Essay On Cirrhosis

Intestinal obstruction secondary to active inflammation is the most common complication. Patients with colonic involvement are at risk for developing colon cancer. Subsets of patients develop fistulas that are usually managed by medication or parental nutrition, but may require surgery. Nutritional and vitamin deficiencies are common, resulting from inadequate diet, intestinal loss of protein, or malabsorption. Systemic complications may include arthritis, skin lesions, anemia, liver and biliary disease, inflammation of the eyes or mouth, and bleeding disorders. Some of these problems resolve during treatment of the disease, but some may be treated separately. Consultations with dietitians, wound care specialists, or pain management clinicians and physiological support clinicians are not uncommon.

One of these symptoms is jaundice, which is characterized by yellowish skin and eyes because of an inability of the liver to remove bilirubin from the blood. Patient with cirrhosis also suffering from itching, due to deposited bile's products in the skin. This patient also suffers from accumulation of fluid in legs that is called edema. As a result of the blockage of blood flow via the liver, fluid accumulation in abdomen which is worsen by the decrease in protein production. Other symptoms include fatigue, weakness, loss of appetite, weight loss and nausea. As the disease progress, complications may develop ,such as varices that happens with cirrhosis patient when the blood flow through the liver slows, so the blood from intestine go back to the vessels of the stomach and esophagus, these vessels are not meant to carry this much of blood so they dilate (varices), with increasing

Decompensated cirrhosis is characterized by the development of a cirrhosis-related complication, including variceal hemorrhage, ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, and/or coagulopathies. For patients with compensated and decompensated cirrhosis, the risk of death is 4.7 and 9.7 times higher than the general population, respectively.4 Survival in patients with decompensated cirrhosis is considerably lower than that of patients with compensated cirrhosis. The median survival times are as low as 2 years in decompensated patients and greater than 12 years in compensated

In the presented case scenario, we have Mr. Gil Martin who is a 55-year-old Hispanic male. He comes in to the clinic today with complaints of weakness, fatigue, and loss of appetite. A student nurse will be precepting your assessment of Mr. Martin and when collecting subjective and objective data it is important to pay close detail to all findings. Ultimately this patient was diagnosis with cirrhosis, which is an abnormal liver condition that leads to irreversible scarring of the liver (National Institute of Health [NIH], 2017), so during assessment we should pay attention to details leading to this diagnosis.

Inflammatory bowel diseases or IBDs affect “as many as 1.4 million Americans”. Crohn’s disease and ulcerative colitis inflame certain areas of the intestines that result into chronic and long-term complications in peoples’ lives. Even though these diseases are not known to be lethal to humans, they are unbearable to its victim. Both ailments can cause patients to “experience abdominal symptoms, including diarrhea, abdominal pain, bloody stools, and vomits” 8. Both diseases result in painful

Based on 2014 hepatic encephalopathy guideline, NA’s hepatic encephalopathy is classified as type C and recurrent due to the cirrhosis and 2 episodes of HE occur with a time interval of 6 months or less. Typical signs and symptoms consistent with his HE includes confusion, forgetfulness, and anxiety. According to the guideline, the goals for the treatment are maintaining two to three bowel movements per day, decreasing elevated ammonia level, prevention of recurrent episodes of HE, and improvement of daily functioning. Lactulose is the first choice for treatment of overt HE. Currently, patient is on lactulose only once a day because of his noncompliance. The dose frequency is incorrect since he does not have at two to three bowel movements per day. Increasing frequency back to three times a day is recommended for the patient. Moreover, rifaximin is an effective add-on therapy to lactulose for prevention of OHE recurrence. Also, counseling the effects of lactulose and rifaximin, importance of adherence, early signs of recurring HE, and actions to be taken if recurrence are also beneficial for the patient.

This case study is about Abdul Chidiac, a 51 year old male, married with 4 children. He had a medical history of hypertension, hypercholesterolaemia and cirrhosis with two admissions in the last six months. He is a smoker and drinks beer, 5-6 bottles per day. As Carithers & McClain (2010) explained the patient’s medical history is another indicator of the risk for cirrhosis; the progression to cirrhosis is adaptable and may take time over weeks or many years. Cirrhosis is a liver disease characterized by permanent scarring of the

The incidence of acute upper gastrointestinal haemorrhage in the United Kingdom ranges between 84-172 /100,000/year, equating to 50-70,000 hospital admissions per year(1). The most common presentation include hematemesis, melena, and/or hematochezia(5). Negative outcomes include rebleeding and death with many deaths due to decompensation of coexisting medical conditions. Increasing age, comorbidity and endoscopic findings predict prognosis (6,7). Peptic ulcer disease is the most common cause of UGIB, accounting for more than 50% of cases of non-variceal UGIB(8). Older age, male gender and NSAID use independently predict gastric ulcer bleeding. Higher mortality rate if acute upper GI bleed started after admission especially in older persons (9,10). Various risk-stratification tools have been for UGIB in order to determine prognostication. The Blatchford and the Rockall scoring systems are commonly used whereby higher score predict greater risk for rebleeding or death (11). The aims of this article are to assess patient demographics and comorbidities, determine timely, efficient use of hospital re in terms of endoscopic intervention and proton pump inhibitor

