What is the prognosis of 75 year old man who's been drinking alcohol heavily for 20 years and now has symptoms of enlarged liver bruising loss of appetite and a lot of weight extreme lethargy?

Answer 1

Liver Swelling due to Alcohol Treatment

In order to avoid further damage to the liver, treatment for alcoholic hepatitis requires complete abstinence from alcohol. Mild alcoholic hepatitis may not require additional treatment. A person with moderate to severe alcoholic hepatitis must avoid medications that place additional stress on the liver and follow a liver disease diet. Severe alcoholic hepatitis requires admission to a hospital for treatment. Unless complications develop, the symptoms of acute alcoholic hepatitis usually resolve within a week.

Treatment for alcoholic hepatitis includes:

• Stop drinking alcohol.
• Avoid acetaminophen
• Avoid aspirin
• Medication to prevent complications:
• • Pentoxifylline (Trental)
• Medications for nausea and vomiting:
• • Metoclopramide (Reglan)
  • Ondansetron (Zofran)
  • Prochlorperazine (Compazine, Compro)
• Vitamin supplements:
• • Folate
  • Thiamine
  • Vitamin K
• Eat a liver disease diet:
• • Low protein diet
  • Low fat diet

The essentials of the liver disease diet:

• High carbohydrate diet:
• • Carbohydrates, rather than protein, are the major source of calories in this diet.
• Moderate fat intake:
• • The increased carbohydrate and fat intake help preserve protein in the body and prevent muscle breakdown.
• Low protein diet:
• • Protein is restricted to 1 gram of protein per kilogram of body weight per day.
  • Severe liver disease may require carefully measured amounts of protein supplements.
• Vitamin B supplements
• Low salt diet

Liver Swelling due to Alcohol Diet

A person with alcoholic hepatitis may benefit from the following diet.

The liver is essential for the digestion of all foods. In the presence of liver disease, the ability to effectively metabolize proteins, carbohydrates, fats, and vitamins can be compromised. A liver disease diet is one in which foods are selected in quantities which provide adequate nutrition, but protect the liver from overworking.

Carbohydrates should be the major source of energy (calories) for individuals with liver disease. Proteins assist in tissue repair and prevent fatty infiltration of liver cells. Those with severely compromised liver function must limit their intake of protein. In this case protein is not properly broken down and waste products can build up in the bloodstream.

Those with liver disease will often suffer from sodium imbalances. Manifestations of sodium imbalance include ascites (abdominal fluid build-up) and edema (swelling) of the extremities. In this case dietary sodium restriction is essential.

The essentials of the liver disease diet:

• High carbohydrate diet:
• • This is the major source of calories in this diet.
• Moderate fat intake:
• • The increased carbohydrate and fat help in preserving the protein in the body and prevent muscle wasting.
• Low protein diet:
• • Restrict protein to 1 gram of protein per kilogram of body weight per day.
  • Severe liver disease may require measured amounts of protein supplements.
• Vitamin B supplements
• Low salt diet

Liver Swelling due to Alcohol Questions For DoctorThe following are some important questions to ask before and after the treatment of alcoholic hepatitis.

Questions to ask before treatment:

• What are my treatment options?
• What are the risks associated with treatment?
• Do I need to stay in the hospital?
• • How long will I be in the hospital?
• What are the complications I should watch for?
• How long will I be on medication?
• What are the potential side effects of my medication?
• Does my medication interact with nonprescription medicines or supplements?
• Should I take my medication with food?

Questions to ask after treatment:

• Do I need to change my diet?
• Are there any medications or supplements I should avoid?
• When can I resume my normal activities?
• When can I return to work?
• What else can I do to reduce my risk for liver disease?
• How often will I need to see my doctor for checkups?
• What local support and other resources are available?

  What is alcoholic hepatitis?

  A person with alcoholic hepatitis has inflammation of the liver caused by the direct toxic effects of alcohol on the liver. Over time, damage to the liver can scar the liver, a condition called cirrhosis.

  What are the symptoms of alcoholic hepatitis?

