Treatment of Compensated Disease
Author: mzPOTTER
When the patient has none of the problems discussed previously are considered to have compensated cirrhosis. The liver is a large body that can continue in office for quite some time, it has capacity for regeneration of cells that die and are replaced by new ones. That is why for years the patient may not need any treatment to have no symptoms.
In these patients should be advised that offset Eating a balanced diet low in salt and should only be prohibited from taking alcohol. Bed rest is not necessary and the majority of those affected can conduct a normal social and work activity.
Patients with chronic hepatitis C can be treated with antiviral drugs (interferon and ribavirin). Although its use is discussed by the amount of side effects it produces, it has been shown to reduce the risk of liver cancer, so in certain subjects, especially in younger patients in good physical condition, you might consider its use.
Autoimmune hepatitis can be treated with steroids, which help to reduce circulating autoantibodies that attack the liver. Patients with hemochromatosis often require extraction of one pint of blood every two months to remove excess iron.
Patients at risk of bleeding from esophageal varices receive drugs like propranolol to reduce the pressure on the veins and prevent bleeding.
It is recommended that patients take aspirin or anti-inflammatory, for the risk of causing fluid retention and worsening ascites. Be very careful with drugs like those used for insomnia, depression, the risk of sleeping in excess of the patient or to encourage the development of hepatic encephalopathy.
In alcoholic patients, where it is often due to an unbalanced diet have vitamin deficiency may be useful to the administration of vitamins B and C and folic acid.
Liver transplantation is a therapeutic option that should be considered in all patients with advanced liver cirrhosis. However, many patients are not treated with this technique. Transplantation is indicated when life expectancy of people with cirrhosis is less than the transplantation, ie when decompensation arise.
Keep in mind that transplantation is an aggressive treatment of high risk during surgery and afterwards, and that the availability of livers, even in a country like ours where the donation rate is very high, is limited. Therefore, you should consider whether the risk of transplantation is greater than not doing it or vice versa. When the patient begins with uncontrolled ascites, hepatic encephalopathy, severe jaundice, their life expectancies are low, that is the time to consider transplantation.
Forecast
The survival of patients with compensated liver cirrhosis (patients who have never had ascites, gastrointestinal bleeding or hepatic encephalopathy) is relatively long. Most live more than 10 years. However, once it has decompensated cirrhosis, prognosis is poor in a short period of time. The probability of remaining alive three years after the imbalance is only 30%.
It is important to follow patients to try to prevent the occurrence of complications and decompensation. That way you can help a person live longer and better. Once diagnosed with cirrhosis, the patient must continue to review by their GP or specialist will make detailed information on his treatment in both phases compensated as decompensation.
Some individuals require, over time, blood transfusions for the anemia present, or frequent emptying of the abdominal cavity (paracentesis evacuator). When this occurs it is often useful to program the treatment according to the needs of each individual, to avoid having to go to the emergency. In many hospitals there are units called ‘Day Hospital’, where you can schedule the patient visit, which made the analysis and transfused blood or fluid is removed if necessary.
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