Liver TIPS not working yet...

[Happyhelen1]

Hi. I'm new here and asking on behalf of my mum. She has been ill with liver issues since January 2014. She had jaundice for approx 6 months caused by autoimmune hepatitis (the doctors landed on this diagnosis but were not entirely convinced but could not offer any other explanation) and for the last year or so she has suffered from ascites.

She had a TIPS procedure in April this year but she is still filling up with fluid. We were advised that the TIPS may not work straight away but four months later we were expecting to see some improvement but none so far. Has anyone else been through TIPS and had a long delay in seeing any improvement in the ascites? She was being drained every 3 weeks before TIPS and is still being drained that frequently and still losing about 8 litres at each drainage. Any comments appreciated. Thank you.

[jojokarak]

Hi I had the tips procedure in December 2013. And to be honest my problems with water and swelling began after I had it fitted I never have it drained, I just have water tablets and elevate my legs when I can, also no salt. Hope your mothers situation improves soon 😊

[MisterX]

I may be be mistaken and I'm sure someone with a better understanding than I have will chip in to confirm or correct......

I think the TIPS procedure is to relieve the pressure on the portal vein. The pressure on the portal vein - caused because the damaged liver has problems allowing blood flow meaning the blood backs up and causes pressure - leads to internal varices (like varicose veins) which can rupture out of sight in the oesophagus and cause a life-threatening bleed.

I'm not aware that ascites is directly treated by TIPS (perhaps there is some benefit). The usual treatment is to reduce sodium intake (salt is about 40% sodium and the largest contributor of sodium) so you have to reduce salt intake right down. As an additional treatment, diuretics are used to move the fluid out of the body, but the better route is strict sodium control as this can minimise the formation of ascites in the first place.

Hope that helps.

Best regards.

[Meteocal1 in reply to MisterX]

It helps with acites as well

[Brett11]

But it can make HE episodes more frequent and worse.

Cheers,

Brett