husband is always asking that question and the pat standard answer is "who knows" How about a guesstimate of what impending liver failure would be and would that be a good indicator?
Posted by HFHSM.D.-D.M. on April 30, 1999 at 15:06:48
Thanks for the follow-up. There is a reason your physicians have been somewhat vague about how long your husband has to live. It is something that is very difficult for us to gauge. In addition, patients and family members are often frustrated if our estimates are off by a lot. It certainly would not be something that would approprite for me to comment on given that I have not seen your husband. You and he should take advantage of the near future to plan his affairs and family members and friends who live a distance away may wish to know he is ill and that this may be a good time to see him while they are still able to talk to him in a meaningful way.
Again, good luck to you. This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.