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Suplements for Ascites and Cirohsiss
I was diagnosed with Cirrhosis of the liver in September of 2014. At the time I had no idea that a lot of health problems that I had been having over the past few years prior to this diagnoses, were almost certainly related to the cirrhosis. I was diagnosed in Michigan, where it is rather easy to get on Medicaid, but I am from Alabama and have no help or family in Michigan, so I moved back to Alabama to be near my family, who can and will help me. The problem is, it is almost impossible to get Medicaid in Alabama and I turned to supplements for relief from the ascites and just the overall health of my liver. I was taking Serrapeptase, Curcumin (Turmeric) and Milk Thistle, along with Mega B Complex Vitamins and a few other things. I was maintaining rather well and I got lax and started taking it here and there, not watching fluid and sodium intake and just generally acting as if I were well……. Bad Idea, to say the least.
I spent several weeks in the hospital due to fluid buildup in my lungs from the ascites and my MELD numbers were just all over the place. I’m out now, after having to undergo a TIPS procedure to get all of the fluid levels back to a level that is manageable with doctor prescribed diuretics, namely Furosemide and Spironolactone.
My question is this, does anyone here have any advice for other good supplements and vitamins for the liver and swelling. I have tried quite a few but the only ones that I seem to have good luck with and benefits from, are the few I listed, Serrapeptase, Curcumin (Turmeric) and Milk Thistle, along with Mega B Complex Vitamins. Any foods or other readily available, without a prescription solution that you all have found, I would be very interested in trying. Thank you for your time and please let me know if you have any advice on non-prescription alternatives for the liver and especially for ascites, that you have found to be particularly helpful to you.
I spent several weeks in the hospital due to fluid buildup in my lungs from the ascites and my MELD numbers were just all over the place. I’m out now, after having to undergo a TIPS procedure to get all of the fluid levels back to a level that is manageable with doctor prescribed diuretics, namely Furosemide and Spironolactone.
My question is this, does anyone here have any advice for other good supplements and vitamins for the liver and swelling. I have tried quite a few but the only ones that I seem to have good luck with and benefits from, are the few I listed, Serrapeptase, Curcumin (Turmeric) and Milk Thistle, along with Mega B Complex Vitamins. Any foods or other readily available, without a prescription solution that you all have found, I would be very interested in trying. Thank you for your time and please let me know if you have any advice on non-prescription alternatives for the liver and especially for ascites, that you have found to be particularly helpful to you.
I have just started taking a supplement called L- Glutathione, and from what I understand it is good for liver cells and detoxification of the liver. If I were you I'd do some research on it, to see what you think.
1 Comments
Build up of fat in the liver in people who drink little or no alcohol (nonalcoholic fatty liver disease or NAFLD). Early research shows that taking glutathione by mouth for 4 months might reduce blood levels of a marker of liver damage called ALT and triglyceride levels in people with liver disease not related to alcohol. However, glutathione does not appear to improve liver stiffness in people with this disease.
Liver cirrhosis means many of your liver cells have died and changed into scar tissue. Dead liver cells scar tissue cannot be helped with any medicine.
They is no such thing as a liver detoxification. Your livers job is to detoxify your body.
Liver cirrhosis means many of your liver cells have died and changed into scar tissue. Dead liver cells scar tissue cannot be helped with any medicine.
They is no such thing as a liver detoxification. Your livers job is to detoxify your body.
Minnesota has the best care for poor ppl. Massachusetts, Vermont, Maryland. As well. Hope your ok
3 Comments
Thank you for your response. I eventually got on Medicaid in Alabama and had a liver transplant on December 29th, 2016. I am well now and am pretty much back to normal. Other than having to take immunosuppressants twice daily, which is really not a big deal.
Thank you for taking time to send me this information.
Best Wishes,
John Johnson
Thank you for taking time to send me this information.
Best Wishes,
John Johnson
That is so wonderful. I knew this was an old post, but so glad to hear good news!!!!
