hepatic encephalopathy diagnosis

[Abby14]

I am sure I have this How is it Diagoesd?

[butterflyEi]

Hi Abby14

The British Liver Trust has a good article on this, here is the link.

britishlivertrust.org.uk/li...

Why do you think you have HE? Do you have advanced liver disease?

Hoping this is not the case for you but if it is I am assuming that you are under the care of an hepatologist who is prescribing for you.

best wishes

[Abby14 in reply to butterflyEi]

Hey, all I know is I have chrrioss (early stage) No varcies & Fibroscan was 6.1 Which I was told is ok! My blood resuits have been better I am diabetic & my sugars are good! & Iron Has come up a bit! I have been so forgetful latey & that is so not me! I am very cospiated! & in so much pain I am doing all I can! I take so many Laxtives I am going the loo, but still consipation. is called fuctnal comsipation, My gp told me! The fat round my liver has reduced alot! ( I have lost nearly 2 stone) & the adomas are stable! Due a MRI soon! so should know more then! But I have never been so forgetful & not able to rember things!

[AyrshireK in reply to Abby14]

You need to get your ammonia levels tested, if your liver is failing to process toxins properly plus you arn't going to the loo then you possibly are not removing toxins from your blood stream and when they find their way to your brain they can indeed cause issues with concentration, forgetfulness, memory etc. In advanced HE you might begin to experience changes in your hand writing, your personality, your hands can begin to flap (asterixis) and in very advanced HE you can even lapse into coma. Get your ammonia levels tested, are you on lactulose as one of the laxatives you mention - it doesn't only act as a laxative but has a specific function of fixing and removing toxins from the body (ideally when you have cirrhosis you need to be moving your bowels 3-4 times daily). There is also a medication called RIFAXIMIN which used alongside lactulose can help with HE symptoms. If you really arn't moving your bowel at all then you need some medical help to do so ........... perhaps even an enema.

Katie

[Abby14 in reply to AyrshireK]

Thanks my bloods are due about now, so will ask for the test to be added, I am seeing gp tomorrow. I saw the other Dr from my pratice & she said the bloods are good so can be left for 6 months! But I am not happy with that! They are normaly done every 3! Yes I am on Latucose, she wanted to swap it for something else! I said no, as I am aware it removes toxins as well! I sometimes don"t go for 2 or 3 days! She did give me some suppotries to use so I am ask how often I can use them! The pain in my back from the cospation was so painful, (& cramping ) I nearly called am amblance! She said my bowel sounds where a bit slugish!

[AyrshireK in reply to Abby14]

I know when my hubby was in hospital but not moving his bowel he was also prescribed laxido and movicol sachets as well as the lactulose. Nowadays he finds that coffee, fruitcake and chocolate get things moving so to speak and goes the requisite 3-4 and sometimes more times per day. If you arn't moving your bowel for that long you will more than likely have toxin build up and they need to get you moving.

All the best with your upcoming appointments.

Katie

[donnalee in reply to AyrshireK]

Hi Katie,

I had all the these issues I take Lactuluse and Xifaxan to control it. I was diagnosed with Liver Disease in March of 2014. The HE came on shortly after that. I don't know if it would come back if, I stopped the medications.

Donna

[gwillistexas in reply to Abby14]

Abby14...you have Cirrhosis and fibroscan score of only 6.1?

[Hidden in reply to gwillistexas]

I have symptoms of advanced liver disease and a fibroscan score that it about 8. These things are possible I'm afraid.

[gwillistexas in reply to Hidden]

MC1189...this is why I feel drs shouldn’t do fibroscans. They should only use the most accurate technology available. 😊

[Hidden in reply to gwillistexas]

It is accurate in the readings it takes. However, it is impossible to replicate the same readings for each scan, since the area covered is not the same each time. Also, the score is only an average and the readings are then open to interpretation. I think the fibroscan alone is too misleading and should only be used to clarify the picture they already have or to confirm thoughts they have. But I agree, not for diagnosis.

[gwillistexas in reply to Hidden]

My first one wasn’t done for diagnosis. I think they’re mainly used as a baseline so the next one, a year later, tells Dr if med is working. I’m just going by what my dr told me. But now, he admits they can be inaccurate, but we all know that. But because my last one showed slight increase in fibrosis, I’ve been referred to a hepatologist. But that’s okay by me, I’ll get better care. 😊

[gwillistexas in reply to Hidden]

MC1189... that’s what is concerning to me, I have no symptoms & feel perfectly normal. Only thing is I know I have PBC. I have a non stop appetite & energy to spare. May I ask how long you’ve been diagnosed?

[Hidden in reply to gwillistexas]

Hi I was diagnosed with AIH about 10 years ago and I've had two fibroscans, both of which showed a low fibroscan score, somewhat to the surprise of my consultant at the QE. However, he told me that in Germany the research shows that it is where the scarring occurs rather than how much, which can dictate progress of my illness/disease. So where they have taken the readings from (in both of my fibroscans, done years apart) indicates very low scarring, but my symptoms indicate damage elsewhere which is causing my problems.

I didn't get diagnosed until I was jaundiced. I was attending the gym 3 times a week, worked part-time teaching A level and didn't have problems until my LFT's were around 1000! Hope that helps

[gwillistexas in reply to Hidden]

MC1189...sounds like the last several years have not been too kind. Sorry you’ve had to go through all that & not diagnosed until PBC got that far. Take care. I’ll keep you in my prayers 🙏🏻😊

[Hidden in reply to gwillistexas]

Very kind of you to think of me. After the inital 9 months of trying to get everything steady, the next 7 years or so were pretty steady. The last couple of years have been more "trying" shall we say. I don't have PBC, "just" AIH. Hope you are as well as can beexpected with your diagnosis. All the very best

[gwillistexas in reply to Hidden]

MC1189...G’morning ☕️. Now I understand. I was thinking you had PBC that progressed to Cirrhosis. From what I’ve researched, AIH can sometimes be worse than PBC. When I was first being diagnosed, my Internist also ran Acute Hepatic Panel. All hep results were nonreactive. I’m praying AIH hasn’t slipped in along the way. Thank you for explaining your situation. My husband says I ask a lot of questions, but I like to know about peoples journeys. It helps us learn. I have to get ready for work now. Have a great day!😊🦋

[Abby14 in reply to gwillistexas]

Yes