HealingWell
Search Close Search
☰

High amonia levels, lactulose and prognosis

Support Forums
>
Hepatitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 3/10/2012 7:18 AM (GMT 0)
Hi everyone,

I am so glad to find this forum.  My husband has alchoholic chirrosis and portal hypertension that led to near fatal esphogeal bleeding back in 2000.  He was able to abstain from alcohol for about 8 years and his liver functions normalized aside from the scarring he was doing fine.  Unfortuanately he has relpased numerous times since 2008 and had serious repruccsions as a result.  A DUI back in 2009 and most recently he drank an extreme amount of vodka at once and was nearly comotose.  Needless to say that caused hospitalizatin and serious damage ot his liver and possibly his brain.  His doctors are now treating him with lactulose to lower and maintain his amonia levels which were 117 the night he was hospitallized.  They gave him lactulose in the hospital but nothing once he went home.  He relapsed two or three times after that although I don't think he drank to an extreme.  Of course this only compounded the damge to his liver.   All of a sudden the confusion set in and severe tremmors.  When his doctor finally gave him a prescription of lactulose his amonia level was 60. 

.

The lactulose has caused  diaharea which has caused him so much discomfort. I am looking for any helpful hints to bring him some relief.  Also is there any hope that his liver will ever be able to metabolize correctly again?  other than the high amonia levels his liver functions are stable and he has abstained from alchohol for 60 days. Over the years his GI doctor does a lot of preventative testing, i.e. ultra sounds, tumor marker tests, endoscopy's and banding of vericies as needed.  I guess my main question is if the lactulose is the only way to lower his amonia levels and if he will have to take it for life? This disease has destroyed our lives.  I am so fearful that life will never be what it was for him now that the amonia levels are high.  How often should there be blood work done to check amonia and sodium levels etc? 

Thank you for any advice,

Majah

 

Posted 3/10/2012 11:20 AM (GMT 0)
Majah , Good to hear he is back on track again . Xifaxin is a good antibiotic that works well with Lactulose . Tucks medicated towelettes relieve some of the discomfort and rawness and possibly a prescription for suppository Hemorrhoid medication . The trots are something he will have to live with until he either gets a transplant or if he's lucky AGAIN he may be able to slowly recover and reduce his need for Lactulose . I am not taking lactulose at this time but did take it for almost 3 years , The Xifaxan seems to be keeping me together pretty well but I still keep a bottle of Lacto around if signs start to reappear .
Addictions is powerful stuff to beat , I been sober goin on 4 years in May . Haven't had a relapse or thought much about drinking again . However I'm not cocky enough to say it can't happen . My situation put me close to death a few times and that still leaves a lasting impression on me . Lifestyle and general healthy eating along with a TIPS surgery has kept me from worsening so far . I still go back to my Hepatologist yearly for monitoring and see my internal medicine doc once a month .
I'm sure you realize his doctors are gonna likely give up on him if he keeps this behavior up with drinking , They don't take kindly to people who piss there lives away and transplantation can be completely removed from his options should they deem it a waste of time and a precious organ . Sorry you had to find us under these conditions but you and your husband are both welcome here .


A. Ziffle
Posted 3/10/2012 6:43 PM (GMT 0)
Hello, Majaj, and welcome to the forum. Ziffle gave you more info than I could, as he's lived it. I really can't say anything more, except that he needs to realize that the next drink could be his last. Should he need transplant, he will need 6 months of documented, continuous sobriety. Once a person has cirrhosis, it never goes away. But he can slow and possibly stop the progress of it if he abstains from alcohol and eats a healthful diet, omitting red meat and increasing fruits and veggies.

BTW, my ammonia level has never been tested, as far as I know. The hepatologists and the transplant team at Mayo go more by how a patient presents themselves (confused, belligerent, talking in a way that doesn't make sense, etc.)

Hugs,
Connie
Posted 3/12/2012 4:52 AM (GMT 0)
Thank you Ziffle. I truely believe my husband is finally scared straight. He realizes he has pushed the envelope way too far and caused what may be irreperable damage. He is taking in two AA meetings per week and one with a PHD. In additon we have a breathalyzer test twice a day. This is a plan he initiated and is working well. I am looking forward to his next labs results and visit with his GI doctor to learn exactly what his Amonia levels are after 30 days of lactose and what the reuslts /outlook is for other liver studies.

Connie thank you for the support. He is about 60 days with out alcohol and we do have documentation thankfully.

I am glad for the benefits of the lactulose however the consequences worry me as well..i.e. dehydration etc.

Thanks again

Majah
Posted 3/12/2012 1:13 PM (GMT 0)
Majah,
As for your worry about lactulose, my hubby has been taking it for over a year for ESLD and HE. I see no negative conseequences for him. In fact, I can now tell whether he needs more than the precribed amount for that day, just by his mental state of confusion. When the lactalose does it's job his HE seems to almost go away for a while.

May your husband's plan work and things work out for him.
Angie1953
Posted 3/12/2012 9:01 PM (GMT 0)
Majah, glad to hear of his 60 days of sobriety and that his AA attendance has been documented.

Hugs,
Connie
Posted 3/12/2012 9:09 PM (GMT 0)
During Mike's 6 month wait, he had blood tests for ethanol (alcohol in his blood) once a week!

He had his AA calendar signed 4-6 times a week!

And the transplant center had him coming once a month toward the end.  Once he was sober about 4 months, they started his work up, MRI, U/S, cardiac tests, etc because they were convinced he was finished with the alcohol permanently.

He got his liver at about 7 months sobriety.

He is now 10 most post transplant, so he has done well.

Good luck,

Carol

 

Posted 3/12/2012 10:18 PM (GMT 0)
wow your husband's regained sobriety is an excellent thing..... you will find many answers here... many characters here at our family... what ever we can do to help we will whether through information or just emotional support... welcome... you've found the right place... Sandia
✚ New Topic ✚ Reply