John Johnson I am in Alabama and newly diagnosed with esophageal varices this past week. I follow up Friday (2-4/19). Did you go to UAB? Are you satisfied with your Hepatologist and GI? I was reading on a DR Magiure GIHepatologist. Who do you recommend? I was put on Disability with Medicare and QMB Medicaid .Thanks
For me shying away from traditional medicine is working great. I was diagnosed with cirrhosis in late 2015. In the ICU for 3 weeks. After not being happy with my GI and not seeing the type of improvement I thought I should be seeing I searched for alternative methods at maintaining or even reversing liver disease. This led me to a doctor outside of my state who is a big believer in alpha lipoic acid, milk thistle and selenium. I take all three daily. My GI never ran my vitamin stats but new doc did and with liver disease comes low vitamin B, D & A and is pretty normal from what I've read. So I take those also along with fish oil, a multi & still take my Xifaxan (although down to 1/2 dose daily). I also juice everyday with organic vegetables (including roots like ginger and tumeric) and / or make smoothies with plain full fat organic yogurt, berries, protein powder, XCT oil, flax seed, coconut water & almond milk. Sometimes I also add bananas and or oranges. Whatever is organic and fresh when I go shopping. All that along with only grass fed meat or chicken and wild caught fish - no farm raised. Expensive - yes. But better than a 750K liver transplant that I felt I was being herded into. Today no jaundice, no bad "bathroom signs", no swelling, itching, skin markings or bruising. GI doc was so concerned about my elevated INR because of bleeding issues...well I cut myself by accident pretty badly opening a can of tomatoes and I probably could have used a stitch or 2 but it was a Sunday so I just put a bandaid on it. Well I didn't bleed to death and the cut is healing quite nicely - and fast. I haven't been sick once since out of the hospital and haven't taken so much as an aspirin. Have had some wine occasionally tho. My cirrhosis was from a combination of partying, too much stress and weight that I carried in my middle due to PCOS and related hypothyroidism & metabolic syndrome. Plus I took all kinds of drugs over the years that were given to me by my then endo doc - including heavy duty Naproxen, which I drank while taking of course. All in all I can just say that this is working for me. I also occasionally use some CBD thru a vapor pen when I can't sleep. I try to reduce my stress levels, and the vitamins and eating good makes it so much easier and I try to be as active as I can and drink lots of lemon water and drink lots of ginger and / or tumeric teas. New doc said coffee is also protective to the liver.
Anyway I hope this helps and if you or anyone else is in a similar situation and you have a doctor that is "annoyed" by your questions and refuses to talk diet and supplements that may just help you a lot - then find someone else! I wish I had done it a lot earlier.
Eating a non-inflamation diet (NO SUGAR) has other advantage too - like being able to finally fit into a very small size pair of leather jeans! Do I cheat? Yes, but I have learned that even somewhat bad things - like ice cream - once in awhile in moderation won't kill me. Just an FYI - in the ICU my MELD score was like a 30. When I started with my new doctor and new supplements down to like anywhere between 10 and 15. Yes your numbers (or mine anyway) do change constantly. Excited about my next round of blood work and sure I will be seeing more improvement from the way I feel.
Best of luck to you.
Anyway I hope this helps and if you or anyone else is in a similar situation and you have a doctor that is "annoyed" by your questions and refuses to talk diet and supplements that may just help you a lot - then find someone else! I wish I had done it a lot earlier.
Eating a non-inflamation diet (NO SUGAR) has other advantage too - like being able to finally fit into a very small size pair of leather jeans! Do I cheat? Yes, but I have learned that even somewhat bad things - like ice cream - once in awhile in moderation won't kill me. Just an FYI - in the ICU my MELD score was like a 30. When I started with my new doctor and new supplements down to like anywhere between 10 and 15. Yes your numbers (or mine anyway) do change constantly. Excited about my next round of blood work and sure I will be seeing more improvement from the way I feel.
Best of luck to you.