  Common symptoms of alcoholic hepatitis include abdominal pain, loss of appetite, fatigue, abdominal swelling, jaundice, and dark urine.

  What is cirrhosis?

  A person with cirrhosis has severe liver disease that causes permanent damage to the liver, which can result in liver failure. Cirrhosis causes an irreversible scarring within the liver that compromises its ability to function. The most common causes of cirrhosis are Alcoholism and hepatitis C. Serious complications of cirrhosis include gastrointestinal bleeding and liver failure.

  What are the symptoms of cirrhosis?

  Symptoms of cirrhosis include weakness, fatigue, swelling, abdominal pain, jaundice and abdominal swelling.

  How does the doctor treat cirrhosis?

  Treatment for cirrhosis includes the strict avoidance of alcohol, liver disease diet, vitamin supplements, and caution when using medications that are metabolized by the liver. Other options include surgery to control severe bleeding in someone with cirrhosis.

  There are different ways that alcohol can affect the

  body.

  If you understand that the liver takes toxins out of the

  body and converts them to a non toxic form that the body

  can easily dispose of...then you will understand this:

  1) over consuming alcohol in a short time period doesn't

  give the liver enough time to convert it to acetaldehyde,

  then to acetate, then to carbon dioxide and water.

  It is a multi step process to do this. If the alcohol is

  not completely converted it can become toxic to the liver

  cells.

  2) consuming alcohol in a long time period lead to the

  build up of fat inside the liver. The liver is surrounded

  by a tight membrane capsule. This fat causes pressure

  inside the liver that can damage the liver cells.

  3) some people are more sensitive to alcohol than other

  are. Just like any other drug, some have no problem and

  others can react to it. Some are even allergic to it.

  4) mixing alcohol with medications can cause an

  interaction between them that will instantly damage the

  liver cells.

  Now for alcoholic fatty liver disease.

  Fat starts to build up inside the liver, but doesn't

  cause a problem...this is known as simple fatty liver.

  However, as the fat continues to develop in the liver,

  it will damage the liver cells. The immune system of

  the body will respond to this damage and cause

  inflammation to develop inside the liver. This

  inflammation will cause the liver to enlarge in size.

  This is no longer simple fatty liver...it is

  Alcoholic steatohepatitis. Steato means fat,

  hepat means liver and itis means inflammation.

  If a person stops the alcohol and the inflammation

  is treated, then the liver cells can heal and the

  problem can be reversed...up to this point.

  However, if this isn't the case and the liver cells

  start to die off and form scar tissue inside the liver,

  then it becomes a progressive disease known as

  Cirrhosis of the liver. It cannot be reversed and

  there is no cure....except a liver transplant.

  It depends on how far advanced a person is in this

  disease. That can only be determined by the doctor

  through a liver biopsy and other testing.

  Can alcoholic fatty liver cause sudden death?

  Yes it can and I will explain why.

  When the liver has Cirrhosis...this means that

  scar tissue has formed inside the liver. The liver

  tries to generate new liver cells, but the new cells

  bunch up against the scar tissue. This scar tissue

  blocks the flow of blood through the liver on its

  way back to the heart and also blocks the flow

  of blood to the functioning liver cells, so they die

  off, also. The blood that once flowed through the

  liver can back up into the portal vein and cause

  pressure there (portal hypertension), it also backs

  up into smaller vessels not used to handling this

  blood and the pressure from it and they can have

  weak spots and balloon outward and break open.

  This vessels are known as varies. It is an

  extreme emergency then. The patient can bleed

  internally or bleed out completely. Keep in mind

  that the liver can no longer make clotting factors

  efficiently to help the blood to clot and the

  enlarged spleen will trap the platelets inside of

  it. People with Cirrhosis bleed and bruise very

  easily. Anyone with Cirrhosis can die suddenly.

  Also, people with Cirrhosis can have a build up of

  toxins reaching the brain...especially ammonia.

  Without medication to help remove this toxin from

  the body...they can go into a coma and die.

  (Any blood in the sputum, vomit, rectal area, or

  belly button area...bleeding from the nose, etc

  should be checked immediately)