Cirrhosis Support Group

Unfortunately, coma often leads to death. Probably one of the better ways to die with this disease. At least the pain has gone.

I'm sure some people come out of coma though. I don't know the percentage, but will try and see if I can find it.

Craig

Here is some more information I had lying about. I don't know if it will help but it is some background info.

In the World Congress of Gastroenterology 1998 in Vienna, a proposed classification of hepatic encephalopathy was presented to standardize the subclasses. According to this classification, hepatic encephalopathy is subdivided in type A, B and C.[3]

Type A (=acute) describes hepatic encephalopathy associated with acute liver failure
Type B (=bypass) is caused by portal-systemic shunting without associated intrinsic liver disease
Type C (=cirrhosis) occurs in patients with cirrhosis.

In addition, the duration and characteristics of hepatic encephalopathy were classified into episodic, persistent, and minimal. The term minimal encephalopathy (MHE) is defined by patients with cirrhosis that do not demonstrate clinically-overt cognitive dysfunction, but that show a cognitive impairment on neuropsychological studies.[3] This is still an important finding, as minimal encephalopathy has been demonstrated to increase the rate of road traffic accidents and violations.[4]

The evaluation of severity of persistent hepatic encephalopathy is based on the West Haven Criteria for semi-quantitative grading of mental status, referring to the level of impairment of autonomy, changes in consciousness, intellectual function, behavior, and the dependence on therapy.[3][5].

Grade 1 - Trivial lack of awareness; Euphoria or anxiety; Shortened attention span; Impaired performance of addition. 67% of cirrhotic patients may have 'minimal hepatic encephalopathy'.[6]

Grade 2 - Lethargy or apathy; Minimal disorientation for time or place; Subtle personality change; Inappropriate behavior; Impaired performance of subtraction

Grade 3 - Somnolence to semistupor, but responsive to verbal stimuli; Confusion; Gross disorientation

Grade 4 - Coma (unresponsive to verbal or noxious stimuli)

Oh, I recently posted an article - Alcoholic Cirrhosis as a Syndrome which also covers treatment of encephalopathy using alternative methods to lactulose, as being more effective.
You may wish to go down through the forum posts for this article. I include a piece of it below.......

For ammonia toxicity, varices, and fibrosis, vitamin C by mouth throughout the day could be considered. If the blood pH is maintained by the presence of ascorbic acid, ammonia will be neutralized as fast as it is encountered. The symptoms of scurvy will also be resolved. For those wishing to undertake a more aggressive therapy, consideration may be given to intravenous administration of sodium ascorbate. See References.
For encephalopathy, intravenous administration of thiamine has repeatedly been reported to be the treatment of choice. See References.

For ascites, balanced amino acids are indicated. For the patient with adequate digestion, diets as prescribed for the starving can be considered. For those with inadequate digestive capability, a brief course of intravenous feeding might be appropriate.

The next time a cirrhotic patient is brought in to the hospital in a comatose state, why not test those wild claims made for intravenous administration of ascorbic acid? Other doctors have reported, in peer-reviewed journals, the injection of more than 200 grams of sodium ascorbate in twenty-four hours for such infections as pneumonia and hepatitis. Two hundred grams should neutralize quite a bit of ammonia. How little might be required to resolve the ammonia toxicity?

Thank you so much Craig for all the info..it is very helpful...I also forgot to mention that my husband is still drinking and will not quit...
Again, Thank you

Margie

Then it would seem we are both wasting our time - I'm so sorry for you, what else can I say?

Craig

We all have knowledge of cirrhosis in our own separate ways. We cannot begin to help with your husbands problems without firm diagnosis and test results.
Craig has given you good information, read it, then read it again. If you have specific questions we can help with explanation.
However, HE HAS TO QUIT ALCOHOL, PERIOD
Otherwise Craig and I will go back to our chess match...........Jeff

Thank you Craig... I have printed off cpoies so if you post anything else please give me a heads up :) cuz in my eyes "you are the man" Thank you for all you do here at DS..a BIG HUG for you from me LOL...~~Janet

Craig did you discuss any of this information with you doctor?

Yes, the part I was doing on cachexia and the use of vitamins to cure cachexia (catabolic wasting) and ascites. He agreed with me.
I didn't discuss use of thiamine for encephalopathy as I don't suffer from it (thank God for small mercys).
I wrote a journal on it. :-) You must have missed it!! :-) Now I'm upset and will sulk.

:-) Craig

Your husband pulled the trigger sometime ago, if he continues to drink it is just slow suicide. The bullet has left the chamber and is seeking an exit, the bullet is always traveling but you can retard it if you want! Been there done that sober 5+ years & starting to love life again. You can get extra mileage if you take care of your self & & like me waiting for a retread to maybe get a bit more out this body. take care have your hubby contact me glad to talk to any one on drinking it is a selfish disease.