I had ESLD before my successful transplant.
The number one thing I'd suggest is going on a no salt ( which means no sodium) diet. This helps with the ascites. I kept mine under control for 3 years this way. It wasn't easy and you must read all labels. Don't eat any processed food. Your best bet is to eat as fresh and freshly prepared as possible, Use herbs and spices as well as things like garlic and onions to help flavor your food.
Next, cut out all red meat. Red meat makes more ammonia.
Although it's true that no vitamin or supplement will reverse the damage done they can help with the side effects of ESLD. I took a whole slew of them and didn't have many of the issues others have. I can't say for certain they helped but I can say they didn't harm me.
So, here's some to look into~ milk thistle, curcumin ( turmeric), bromelian, alpha lipoic acid ( ALA) and more
.
There was a member here who posted about supplement regularly. You can check out his posts by searching under his username~
Hepatitis Researcher
good luck~OH
The number one thing I'd suggest is going on a no salt ( which means no sodium) diet. This helps with the ascites. I kept mine under control for 3 years this way. It wasn't easy and you must read all labels. Don't eat any processed food. Your best bet is to eat as fresh and freshly prepared as possible, Use herbs and spices as well as things like garlic and onions to help flavor your food.
Next, cut out all red meat. Red meat makes more ammonia.
Although it's true that no vitamin or supplement will reverse the damage done they can help with the side effects of ESLD. I took a whole slew of them and didn't have many of the issues others have. I can't say for certain they helped but I can say they didn't harm me.
So, here's some to look into~ milk thistle, curcumin ( turmeric), bromelian, alpha lipoic acid ( ALA) and more
.
There was a member here who posted about supplement regularly. You can check out his posts by searching under his username~
Hepatitis Researcher
good luck~OH
I take lactulose for Hepatic Encephalapathy but have read that inulin powder mixed in with a protein drink can help.
I am so sad to hear that Hector has passed away. He will be terribly missed by everyone he ever helped. He was on this site, other sites, went to hospitals to help people, and served on support groups.
My heart is breaking over our loss, my hero.
I am so sad to hear that Hector has passed away. He will be terribly missed by everyone he ever helped. He was on this site, other sites, went to hospitals to help people, and served on support groups.
My heart is breaking over our loss, my hero.
If I may add my thoughts to this discussion
You came here asking for help and your questions were answered based on knowledge and experience.
Once you have liver disease no vitamin or supplement is going to reverse the damage done. Does that answer your question?
There is no need to be sarcastic or belittling.
I would suggest that you ask your friend whom was given a year to live and is now thriving after 8 years.
K
You came here asking for help and your questions were answered based on knowledge and experience.
Once you have liver disease no vitamin or supplement is going to reverse the damage done. Does that answer your question?
There is no need to be sarcastic or belittling.
I would suggest that you ask your friend whom was given a year to live and is now thriving after 8 years.
