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medication induced hepatitis???

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Posted 11/20/2009 3:08 AM (GMT 0)
I know, this is supposed to be temporary....but I have some concerns.

 

I was given Septra (a sulpha antibiotic) and this is the second time this has happened...it took the second time to determine it was "an allergic reaction to Septra". The first time they thought it was Hep A, and because there were no antibodies, they left it as "possibly passed a gallstone"

 

Within a week after starting Septra I was yellow - on both occassions.

This time, I am not bouncing back as well.

I was yellow two weeks, tired, and a little itching the first time.

 

This time, my liver levels are going up and down, and I am clawing constantly!! My bilirubin stayed at 7.6 for 2 1/2 weeks...just this week lowered to 5.8 - I suppose this isn't too bad concidering the dr said soemone with a tumor having a bilirubin of 30...

 

sigh...I am confused often, don't sleep well at night, have very dark urine (last two weeks intermitently), and the itching is worse than chiggers, and the nausea is worse than any of my five pregnancies!! This has been five weeks now. My apologies if this is offensive to those who have been miserable for much longer...

 

I can't eat anything chocolate, spicy, or acidic. not much digests well (reflux)

I can't really eat sweets, but I can eat ice cream ---all the can'ts have to do with awful nausea.

Salty foods settle best, but I assume this has to do with the nausea (was helpful during pregancy anyway)

 

All I can get from the drs is "we just want to see the levels go down"...all they've done is blood work and a liver ultrasound.

I am tired of "let's wait a week and see what your blood results are then." In the mean time I am miserable. Not to mention I just got a new job, and am trying not to lose it! I fall asleep at the computer, I am constantly nauseated and watch the clock waiting to clock out at the end of the day. I also fall asleep on the drive to and from work - I had to start munching something to help keep me awake.

my reason for writing, besides venting:

 

Can someone suggest a way to "hurry along" the healing for my liver. We don't have a bunch of money to purchase a bunch of supplements, but I am always willing to eat :) as long as it will help, and settle well with my tummy.

I read about the coffee enemas, but I am not so sure about trying that.

Can someone suggest "healthy" help? Does it sound like maybe I should get other help or request other tests? I am seeing a GI dr.

How long do the levels have to be elevated before there really is concern of something really bad going on?

currently my ALT is159, last week was 129...my AST is 129, last week was 74....but my bilirubin has gone down????

I think I've posted too much - any help would be appreciated!

Posted 11/20/2009 4:12 AM (GMT 0)
Hi, Mamaduck and welcome to the forum.  I'm sorry you have the need to be here, but I can understand how concerned you are.

 

Now that you know what happens when you take Septra, I suggest you stay away from all sulfa drugs altogether in the future.  I also suggest that you see a hepatologist (liver specialist.)  Sometimes these drug-induced forms of hepatitis can permanently damage the liver.  If you are not retaining fluid, I would drink lots of spring water.  They always have me do that after I've had IV contrast for scans, to flush the toxin out of my system.  So it should help you, also.  In addition, eat lots of fresh fruit and veggies.  If you ARE retaining fluid, then the salt is a bad idea and you also may need to limit fluids.  BTW, I had liver cancer and my bilirubin was never above 11.5.  So you can't always go by blood work.  How you are feeling and the symptoms you are having are more indicative of what is going on.

 

The only alternative I would suggest is milk thistle.  Get it at a health food store and ask what dosage they recommend in your case.  I really do think it's most important for you to get a consult with a hepatologist.  They are much more savvy about the liver than a PCP or GI doc.  For the itching, you might try a colloidal oatmeal bath.

 

Hopefully, your situation will reverse itself in time.

Hugs,

Connie

Posted 11/21/2009 3:58 AM (GMT 0)
Thank you for your reply. It was encouraging to hear you mention the symptoms are more important than the blood work. I felt that way, but I am just a patient, not a Dr.

 

I'm currently not retaining fluid, and I'm drinking at least 32oz of filtered water each day. Being from the South, I used to drink about that much in sweet tea as well, but haven't touched it since this began. Thought it wouldn't be helpful for my kidneys at this time.

For the itching I have tried the oatmeal bath, and baking soda bath. The baking soda eases the itching for longer period of time, but I am really broke out bad in hives right now. They prescribed 50mg Hydroxizine, 100mg at bedtime, just makes me feel so yucky - would rather itch than to feel so sick at my stomach so I only take it when the itching is almost unbearable.

 

I plan to look into the hepatologist first thing on Monday. I'll ask about recommendations on the milk thistle then as well.

 

I read some naturopathic options, but the most practical for me, for detox were a list of veggies.

Tomorrow is grocery day, and hopefully they will make the a little difference. Thankfully I am craving veggies anyway.

I read that celery, califlower, asparagus, and cabbage to name a few, were a liver detoxifying rolleyes   I guess them being organic probably makes a difference but I'll eat what I can get at the local grocery.

If anyone else has any other ideas, I'd be very grateful.

~Mommaduck

Post Edited (mommaduck) : 11/20/2009 9:04:10 PM (GMT-7)

Posted 11/21/2009 4:11 AM (GMT 0)

I've heard of asparagus and cabbage as detoxifiers.  None of those veggies can hurt and are good for you, so go for it.

Let us know how you make out with a hepatologist.

