Lactulose, get on it right away. use enugh fr 3 good BM's a day and it will help bring ammonia down....are yooou eating low protien diet?
Hi Patty,
Sorry to hear all the poor news you’ve received recently. Who is monitoring your medical care right now? It’s important for you to be seeing either a competent gastroenterologist or a hepatologist at this point; if not, ask your primary care physician for a referral.
Lactalose is a medication that can help control serum ammonia levels; it sounds like you might already be taking it. If you do not respond, there are other meds that can by used in conjunction with Lactalose to help.
There is a cancer marker known as Alpha-Feta Protein (AFP) that can be used to help diagnose liver cancer… however, just having advanced liver disease *can* raise AFP significantly in the absence of cancer.
More on this from Labtestsonline:
http://www.labtestsonline.org/understanding/analytes/afp_tumor/test.html
Please use caution when altering dietary protein to control ammonia levels/hepatic encephalopathy. Nothing will replace the advice of a qualified medical doctor; it sounds like it’s time to consult with one, if you haven't already.
Take good care-
Bill
My diet is very hard for me to do as of the hours I work and my husband just doesn't seem to understanding as I try to tell him what is going on with me and my health. But as a month ageo I have tried watching what I eat and I thought I would get on the enternet and get some good healthy ideas from that. I have to do what is good for me .
Thank-you for your message
patti52
I agree with Bill1954, you need to see a qualified medical doctor. How can someone who knows nothing about your history just tell you to take anything right away.
Were NOT Doctors here, Besides would you just call ANY Doctor on the phone and without them knowing anything about you just do as they say.
Hopefully the doctor you are going to is a gastroentrologist or a hepatologist. They are the best equipped to deal with people who have HepC/cirrhosis/end stage liver disease.
AFP is a blood test often used to detect tumor that may indicate cancer. Not only is this test used to detect liver cancer but it can also detect cancer of the ovaries, testes, stomach, colon, lung, breast as well as lymphoma.
It's not abnormal for a person with HepC/cirrhosis to have levels that fluctuate. I believe this why doctors keep an eye on your results to try to keep an eye out for any increase that continues to climb.
Pregnant women are also given the AFP blood test to see if there is any indication of abnormalities with the fetus. When women become pregnant their AFP rises until about the 12th week of pregnancy, then falls of until delivery. Sometime during the 15th-20th week of pregnancy a AFP test is performed to see if the normal falling off is occurring or if the levels are continuing to rise. If they are still rising this may be an indication of such problems with the fetus as Down Syndrome and a few other disorders.
Back to HepC and AFP testing. Your doctor should/will periodically check your AFP levels from here on out to monitor you in attempts to catch any increase early in an attempt to catch any cellular activity that could be an early indicator of liver cancer.
As for increase in ammonia levels in the blood let me share a few things with you. My husband is the one in our family with HepC/cirrhosis. He recently (Feb of '08) had his first issue with Hepatic Encephalopathy. The condition that happens when ammonia levels get too high. His doctor prescribed Lactulose. The liquid medication that does indeed increase the need for the bathroom. He is taking 3T. three times a day. In the beginning he would find himself rushing off the bathroom pretty frequently. Once the meds became established in his system (a month or so seems to be my recollection of how long it took) he now has 3-4 soft BM's a day and no longer feels chained to the bathroom. In the early days his doctor did decrease the amount to 2T three times a day but there was an increase in his ammonia level so back to 3T's three times a day.
There is a pill, Xifaxan, that can be used to keep ammonia levels in check, however, it is terribly expensive. Even in it generic form, Rifaximin. Typical dosage is 200 mg. three times a day. At an average cost of $4.50 per pill it adds up. I figured a monthly prescription probably costs 450.00 a month. I've already checked with our insurance co. to see what they would cover. Our insurance (Medical Mutual) said they would cover everything except $40.00 a month. Sounds like a fairly good deal to me. Since hubby has adjusted to the Lactulose for now, the Xifaxan was pushed back until such time as he may need it.
I only mention the Xifaxan as a possible option for you if you cannot tolerate the Lactulose. You can always discuss this with your doctor if the Lactulose doesn't become more tolerable.
You can also mix the Lactulose with a small amount of fruit juice to help with the awful taste. My husband prefers to mix it with a bit of Cranberry juice. Makes it go down easier with not as bad an after taste.
Good luck and keep us posted on how you're doing.