K
My doc prescribes Vitamin B12 and Vitamin D and I take Spironolactone. I have been cured of Hep C for a about a year. Everyone goes through this Western medicine vs. herbs and supplements exploration in their initial research
Here's the deal for me - when appropriate, I lean towards Eastern medicine for things like stress and pain relief
When I was facing something that was life-threatening, like cirrhosis caused by Hep C or Breast Cancer, I went with the Western medicine
I also have learned so much from Hector - more than anyone else really, about how to cope with the hundreds of questions that I had to face and I will always be grateful for his guidance. If it were not for the support of Hector and others on this site, I would have been a basket case
Even if one has the best doctor on the planet, they are likely too busy to answer all your questions - especially the ones that you have at 3:00 AM
Do you think your irritability id one of the symptoms of your disease? Good luck to you
The Vit B12 seems to really help my energy level
Here's the deal for me - when appropriate, I lean towards Eastern medicine for things like stress and pain relief
When I was facing something that was life-threatening, like cirrhosis caused by Hep C or Breast Cancer, I went with the Western medicine
I also have learned so much from Hector - more than anyone else really, about how to cope with the hundreds of questions that I had to face and I will always be grateful for his guidance. If it were not for the support of Hector and others on this site, I would have been a basket case
Even if one has the best doctor on the planet, they are likely too busy to answer all your questions - especially the ones that you have at 3:00 AM
Do you think your irritability id one of the symptoms of your disease? Good luck to you
The Vit B12 seems to really help my energy level
Hector,
No disrespect intended, I do thank you, and my doctors have all pretty much said the same thing that you are saying. The thing is, I know people who through regimented diets, exercise, proper sleep and vitamins and supplements have beat all doctors predictions for their life expectancy. I have one friend, who I know personally, that was told by several liver doctors that he would be dead inside of a years time. That was 8 years ago and he is still alive, and doing quite well I might add. I've gone through this on nearly every cirrhosis help site I have posted anything about supplements on. Almost every medication known to man came from some natural source and it's foolish to think that none of it can have positive benefits, if it hasn't had a label slapped on it by big pharma. Do a little research on Mephyton and the pending lawsuits against the company charging $2500 dollars for month supply of what is nothing more than a man-made form of (Phytonadione), vitamin K. I'm not looking for a debate, it's just wasting my time and telling me things I have already heard 1000 times. It's a simple question and the question is not, "what is your opinion of holistic medicine". Thank you for your answer, point taken, but I don't want to spend all my time on this site debating something that I never asked.
Thanks,
Wesley
No disrespect intended, I do thank you, and my doctors have all pretty much said the same thing that you are saying. The thing is, I know people who through regimented diets, exercise, proper sleep and vitamins and supplements have beat all doctors predictions for their life expectancy. I have one friend, who I know personally, that was told by several liver doctors that he would be dead inside of a years time. That was 8 years ago and he is still alive, and doing quite well I might add. I've gone through this on nearly every cirrhosis help site I have posted anything about supplements on. Almost every medication known to man came from some natural source and it's foolish to think that none of it can have positive benefits, if it hasn't had a label slapped on it by big pharma. Do a little research on Mephyton and the pending lawsuits against the company charging $2500 dollars for month supply of what is nothing more than a man-made form of (Phytonadione), vitamin K. I'm not looking for a debate, it's just wasting my time and telling me things I have already heard 1000 times. It's a simple question and the question is not, "what is your opinion of holistic medicine". Thank you for your answer, point taken, but I don't want to spend all my time on this site debating something that I never asked.
Thanks,
Wesley
3 Comments
"So please get your data right before posting that people can of should attempt to treat own liver disease"
Where on earth in all of this BS did I give anyone any advice? I am the one asking for advice, not once in this entire post have I given any. I do not have ESLD as of yet and the Mega B Vitamins and also a Ensure after every meal are at the advice of an actual liver doctor, not a transplant center volunteer or a witch doctor.
I can not get on a transplant list without private Insurance or Medicaid, neither of which I have at present. Please go away, I think I've got "your opinion" on the subject loud and clear.
Doctor's can and do offer advice on vitamins and other things that help with any form of disease, not just liver issues. I'm thrilled for you that you are a volunteer at a liver transplant center, but here's a news flash for you, YOU ARE NOT A DOCTOR! A cat can have kitten's in the oven, but it don't make them biscuit's!
Where on earth in all of this BS did I give anyone any advice? I am the one asking for advice, not once in this entire post have I given any. I do not have ESLD as of yet and the Mega B Vitamins and also a Ensure after every meal are at the advice of an actual liver doctor, not a transplant center volunteer or a witch doctor.
I can not get on a transplant list without private Insurance or Medicaid, neither of which I have at present. Please go away, I think I've got "your opinion" on the subject loud and clear.
Doctor's can and do offer advice on vitamins and other things that help with any form of disease, not just liver issues. I'm thrilled for you that you are a volunteer at a liver transplant center, but here's a news flash for you, YOU ARE NOT A DOCTOR! A cat can have kitten's in the oven, but it don't make them biscuit's!
