Issue with Ascites

[blueaqua02]

Hi guys , my mother has decompensated cirrhosis and i am first time posting on this wall. She had varices banded last year and gave dieuretics for ascites which was gone that time then doctor put her off from diuretics 6 months before. Now from few days she again feel bloated and tight stomach due to ascite and doctor gave her diuretics which helps, but my question is there anything she can take or natural diet to stop ascites from coming again.? Please help me i am so worried about her. How to manage things as she get anxious on little things.

[kensimmons]

As little salt as possible. Zero if possible.

[AyrshireK]

Dietary protein is essential to maintain albumin levels.

[blueaqua02 in reply to AyrshireK]

Okay but her hemoglobin drops but there's no sign of internal bleeding no blood loss showing still her hemoglobin drops and she need transfusion .why this happen.? Please if you know then guide me

[AyrshireK in reply to blueaqua02]

That's something you need to explore with her doctor.

There are many reasons why low haemoglobin may occur.

Low hemoglobin counts associated with diseases and conditions

A low hemoglobin count can be associated with a disease or condition that causes your body to have too few red blood cells. This can occur if:

Your body produces fewer red blood cells than usual

Your body destroys red blood cells faster than they can be produced

You have blood loss

Diseases and conditions that cause your body to produce fewer red blood cells than normal

include:

Aplastic anemia

Cancer

Certain medications, such as antiretroviral drugs for HIV infection and chemotherapy drugs for cancer and other conditions

Chronic kidney disease

Cirrhosis

Hodgkin's lymphoma (Hodgkin's disease)

Hypothyroidism (underactive thyroid)

Inflammatory bowel disease (IBD)

Iron deficiency anemia

Lead poisoning

Leukemia

Multiple myeloma

Myelodysplastic syndromes

Non-Hodgkin's lymphoma

Rheumatoid arthritis

Vitamin deficiency anemia

Diseases and conditions that cause your body to destroy red blood cells faster than they can be made include:

Enlarged spleen (splenomegaly)

Hemolysis

Porphyria

Sickle cell anemia

Thalassemia

A low hemoglobin count can also be due to blood loss, which can occur because of:

Bleeding in your digestive tract, such as from ulcers, cancers or hemorrhoids

Frequent blood donation

Menorrhagia (heavy menstrual bleeding) (heavy menstrual bleeding-although even normal menstrual bleeding may cause a slightly low hemoglobin count)

[BritishLiverTrust3 Administrator British Liver Trust]

Dear Blueaqua02,

If you [are in the UK and] would find it useful to talk things over, our nurse-led helpline is open Monday to Friday from 9am to 3pm on 0800 652 7330 (excluding bank holidays)

Please note the helpline is closed tomorrow, Friday the 20th of Jan but will reopen again on Monday the 23rd.

Best wishes

British Liver Trust

[Laurap18]

Avoid salt. Pay attention that salt is everywhere, so read the nutritional information. Try to cook from scratch as much as you can, at least you can substitute salt with other spices. Also, limiting fluids to no more than 2l per day could be beneficial. The doctors usually also suggest to walk, even just a few minutes per day.

[Readlots in reply to Laurap18]

I agree, this is the advice my mother was given when she had ascites.

[Kristian]

Hi blue,

Yes keeping to a low salt diet will be helpful and others have mentioned restricting fluid intake. There's not likely to be much issue with reducing the salt however before she goes down the route of limiting fluid intake, that needs to be discussed with her own doctor first. Whilst some do get that advice, it may not be right for everyone's circumstances.

I'm sure there are some natural diuretics out there, but these are not likely to be that effective at removing or preventing things like Ascites build up. That needs something a bit more potent. Laura does make a good point though, being quite sedentary will contribute to the build up, so getting up and moving about will be helpful. She makes another good point too about adding herbs or other spices when cooking. This helps overcome the blandness in taste that can come when you dont add salt and is quite effective. I used to use a bit more pepper and that helped for me.

Whilst these things will all help, the ascites build up is a result of the severe impairment to her liver's function caused by the cirrhosis. So it may not be possible to prevent ascites and fluid returning. It is though positive that the diuretics she has been given in the past have been helpful. So going back on to those for a while may be the best option. Indeed its not unusual to start and stop these repeatedly. They have their own side effects so the docs prefer to stop them when not needed for a while before restarting them again once the fluid returns.

You mention in a response to Katie about your mother's heamaglobin level too. Again this is something that can be seen in cirrhosis especially if its decompensated. There's a few reasons for it. Firstly, the liver plays a role in production of red blood cells, so if it is impaired then this function is impaired too. She's had varices banded so clearly there is portal hypertension present which is likely to result in spleen enlargement. As the spleen is responsible for removing old or damaged blood cells from the body, a bigger spleen means more blood cells can be removed, again contributing to the lower blood counts.

There is some good dietary suggestions in the comments of others and all these will help in some way shape or form. However getting bespoke dietary advice from her own medical team would be a pretty sensible move too.

Hope thats helpful and good luck.

[Oludeniz2017 in reply to Kristian]

Great reply

[blueaqua02 in reply to Kristian]

Thanks for your helpful reply and your effort to write all these things and make all things clear . I will surely look for her diet plan and avoid salt as much as she can because her doctor advised to take regular meals but don't sprinkle salt on anything. She has another complication too like her head get heavy and her body shiver sometime not due to cold don't know whats the cause she is so sensitive and i am worried what to do to help her. Is ascites build up again and again is harmful.? Do people live normal long life with ascites buildup again and again. I will be very thankfull if you answer my questions.

[Charlie15melissaabb in reply to blueaqua02]

I did l had two drains as well the drains are for her to get temporary relief do felt so good

[Charlie15melissaabb]

l have decompensated cirrhosis I only say the only thing that can work spironolastone it takes it time I am on 2 .100mg tablets but please see your consultant hopefully it will help

[Charlie15melissaabb]

sorry to hear about your mum I have the same thing is she still thanking her water tables but go to the doctor’s straight way because I no how much pain she in with Acsites good luck hope she be better soon

[blueaqua02 in reply to Charlie15melissaabb]

She has edema with ascites she is on water tablet but she take only one after 2 days.

[Charlie15melissaabb in reply to blueaqua02]

they will double if will help as the consultant it help me I also had a hernia and the ascites was pushing the up if was the bad ask for furosemide as well as spironolactone it helped me hopefully it will ease up pain thinking about you good luck

[Chick_atee]

Taking spironalactone 200mg and 80mg ferusamide. Has helped decrease ascities and made more comfortable to try and eat but it seems to be just keeping the level ascities from getting worse when they decreased dose it went up again.

Suggest asking Dr/consultant about it because deuretics are not good for the kidneys. I have to be on them for now but I keep asking how my kidneys are functioning at appointments.

Good luck and keep us posted

[blueaqua02 in reply to Chick_atee]

Yeah you are right its bad for kidneys. Now she is better doctor took her off dieretics because she has heavy head and dizziness still have it don't know why its happening now. She is off the dieretics 1 week now still her head feel heavy and dizziness