Aa
Hep- C
51 year old male, found out within this year I have hepatitis C. 2,000,000 + viral load. Legs have excessive fluid retention both legs. Pain periodic in liver. I need a biopsy & Dna profile. Im in Manchester Nj. 08759.I cannot receive interferon without a DNA profile of the virus. I have made $100.00 over the max/min to receive medicade. I feel like im alone without help if it wasn't for my faith in Jesus. Any suggestions would be a big help. Thank you, Ang.
Probably misunderstanding each other. I'm just saying that the hep c itself can cause fluid retention in some people, even without having advanced to cirrhosis. Myself for instance, that's all. With me it was an all over fluid retention, and true, it wasn't accumulated in a certain area; which might be a cause for concern as you stated. I'm certainly no expert. It would be great if spaceley could get to a good hepatologist as soon as possible. Have a good weekend guys! I always try ;-)
I didn't say that fluid retention can ONLY be caused by advanced cirrhosis. But in someone with hepatitis C and complains of pain in the area of the liver it certainly is certainly possible. While I know that congestive heart failure, certain cancers and kidney disease can also cause edema these conditions I haven't had except for two types of cancer but none that produced edema.
Here is a little primer on fluid retention in people with cirrhosis of the liver. Ascites fluid retention in the abdomen is the most common first sign of decompensation which can lead to End-Stage Liver Disease and the need for liver transplantation.
People who have ascites and peripheral edema caused by our cirrhosis are given diuretics which helps to manage the fluid retention. When my ankles would start to disappear I knew I would soon see my ascites start getting worse and large also. If the diuretics don't work well enough which can happen as the liver fails to work during ESLD a person typically needs to have the fluid drained periodically (paracentesis) because the fluid can get infected which is life-threatening and it makes it very difficult to breath as the fluid takes up the space where our lungs expand. Each liter of fluid weights 2.2 lbs. Very uncomfortable! You can literally hear yourself slouching as you walk. I'm feeling sea-sick just thinking about it. Yuck! Thank goodness that was gone overnight after my transplant.
---------------------------------------------------------------------------------------
Why do patients with liver disease develop ascites and edema?
When liver scarring becomes advanced, the condition is called cirrhosis of the liver. "Ascites" is fluid that accumulates in the abdominal (peritoneal) cavity. It is a complication of cirrhosis and appears as an abdominal bulge. The peritoneum is the inner lining of the abdominal cavity, which also folds over to cover the organs inside the abdomen such as the liver, gallbladder, spleen, pancreas, and intestines.
Ascites develops because of a combination of two factors: (1) increased pressure in the vein system that carries blood from the stomach, intestines, and spleen to the liver (portal hypertension); and (2) a low level of albumin in the blood (hypoalbuminemia). Albumin, which is the predominant protein in the blood and which helps maintain blood volume, is reduced in cirrhosis primarily because the damaged liver is not able to produce enough albumin.
The fluid of ascites can be removed from the abdominal cavity by using a syringe and a long needle. This procedure is called paracentesis. Analysis of the fluid can help differentiate ascites that is caused by cirrhosis from other causes of ascites, such as cancer, tuberculosis, congestive heart failure, and nephrosis. Sometimes, when ascites does not respond to treatment with diuretics, paracentesis can be used to remove large amounts of the ascitic fluid.
Peripheral edema, which is usually seen as pitting edema of the legs and feet, also occurs in cirrhosis. Pitting edema is seen when you press on the swollen ankle, foot or lower leg and after you let the pressure of your finger off the skin stays indented for some time instead of rising back quickly like when we normally press our skin in.
Here is what pitting peripheral edema and ascites looks like. Warning it isn't something to look at at dinner time.
Pitting peripheral edema
http://2.bp.blogspot.com/_EJCviHJaPjI/TSkG_DlyzOI/AAAAAAAADjM/Iwgak86K8DY/s400/Pitting_edema_PI_edt.jpg
"Tense" ascites
http://www.gastrohep.com/images_pdfs/images/medium/mallison17.jpg
Be well.
Hector
Here is a little primer on fluid retention in people with cirrhosis of the liver. Ascites fluid retention in the abdomen is the most common first sign of decompensation which can lead to End-Stage Liver Disease and the need for liver transplantation.
People who have ascites and peripheral edema caused by our cirrhosis are given diuretics which helps to manage the fluid retention. When my ankles would start to disappear I knew I would soon see my ascites start getting worse and large also. If the diuretics don't work well enough which can happen as the liver fails to work during ESLD a person typically needs to have the fluid drained periodically (paracentesis) because the fluid can get infected which is life-threatening and it makes it very difficult to breath as the fluid takes up the space where our lungs expand. Each liter of fluid weights 2.2 lbs. Very uncomfortable! You can literally hear yourself slouching as you walk. I'm feeling sea-sick just thinking about it. Yuck! Thank goodness that was gone overnight after my transplant.
---------------------------------------------------------------------------------------
Why do patients with liver disease develop ascites and edema?
When liver scarring becomes advanced, the condition is called cirrhosis of the liver. "Ascites" is fluid that accumulates in the abdominal (peritoneal) cavity. It is a complication of cirrhosis and appears as an abdominal bulge. The peritoneum is the inner lining of the abdominal cavity, which also folds over to cover the organs inside the abdomen such as the liver, gallbladder, spleen, pancreas, and intestines.