HectorSF, has been answerin g quest ions and trying to help people on this forum for years. all of the information I have ever seen him give was medical facts which are written In medical journal.
HectorSF took his time, even though he had major medical issues. He passed away yesterday.
HectorSF took his time, even though he had major medical issues. He passed away yesterday.
HectorSF, has been answerin g quest ions and trying to help people on this forum for years. all of the information I have ever seen him give was medical facts which are written In medical journal.
HectorSF took his time, even though he had major medical issues. He passed away yesterday.
HectorSF took his time, even though he had major medical issues. He passed away yesterday.
COMMUNITY LEADER
Most hepatologists tell their cirrhotic patients to beware of any vitamin or herb or supplement. Just like any med can't be changed without a doctor's approval all must be known to manage liver disease effectively..
Certain vitamins or herbs are known to be toxic to the liver. I have met hundreds of liver transplant patients none have seen improvements in there liver disease other than with proper care through a hepetologist,
I do volunteer work at a liver transplant center where we do 200 liver transplants a year so I am very familiar with all the realities of liver disease and its consequences. So please get your data right before posting that people can of should attempt to treat own liver disease. Liver disease if a live and death issue for many of us and we need proper medical sooner rather than later.
Be well.
Hector
Certain vitamins or herbs are known to be toxic to the liver. I have met hundreds of liver transplant patients none have seen improvements in there liver disease other than with proper care through a hepetologist,
I do volunteer work at a liver transplant center where we do 200 liver transplants a year so I am very familiar with all the realities of liver disease and its consequences. So please get your data right before posting that people can of should attempt to treat own liver disease. Liver disease if a live and death issue for many of us and we need proper medical sooner rather than later.
Be well.
Hector
I am seeing a liver specialist but my MELD numbers have stabilized and are well below the point that they would even consider doing a liver transplant at this stage.
My Herpetologist is well aware of the supplements I am taking and is in agreement that they are most likely helping me and none of them are dangerous to take.
I am just wondering if anyone else has had any substantial improvement using other supplements. Everything I am taking is approved by my Herpetologist as being safe for me to take, before I will take it. He will not however and cannot give any advice on the subject since none of it is medically approved as a treatment.
Thanks for your feedback, but I am looking for success stories, not a new liver doctor!
My Herpetologist is well aware of the supplements I am taking and is in agreement that they are most likely helping me and none of them are dangerous to take.
I am just wondering if anyone else has had any substantial improvement using other supplements. Everything I am taking is approved by my Herpetologist as being safe for me to take, before I will take it. He will not however and cannot give any advice on the subject since none of it is medically approved as a treatment.
Thanks for your feedback, but I am looking for success stories, not a new liver doctor!
2 Comments
I don't think you will find any success stories of treating the serious medical condition of ESLD (end stage liver disease) with supplements and vitamins. As Hector said tha would be like treated a major injury with a bandaid. You need to be followed by a doctor associated with a liver transplant center even if you are not currently eligible to be on the list. Those doctors are best able to follow and treat patients with advanced liver disease.
The good news is that with care you can continue to live a long life even with cirrhosis if you can do something about the cause like for those who drink stopping drinking and if you have hep c getting that cured with the new treatments.
I was diagnosed with cirrhosis in Jan 2008 and continue to live a full life. I thankfully was cured of hep c a year ago and I am looking forward to a long remaining life and dying from something other than my liver disease.
I have had edema in my lower legs but it is manageable and I had esophageal varicies that required banding back in 2012 but have had no reoccurance since. I don't do anything special just try to eat a healthy diet avoid sodium and obviously no alcohol.
My MELD score is 7 down from 8 and my liver enzymes are normal in fact my only out of normal test is my platelet count which is low at 110 but even that is improved from my results from the past ranging from 80 to 90 before I treated and was cured.