Helicobacter pylori weaken the gastric layer, predispose the stomach to infection which can lead to achlorhydria. “The classic symptoms of GERD are heartburn, acid regurgitation, dysphagia, and belching”( over time cause narrowing and strictures. A person can experience reflux one hour after eating high fatty undigested meals, smoking (nicotine) and alcohol drinking, sore throat and asthma. Pressure on the diaphragm from pregnancy and obesity in male and female increases intra-abdominal pressure exposing the individual to reflux and heartburn. GERD can occur in infants, elderly, and at any age in between. Patient can take antacid (Tums) to neutralize the acidity, H2 blocker (cimetidine, famotidine, or ranitidine) decrease acid production in the stomach and Proton pump inhibitors (PPI) inhibit acid production from gastric parietal cells. Others treatment, Endoscopy of esophagus or stomach, to obtain a biopsies for (precancerous cells), pH monitoring rule out H. pylori infection, looking for edema, erosion, and bleeding. If blood loss is low, replace with

Triple therapy with metronidazole and either bismuth subsalicylate or bismuth subcitrate plus either amoxicillin or tetracycline for 14 days eradicates H pylori infection in 70–95% of patients. An acid-suppressing agent given for 4–6 weeks enhances ulcer healing. Proton pump inhibitors (such as omeprazole) directly inhibit H pylori and appear to be potent urease inhibitors. Either 1 week of a proton pump inhibitor plus amoxicillin and clarithromycin or of amoxicillin plus metronidazole also is highly effective [51].

Stress-related mucosal disease (SRMD), an acute erosive gastritis that may potentially lead to stress ulcers and/or stress-related injuries, remain a significant concern for patients within the critical care setting.1 The initiation of anti-secretory therapy (AST) for stress ulcer prophylaxis (SUP) within the critical care setting has gained widespread use as it has been noted to protect against SRMD and clinically important gastrointestinal (GI) bleeding.2 Although the use of these agents is well established in the critical care setting, several research studies have confirmed the extensive and inappropriate use of AST in both intensive care unit (ICU) and non-ICU patients, based on current recommendations.3

According to Middleton, Teefey and Darcy,8 TIPS placement is successful in about 90% of patients, but does hold a complication rate of 10-16%. Research has shown that placement of TIPS as a secondary treatment for variceal bleeding has produced encouraging results. In 13 random clinical trials, including over 900 patients, recurrent variceal bleeding rates were 9-40%, which is superior to endoscopic treatments that have recurrent bleeding rates from 20-60%. This success rate has made TIPS procedures more utilized in the setting of variceal bleeding. Additionally, the same clinical trials indicate that ascites reduction after shunting ranges from 38-84%, which is favorable to large volume paracentesis that reported rates of 0-43%. “Compared with large-volume paracentesis, TIPS improved transplant-free survival and the incidence of recurrent ascites in cirrhotic patients with refractory ascites.”26 There is evidence of an increase in the development of HE in patients who undergo TIPS, whereas endoscopic treatment does not show an increase. Furthermore, HE is twice as likely to occur when paracentesis is performed. An important consideration is that the complication rate for hepatic encephalopathy does increase with TIPS usage whereas it doesn’t with endoscopic treatment and it is twice as likely to occur as when paracentesis is performed.28 Presently, TIPS is often used as a temporary solution for patients who are

Despite the widespread use of HD as the main RRT, PD as a RRT for cirrhotic patients with ESRD may have several advantages over HD. The maintenance of relatively stable hemodynamics is one of the biggest

This report will discuss how liver cancer affects the liver. I will discuss the how liver cancer affects the normal operation of the liver, what causes liver cancer, how this cancer can be detected and how this cancer can be treated. I will conclude with a discussion of how common liver cancer is.

The Liver is the body's largest gland, weighing about three to four pounds. It is located beneath the diaphragm in the right upper quadrant (RUQ) of the abdominal cavity. Without the liver, our bodies would be poisoned and unfit for us to do anything at all. It is a metabolically active organ responsible for many vital life functions. The primary functions of the liver are: Bile productions and excretion. Excretion of bilirubin, cholesterol, hormones, and drugs. Metabolism of fats, proteins, and carbohydrates. Enzyme activation. Storage of glycogen, vitamins, and minerals. Synthesis of plasma proteins, such as albumin, and clotting factors. And blood detoxification and purification.