cirrhosis and arthritis and pain relief

[Rshc]

hi, partner is listed for TX and has been experiencing a severe pain in one toe for around 6 months. His GP now says she thinks its either arthritis or gout but she isn't sure what to give him that will be safe for him to take. Paracetamol doesnt help. She has suggested rubbing ibuprofen gel on it and of course we are checking with transplant co-ordinator before doing this but I wondered has anyone else dealt with arthritis and what did you take? We will check everything out with consultant before doing anything of course

thanks

[Oscar21]

I was informed by St James liver unit that Ibuprofen is not to be used under any circumstances. Either in tablet or gel/cream form. Apparently the gel/cream will absorb into the blood stream and make its way to the liver.

[Rshc in reply to Oscar21]

that is what I thought which is why we have emailed his liver team locally to find out. I hope there is something they can recommend

[kensimmons]

I'm not a doctor but "one toe" sounds more like gout than arthritis. I would imagine the drugs, therefore, would differ since from what I understand (not being a doctor or medical person of any sort) the causes are different thus the meds would seem to need to be different too.

[Rshc in reply to kensimmons]

the GP did say the treatment would be the same but who knows!!

[kensimmons in reply to Rshc]

Obviously he (a doctor) is right and I (a non doctor) is wrong in that case. Good luck to you, I'm sure you are not the first or last with this and it will all get figured out.

[Ewife]

My husband suffered gout/arthritis for years- and it was partly the long term use of prescribed pain meds which caused his liver damage. When he had a flare up post liver diagnosis he was eventually prescribed colchicine which is apparently kinder on the liver. You could ask about it. It did eventually settle down though without taking much.Just by the way, he has never taken any paracetamol since the day they discovered meds were such a problem. Tongue in cheek because he has a supremely high pain threshold and is VERY stubborn and strong minded, but GPs will tell you to take paracetamol happily - I don't actually think you should if you can at all help it. I'm pretty sure my husband would have gone downhill much quicker if he had used them when in pain or feeling rough.

Take care, hopefully you will hear back from consultant soon.

Ewife

[wurzle]

I can't have ibuprofen but I use voltarol gel for my arthritic thumb joints which is diclofenac based which is fine to use and quite effective for the pain

[theoldboiler in reply to wurzle]

are you sure diclofenac is OK for people with liver disease?

[wurzle in reply to theoldboiler]

I think so but I'm not medical. I also have peripheral neuropathy for which I take gabapentin but it doesn't touch the pain from the arthritis

[AyrshireK in reply to wurzle]

Diclofenac is just another non s steroidal anti inflammatory (same as Ibuprofen) and usually contraindicated for liver patients.

[wurzle in reply to AyrshireK]

Yes I just looked it up and it does say that. I've been using it since before my cirrhosis diagnosis and thought it was ok to carry on using. They never tell you these things

[theoldboiler]

Have they considered that it may be peripheral neuropathy which is common in people with liver disease? I have peripheral neuropathy as a result of liver damage, manifests as painful feet which sometimes are numb or have spiking/shooting pains (hard to explain)

[Rshc in reply to theoldboiler]

no, nothing like this has been considered. Will mention it, thank you

[Hidden]

I find turmeric helps but I have no idea if it’s suitable I your case

[55spenc]

Hi, I have it in my elbows in a bad way! I use tiger balm, it helps but not not the solution.

[Readlots]

Would warmth help? I’m thinking a warm foot bath, wheat sack wrapped around it or or heated blanket?

[Rshc in reply to Readlots]

yes we have a foot bath and it does help a little, thank you

[Hdon]

Has your partner had their iron levels checked? Haemochromatosis (Iron Overload) can cause liver disease and painful pseudogout.

[Rshc in reply to Hdon]

yes he does have very high iron - which they say is just a symptom of cirrhosis and haven't recommended any treatment for

[Hdon in reply to Rshc]

Yes, serum Ferritin can be raised as a result of liver disease/cirrhosis, true enough. But cirrhosis can be caused by iron overload due to haemochromatosis. Have they said why he has cirrhosis?

[Rshc in reply to Hdon]

he has ARLD. His high ferritin transference was flagged at TX assessment by the Royal Free but they haven't really looked into it feeling that it will be resolved following TX

[Hdon in reply to Rshc]

OK fine if there is a definite identified cause, it's just that over the years I have known of people with haemochromatosis who slipped through the net.