Good luck to you
The good news is that with care you can continue to live a long life even with cirrhosis if you can do something about the cause like for those who drink stopping drinking and if you have hep c getting that cured with the new treatments.
I was diagnosed with cirrhosis in Jan 2008 and continue to live a full life. I thankfully was cured of hep c a year ago and I am looking forward to a long remaining life and dying from something other than my liver disease.
I have had edema in my lower legs but it is manageable and I had esophageal varicies that required banding back in 2012 but have had no reoccurance since. I don't do anything special just try to eat a healthy diet avoid sodium and obviously no alcohol.
My MELD score is 7 down from 8 and my liver enzymes are normal in fact my only out of normal test is my platelet count which is low at 110 but even that is improved from my results from the past ranging from 80 to 90 before I treated and was cured.
Good luck to you
Thank you for your response. I eventually got on Medicaid in Alabama and had a liver transplant on December 29th, 2016. I am well now and am pretty much back to normal. Other than having to take immunosuppressants twice daily, which is really not a big deal.
Thank you for taking time to send me this information.
Best Wishes,
John Johnson
.
Thank you for taking time to send me this information.
Best Wishes,
John Johnson
.
COMMUNITY LEADER
Unfortunately when a person's liver disease has progressed to advance cirrhosis, sometimes known as decompensated cirrhosis, like yourself with uncontrolled ascites and fluid on the lungs you need to be cared for by a liver specialist, hepatogologist.. Meaning you should be preparing yourself for a liver transplant as your liver is starting to fail and won't be able to be repaired again..
Ascites is only one complication of a liver that is failing to function because your liver is too damaged to function normally. It is your liver disease that needs to be addressed not just the ascites which is only a complication of yoru advanced liver disease.
Serrapeptase, Curcumin (Turmeric) and Milk Thistle, along with Mega B Complex Vitamins will do nothing to help you. It is like putting a band-aid on your arm after an artery has been cut. If these remedies could could all us we all would have avoid transplant,Live/reality is not so easy. It is time to face reality which is scary but better than what is in store if you don't; get a transplant..
Anyone who tells you of a fake remedy for cirrhosis is either a fool or swindler. We have seen too many die because whey were misinformed don't be one of them..
At our transplant center we see too many people who wait until the last moment when the doctors are limited in what thy can do.
If your parent want to help you get their help finding a transplant center and hepatologist who will list you for liver . It could save your life.
-------------------------------------------------------------------------------------------------------
Updated Guidelines for Management of Ascites
Atif Zaman, MD, MPH reviewing Runyon BA. Hepatology 2013 Apr.
The American Association for the Study of Liver Diseases has released its latest recommendations, including drugs to avoid or use with caution.
The American Association for the Study of Liver Diseases (AASLD) has published its fourth iteration of management guidelines for ascites — the most common manifestation of decompensated cirrhosis. The following are some of the major updates to the guidelines:
Drugs that lower arterial pressure, including angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and even beta-blockers, should be avoided or, if used, should be accompanied by careful monitoring of blood pressure and renal function. This recommendation is based on emerging findings that arterial pressure is an independent predictor of survival in patients with cirrhosis.
(most of us take meds (I took two,spironolactone and furosemide) to prevent fluid build up but you'll need a doctors prescription.)
Vaptans, which inhibit the action of vasopressin on its receptors, should be avoided in patients with cirrhosis. In a recent, large, randomized, controlled trial in patients with cirrhosis, use of vaptans showed no clinical benefit in the long-term management of ascites and a possible increase in mortality (Gut 2012; 61:108).
The use of intravenous albumin infusion after large-volume paracentesis has been controversial. A recent meta-analysis demonstrated that its use was associated with a reduction in mortality in this setting (odds ratio, 0.64; 95% confidence interval, 0.41–0.98; Hepatology 2012; 55:1172). Albumin infusion should be given at a rate of 6 to 8 grams per liter of fluid removed when >5 liters of ascites are drained.