Ascites develops because of a combination of two factors: (1) increased pressure in the vein system that carries blood from the stomach, intestines, and spleen to the liver (portal hypertension); and (2) a low level of albumin in the blood (hypoalbuminemia). Albumin, which is the predominant protein in the blood and which helps maintain blood volume, is reduced in cirrhosis primarily because the damaged liver is not able to produce enough albumin.
The fluid of ascites can be removed from the abdominal cavity by using a syringe and a long needle. This procedure is called paracentesis. Analysis of the fluid can help differentiate ascites that is caused by cirrhosis from other causes of ascites, such as cancer, tuberculosis, congestive heart failure, and nephrosis. Sometimes, when ascites does not respond to treatment with diuretics, paracentesis can be used to remove large amounts of the ascitic fluid.
Peripheral edema, which is usually seen as pitting edema of the legs and feet, also occurs in cirrhosis. Pitting edema is seen when you press on the swollen ankle, foot or lower leg and after you let the pressure of your finger off the skin stays indented for some time instead of rising back quickly like when we normally press our skin in.
Here is what pitting peripheral edema and ascites looks like. Warning it isn't something to look at at dinner time.
Pitting peripheral edema
http://2.bp.blogspot.com/_EJCviHJaPjI/TSkG_DlyzOI/AAAAAAAADjM/Iwgak86K8DY/s400/Pitting_edema_PI_edt.jpg
"Tense" ascites
http://www.gastrohep.com/images_pdfs/images/medium/mallison17.jpg
Be well.
Hector
I'm sure you're right about cirrhosis, and, of course, you know much more than I do. (And you probably always will ;-) Particularly if it's in that particular place as you say. But I only have F-1 liver damage in a biopsy I did a year and half ago now, and I suffered from fluid retention just from the hep c, and I know a lot of other women who have also. I don't know that much about men, but I have heard some men complain about it (from the hep c itself) on these boards without having advanced to cirrhosis. I know that it can be from other issues as well, prednisone and other drugs, etc. But since I did have finished this treatment, I've lost about 5 pounds in a few weeks (and I got my cheekbones back!) and I don't look so bloated. I'd have to go look it up, but I have read that fluid retention can be a symptom of hep c alone. Just my views. And I really want to thank you for all your knowledge, you have helped me as well on these boards. Respectfully.
Fluid retention is not a symptom of hepatitis C. Fluid retention in the lower legs and feet, commonly called peripheral edema, can be a complication of cirrhosis of the liver, advanced liver disease which can be the result of being chronically infected with hepatitis C over many decades. Cirrhosis of the liver is advanced liver disease is a serious medical condition that needs proper medical care for the best outcome.
You should see a doctor who can help diagnose fully your hepatitis C and the extent of your liver disease. Many primary doctors and doctors at clinics are ignorant of properly diagnosing people with liver disease. A gastroenterologist (digestive disease specialist) would be the type of specialist you need to see for a proper diagnoses and assessment of your hepatitis and any resulting liver disease.
Of course fluid retention can be cause by other underlying conditions as well, but either way you need a proper diagnoses before deciding if and what treatment would be best for treating your hepatitis C.
Hopefully someone else here will know of resources in your area.
Good luck.
Hector
You should see a doctor who can help diagnose fully your hepatitis C and the extent of your liver disease. Many primary doctors and doctors at clinics are ignorant of properly diagnosing people with liver disease. A gastroenterologist (digestive disease specialist) would be the type of specialist you need to see for a proper diagnoses and assessment of your hepatitis and any resulting liver disease.
Of course fluid retention can be cause by other underlying conditions as well, but either way you need a proper diagnoses before deciding if and what treatment would be best for treating your hepatitis C.
Hopefully someone else here will know of resources in your area.
Good luck.
Hector
Don't despair. Even though your viral load seems high to you, it really isn't. There are many things you can do. When I first was diagnosed, I didn't have insurance and I went to the best teaching hospital liver clinic and a doc took me on pro bono. (without payment) I just wrote them a nice letter. There also must be a county hospital to go to as well, that could assign you a liver doc (hepatologist or gastro) you need to get checked out and take a full compliment of labs, etc. Find out your genotype. Once you've done these things and your doctor advises, many of the drug companies themselves have programs for people who cannot afford their drugs and your doc just needs to write them a prescription after you have contacted the drug companies, if you take a Sovaldi type treatment you would be contacting Gilead. I did and they approved me when my insurance at first refused my case. Then I appealed and they did approve me, at which time the drug company said okay, we'll go ahead and let your insurance pay for it. (Guess they need the money ;-) Anyway, study as much as you can at boards like this. Read about the various types of treatments they have now, and the ones that will be approved relatively soon. Find out all you can. You have a computer and you are online, that's a big start right there. You will be able to take care of this, we're in a much better age for treatments than just a few years ago. Many people are getting cured of this. There will probably be other people to come along and put in their opinions. Really, don't despair, be glad you weren't diagnosed 10 years ago! Best of luck to you!
Have an Answer?
You are reading content posted in the Hepatitis C Community
Learn about this treatable virus.
Getting tested for this viral infection.
3 key steps to getting on treatment.
4 steps to getting on therapy.
What you need to know about Hep C drugs.
How the drugs might affect you.
These tips may up your chances of a cure.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
