Cirrhosis itching help

[Bacon123]

Has anyone successfully combated the severe itching associated with cirrhosis?

[WayCas]

Great question. I started having itching about 8 week ago. It has been very severe. I have gone down my list of doctors and they each really didn't have an answer just said try this. Here is the list I went through: Lotions, Gabapentin, Vistaril, Naltrexone, 4% Lidocaine patches and finally my Hepatologist suggested Cholestramine 4gm. I am starting to have some success with Cholestramine. Here is an article I just found to support the reason for itching and give some evidence to different treatment.

ncbi.nlm.nih.gov/books/NBK2...

Let me know what you find out and appreciate any comments from other members of the community. I will let you know if I get better.

Wayne

[Fibro2021 in reply to WayCas]

Many thanks. Very informative article. My itching is not very intense. I occasionally use a moisturizing lotion and occasionally take one antihistamine tablet.

[Harting in reply to WayCas]

I would ask your GP about sertraline (normally prescribed as an anti-depressant), as it appears to be a very well tolerated first-line treatment for pruritis (itching) as a result of liver disease.

[Bikafella in reply to WayCas]

Thanks for posting this link. My pruritus is currently severe but I csn go for a few days to a few weeks without any itching. I am on 2 x 4g Questran ( Colestyramine) daily and whilst it was highly effective when I started it in September, it's not so effective at the moment. I've already had a transplant and there's discussion taking place as to whether a further transplant could be done. I learnt a lot from this paper.

[LorraineLouise in reply to WayCas]

I for years, I have thought the itch. I’ve tried everything in the past. Nothing has worked for me. Till I saw my dermatologist. She put me on something called.Doxepin. It was instant relief. Have not had the itch since. It was like a miracle drug for me. Hope this information helps someone else.

Best wishes,

Lorraine Louise

[WayCas in reply to LorraineLouise]

Thank you very much for sharing this information. Will definitely check it out. Wayne

[Braveheart65]

Hi, I never encountered itching until after my transplant when I then had bile duct problems and also developed cholangitis. The itching was caused by stones blocking the bile duct . I had stones removed and stents inserted via ERCP 5 times over a period of 11 months, during which I developed severe cholangitis, had an episode of acute pancreatitis associated with ERCP procedure. This resulted in chronic pancreatitis which I still suffer from.

Throughout the 11 months, post transplant, I suffered from itching so intense that I scratched both arms, feet and hands until they bled, had no skin and my wounds were permanently dressed. I’m talking my entire arms and legs shredded. Initially I was prescribed piriton. I was admitted to hospital on 7 occasions due to the itching/cholangitis. Then I had cholestyramine 4g sachets prescribed. They helped enormously but at my worst bouts of itching I was taking up to 8/10 sachets a day (more than prescribed). The downside was SEVERELY BULKED CONSTIPATION-I genuinely mean severe. Laxido/Movicol wouldn’t shift it. The cholestyramine bulks out faeces.

After 5 failed stents it was decided to rebuild the bile duct and reroute bile into my intestine. That’s mercifully stopped the itching. I had that surgery (which was worse I have to say than the transplant as unbeknown pre surgery, the last stent to be inserted via ERCP had migrated to my bowel which necessitated partial removal of my bowel), 7 months ago and until tonight was itch free. Tonight, I’ve started to itch a little, so I’ve taken cholestyramine again and suspect that an episode of cholangitis is looming. Lucky me……

[Bikafella in reply to Braveheart65]

You have been through a really tough time and my heart goes out to you. I frequently lose whole night's sleep through itching. My Consultant recommended 2% Menthol cream which is great at cooling the skin down. Doesn't last for too long though - but enough to get me to sleep.

[Liver3]

Omg? Talk about a terrible time. I went through it a few years ago? Doctors gave me drugs that helped some but I thought I want going to tear my skin apart! It lasts for a few months as I recall worse at night! Meds do help it was shortly after that I was advised I had cirrhosis! Best of luck I'm in u.s.

[Daphnis61 in reply to Liver3]

Hi, Liver 3, was interested in your reply. I had intense itching, which appeared suddenly on both forearms, then a little bit on my trunk, worse at night. Poor you - it's horrible. It came shortly after I'd had a virus of some sort, so I thought it was connected with that. It lasted for the best part of a year then one day it was gone. I get eczema though now mostly just on my hands so I thought it was that but creams didn't really help, though Eumovate, my usual eczema cream helped a bit. I assumed it wasn't to do with liver disease as the condition disappeared but what you say makes me wonder if that was the cause. Can itching associated with liver disease just arrive and then go like that? I suspect I have liver disease but have got nowhere with doctors.

[PurpleNanna]

Hi Bacon, I have tried most of the suggestions made so far which have had limited results for me. The only way I can stop the itch is with an ice pack directly to the area and cortisone cream also helps but is not a long term solution

[Bikafella in reply to PurpleNanna]

Try the 2% menthol cream it's more comfortable than the ice pack and worth a go.

[cammeag]

First of all, Braveheart65, my heart goes out to you. Most of us view a transplant as a possible new beginning, not a possible beginning of more problems. I must admit, while decompensated, my itching was crazy intense too, but not to the extent of hospitalisation. I tried everything too. The urea cream i used from the beginning had a partial relief, but the combination of Eurax cream, fexofenadine 120mg and plenty of tonic water(quinine) with fresh lemon made all the difference for me. I really hope you all get these issues sorted and regain some quality of life. All the best 🙏

[Braveheart65 in reply to cammeag]

your reply hit home and you’re the first person ever who has zeroed in on the understanding that it should be about quality of life not length expectancy. Since the transplant my quality of life is non existent. I feel like the worst person alive as I’m not grateful for the organ donation and don’t feel like celebrating my new life. I’m now diagnosed as suffering PTSD related to the aftermath of the transplant. All I want to do is get to a point where I can work.

But this thread isn’t about me and I don’t want to hijack it. I just wanted to thank you for the comment you made.

[sophiaS1980]

CeraVe shower gel for itchy skin, and CeraVe lotion after shower.

[oap74]

I had itching which was diagnosed as eczema it can appear anywhere I use Diprobase advanced Eczema cream applied in the morning to affected areas, and have no itching at all. So maybe a cream may help. I have cirrhosis and liver cancer. All the best.

[Bacon123 in reply to oap74]

Thank you. We'll try it.