Hugs,

Connie

Posted 11/23/2009 9:41 PM (GMT 0)

Hello Mommaduck,

I have Autoimmune Hepatitis (AIH).  Mine wasn't caused by anything in particular but there are some medications that can trigger it.  When you do get in to see a hepatologist (Connie is right, you need to see a hepatologist not just a GI), you should bring that up as a possibility.  Bili at 7.2 isn't a good thing no matter what is wrong.  I know someone who is on hydroxyzine too for her itching that's associated with her AIH.  Liver disease in general can cause itching but since your bili is high, I would think that's it.  As for AIH, blood tests followed by a biopsy are needed for diagnosis.  So don't be afraid if the hepatologists suggests a biopsy.  It really isn't that bad!

Please let us know if you see a specialist!

Posted Yesterday 10:26 AM (GMT 0)
 

Some of your symptoms could indicate PBC (Primary biliary cirrhosis). For your itching you might consider Ursofalk.

Where are the figures for your P-Alanine aminotransferase and especially your P-alkaline phosphatase?

Posted Today 2:02 PM (GMT 0)
 

I also have autoimmune hepatitis from medications once you have it you always have it but you can go into remission but must be very careful when taking any kind of medications.  Mine was caused by Lipator,  The only thing that got mine under control was Prednisone.  I have been on and off Prednisone for 3 years but it does work.  My levels were AST 650 ALT 900

and the Prednisone brought them right down.

MJ 

Posted Today 6:33 PM (GMT 0)
Mommaduck, For diet to help your liver is limit your beef to 4oz a week and stay away from melons. I worked for 9 years in a rehab working the diet part of people with liver damage, certain foods cause the liver to work harder producing the digestive bile. When there is food in your stomach it continues to work. So the easier and faster the food breaks down the less work the liver has to do. Melon will actually ferment before they digest and beef stays in the stomach longer before it can be processed. We also recomended steamed veggies and limit the raw. This again is to allow your liver a resting period. The liver is the only forgiving organ.
Posted 12/1/2009 1:56 AM (GMT 0)
Thank you all so much for your replies. It gave me the courage to confront my GI Dr today...my levels were up again last week, but they didn't call me - with the holiday I guess...

 

First he didn't have today's results (the nurse's oversight) and he was concerned that the levels were up, so I said "Can I see a hepatologist now?" He said he actually does 30% hepatology in his practice. He studied under a hepatologist. blush

Then, he asked the nurse for the results of what was drawn today and my levels have gone down. I also explained to him that I had a steroid shot the day before the last draw, for the hives that had gotten out of control.

I mentioned the Autoimmune hepatitis, and he told me that he had tested for that. He also said that it is still possible even though everything was negative, but he didn't believe it was an issue with me. He spent over an hour explaining the blood levels. Then he went on to explain ALL the different tests they had run and what they had been looking for.

So, the final conclusion is that this was a drug reaction, and the steroids bumped my levels a little. He said since they are back down this week, then he isn't concerned at this time. I'm to have blood drawn in two weeks, and if that has bumped at all, he will do a biopsy. He said he doesn't like to do them just because, since there are risks.

 

My bilirubin is down to 2.2!! yeah! He doesn't believe the hives have anything to do with any of this - I think it's nerves, maybe. The only thing I can't seem to kick is the nausea.

Thanksgiving was kinda yucky since I couldn't just eat whatever I wanted. Sweets still make me sick. He had no answer for that. He said it could be because my AST/ALT are still elevated (85 and 206), but it could be from something else. We'll wait around another two weeks and see what happens.

My husband said he is sick of the waiting game...me too but what else can ya do - the wait for a hepatologist is 2-3 months; so, I'd be waiting anyway!

SHADOWGHOST - thanks for the food info! I thought raw were better, and I have been consuming lots of raw celery and fruits, but I've been avoiding red meat. I appreciate the advice and will try cooking my veggies instead. Can you believe all sweets except ice cream make the nausea awful! Dr said that was strage because ice cream is high in sugar and fat, and the fat should bother me??!!!

JFT - I don't have my most recent results, only what they tell me, but they seem focused on the ALT/AST because of the "injury" I have.

again I think I posted too much - I'm still working full tiem and don't get the chance to get on here often enough wink

Posted 12/3/2009 10:17 PM (GMT 0)
Hi Mommaduck!

Glad to hear your levels are coming down.  If it is drug-induced hepatitis, you do have to wait it out.  I understand that he sees 30% of liver troubles but it still isn't 100%...that's my 2 cents.  If you like this doc and still think he's thorough, then stick with him a while.  If you don't get better in a few months...request a hepatologist though.

Your nausea is likely due to the fact that your ALT/AST are elevated (my highest were 848/748---but others on another group have been in the 1000's).  With your bili being lower you should be less yellow and your urine should start getting back to normal.  At my worst, my bili was 23.3...I was orange!  It's very encouraging that your bili is decreasing.  Although your ALT/AST went up from the last time...how often are you going in for blood work?

I understand your frustration...especially with the holidays and lots of eats around! turn Take care,

Posted 12/5/2009 4:59 AM (GMT 0)
I was getting blood work done weekly. This time he had me wait two weeks - a week from Monday.

He said if the levels go up at all, he'll do a biopsy. He is also doing another thorough workup at that time.

My ALT and AST are 85 and 208 - I'm not sure which is which this time...but overall that's really good. At this time everything is back to "normal" except the nausea and my skin is in rough shape from the residual of the hives. I also am still fairly sleepy a lot of the time, but not as much as I was.

The Dr. told me that the only local hepatologist has only been practicing 2 years...I think I need to trust this guy...whom, by the way, is also my husband's Dr. for his Crohn's Disease.

 

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