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Old 03-02-2009, 04:01 PM   #1
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PLease help Advice re Acute alcoholic hepatitis

Hi

my sister was admitted to hospital 3 weeks ago with acute alcoholic hepatitis. She has extreme jaundice, ascites, extremely malnourished, has bouts of constipation and problems passing urine, frequent nose bleeds and is very very weak. 3 weeks on and there is absolutely no change in her
condition at all.

When admitted she was given vitamin K, she is on a salt free diet with fortified food and drinks. She has not been administered with steroids although they are monitoring this (could this be because of the nosebleeds?) She has been given ultrasounds but I do not know if she has had a biopsy.

She is only 31. She has been drinking very heavily for many years (unable to hold down a job or leave home without drink in her bag). We are all fearing the worse. She refuses to tell us what the doctors are saying and the doctors refuse to tell us because we are not next of kin (she is married, but he is in Dubai and wouldnt tell us anyway). My older sister and my mum and I have been going to every hospital visit but still no change and no light at the end of the tunnel... hence this post.. could anyone advise me... how worried should we be, will she improve, how long might that take... why is she just being left to sit and wait this out, is there nothing that the doctors can do??

Any information would be appreciated, as we are living day to day, visit to visit.

 
Old 03-03-2009, 06:44 AM   #2
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Re: PLease help Advice re Acute alcoholic hepatitis

so sorry for what you ar having to go thru here,really. i watched my youngest son go thru liver failure at age 12, but of course it was not caused by alcohol. that is a whole other situation that is going to have to be dealt with. unfortunetly hon,your sisters nose bleeds are being caused by what is called portal hypertension?(there i actually a thread on this condition right below here). what occurs with alcoholic cirrhosis is scarring of the liver. while that is going on, and over time, it starts to also close off the very important blood flow thru that P vein. once this happens, alot of pressure begins to build up from that backed up blood that has no where to go but the paths of least resistance. it will back up into some surrounding organs, then the low pressure veins surrounding that area which also include the stomach and the very delicate vessels in he throat and the nose too. she actually is probably also having small breaks and bleeds in her throat and stomach as well as the bleeds in the nose too. its the process. has she been vomiting up any blood?

there is a procedure that they can do that kind of creates another pathway for that blood to flow thru the liver again using like a bypass vessel that is large enough to place a stent into. it is called the TIPS procedure. but on the downside it can cause the ammonia to build up in the system and go to the brain. one of the jobs that the P vein does when blood passes thru it is to remove the ammonia that is the metabolite of protien we eat. but since the P vein is already closed of, or very close, the same kind of thing is happening anyway? the difference here is getting rid of that high pressure that is currently flowing thru the veins that are just not ment to carry high pressure blood flow. this just gets rid of that 'hypertension" part,which by the way,before this procedure was invented,it was usually around this stage where people would have died very quickly. the TIPS is what actually saved my sons life one day and allowed us time to get a transplant.

i really am so sorry you are having to go thru this and your sister too. she is going to have to make some big hard decisions here,and it wont be easy. hopefully she WILL turn to you so you will know whats going on much more than you do now. from what you have stated here,her condition is not good. but alot depends upon the real true overall damage that is already there and how her labs and biopsies look too. but the alcohol part of this could be problematic if she needs to be on the waiting list for transplant. its just the way the system works here in the US. i am not certain how it is where you live right now. it would be worth your time to check into who ever governs transplant in the UK to find out just how someone there qualifies for transplant and also alcohol usage induced need for transplant, there very well could be a big difference like there is here in the US.

i do wish you luck here. please keep me posted on how things are going. Marcia

 
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