Terlipressin plus albumin was shown to reduce mortality compared with albumin alone (relative risk, 0.81; 95% CI, 0.68–0.97) in patients with type
1 hepatorenal syndrome (Hepatology 2010; 51:576). Terlipressin is not available in the U.S., but if results of a nearly complete phase III study are promising, it should receive FDA approval. Until then, octreotide plus midodrine should be considered.
The common use of quinolones to prevent spontaneous bacterial peritonitis in high-risk patients with cirrhosis has led to an increase in multidrug-resistant organisms. To reduce the risk for resistance, prophylactic antibiotics should be used only when indicated and for a limited duration when possible. The spectrum should be narrowed once susceptibility results are available.
---------------------------------------------------------------------------------------------------
Good luck to you.
Hector
Ascites is only one complication of a liver that is failing to function because your liver is too damaged to function normally. It is your liver disease that needs to be addressed not just the ascites which is only a complication of yoru advanced liver disease.
Serrapeptase, Curcumin (Turmeric) and Milk Thistle, along with Mega B Complex Vitamins will do nothing to help you. It is like putting a band-aid on your arm after an artery has been cut. If these remedies could could all us we all would have avoid transplant,Live/reality is not so easy. It is time to face reality which is scary but better than what is in store if you don't; get a transplant..
Anyone who tells you of a fake remedy for cirrhosis is either a fool or swindler. We have seen too many die because whey were misinformed don't be one of them..
At our transplant center we see too many people who wait until the last moment when the doctors are limited in what thy can do.
If your parent want to help you get their help finding a transplant center and hepatologist who will list you for liver . It could save your life.
-------------------------------------------------------------------------------------------------------
Updated Guidelines for Management of Ascites
Atif Zaman, MD, MPH reviewing Runyon BA. Hepatology 2013 Apr.
The American Association for the Study of Liver Diseases has released its latest recommendations, including drugs to avoid or use with caution.
The American Association for the Study of Liver Diseases (AASLD) has published its fourth iteration of management guidelines for ascites — the most common manifestation of decompensated cirrhosis. The following are some of the major updates to the guidelines:
Drugs that lower arterial pressure, including angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and even beta-blockers, should be avoided or, if used, should be accompanied by careful monitoring of blood pressure and renal function. This recommendation is based on emerging findings that arterial pressure is an independent predictor of survival in patients with cirrhosis.
(most of us take meds (I took two,spironolactone and furosemide) to prevent fluid build up but you'll need a doctors prescription.)
Vaptans, which inhibit the action of vasopressin on its receptors, should be avoided in patients with cirrhosis. In a recent, large, randomized, controlled trial in patients with cirrhosis, use of vaptans showed no clinical benefit in the long-term management of ascites and a possible increase in mortality (Gut 2012; 61:108).
The use of intravenous albumin infusion after large-volume paracentesis has been controversial. A recent meta-analysis demonstrated that its use was associated with a reduction in mortality in this setting (odds ratio, 0.64; 95% confidence interval, 0.41–0.98; Hepatology 2012; 55:1172). Albumin infusion should be given at a rate of 6 to 8 grams per liter of fluid removed when >5 liters of ascites are drained.
Terlipressin plus albumin was shown to reduce mortality compared with albumin alone (relative risk, 0.81; 95% CI, 0.68–0.97) in patients with type
1 hepatorenal syndrome (Hepatology 2010; 51:576). Terlipressin is not available in the U.S., but if results of a nearly complete phase III study are promising, it should receive FDA approval. Until then, octreotide plus midodrine should be considered.
The common use of quinolones to prevent spontaneous bacterial peritonitis in high-risk patients with cirrhosis has led to an increase in multidrug-resistant organisms. To reduce the risk for resistance, prophylactic antibiotics should be used only when indicated and for a limited duration when possible. The spectrum should be narrowed once susceptibility results are available.
---------------------------------------------------------------------------------------------------
Good luck to you.
Hector
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