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What Causes Confusion, Memory Loss And Visual Impairment While Suffering From Liver Cirrhosis?
Question: Wife has cirrhosis of liver, diuretics dropped 20 lbs in a week, clinical tests, milkmaid extended palms show muscle response but has confusion loss of memory and visual impairment, Doctor says ammonia blood test not needed?
Brief Answer:
Hepatic encephalopathy.
Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic for your query.
Most ammonia in the body forms when protein is broken down by bacteria in the intestines . The liver normally converts ammonia into urea, which is then eliminated in urine. Ammonia levels in the blood rise when the liver is not able to convert ammonia to urea. This is caused caused by cirrhosis as in case of your wife.
Brain is normally protected from the low levels of ammonia in your body by the blood-brain barrier. Liver dYSfunction can cause ammonia levels to build up in your brain causing permanent brain damage, a condition known as hepatic encephalopathy.
The condition your wife is having is Hepatic encephalopathy.Hepatic encephalopathy is a decline in brain function that occurs as a result of severe liver disease. In this condition, the liver cannot adequately remove toxins from the blood. This causes a buildup of toxins in the bloodstream, which can lead to brain damage.Confusion,loss of memory and disorientation are a result of elevated ammonia levels and toxins in body.
Treatment options-
Ammonia levels hould be checked weekly.
-Treatment should be started if the plasma ammonium level is 3 times the reference level. High parenteral intake of calories from 10-15% glucose and intralipids should be provided. Intravenous infusion of sodium benzoate and phenylacetate should be started.
-Lactulose 30 ml to be taken twice daily- appears to inhibit intestinal ammonia production by a number of mechanisms. The conversion of lactulose to lactic acid and acetic acid results in acidification of the gut lumen.This favors conversion of ammonia (NH3) to ammonium (NH4+); owing to the resultant relative impermeability of the membrane, the NH4+ ions are not easily absorbed, thereby remaining trapped in the colonic lumen, and there is a reduction in plasma NH3.
-However final treatment is liver transplantation.
Regards.
Hepatic encephalopathy.
Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic for your query.
Most ammonia in the body forms when protein is broken down by bacteria in the intestines . The liver normally converts ammonia into urea, which is then eliminated in urine. Ammonia levels in the blood rise when the liver is not able to convert ammonia to urea. This is caused caused by cirrhosis as in case of your wife.
Brain is normally protected from the low levels of ammonia in your body by the blood-brain barrier. Liver dYSfunction can cause ammonia levels to build up in your brain causing permanent brain damage, a condition known as hepatic encephalopathy.
The condition your wife is having is Hepatic encephalopathy.Hepatic encephalopathy is a decline in brain function that occurs as a result of severe liver disease. In this condition, the liver cannot adequately remove toxins from the blood. This causes a buildup of toxins in the bloodstream, which can lead to brain damage.Confusion,loss of memory and disorientation are a result of elevated ammonia levels and toxins in body.
Treatment options-
Ammonia levels hould be checked weekly.
-Treatment should be started if the plasma ammonium level is 3 times the reference level. High parenteral intake of calories from 10-15% glucose and intralipids should be provided. Intravenous infusion of sodium benzoate and phenylacetate should be started.
-Lactulose 30 ml to be taken twice daily- appears to inhibit intestinal ammonia production by a number of mechanisms. The conversion of lactulose to lactic acid and acetic acid results in acidification of the gut lumen.This favors conversion of ammonia (NH3) to ammonium (NH4+); owing to the resultant relative impermeability of the membrane, the NH4+ ions are not easily absorbed, thereby remaining trapped in the colonic lumen, and there is a reduction in plasma NH3.
-However final treatment is liver transplantation.
Regards.
Above answer was peer-reviewed by :
Dr. Kampana
Dietician recommendations , sugars,fats etc? Will consult caregiver!
Where do we go if this is ignored???
Where do we go if this is ignored???
Brief Answer:
Follow up answer.
Detailed Answer:
Hi again,
A low protein diet or No protein diet is to be taken initially,Carbohydrates can be taken in normal quantity fat and salt should ber restricted.
If the condition remain untreated as told above levels of toxins and ammonia will increase in blood ultimately damaging brain and other vital organs causing death of patient.
Regards
Follow up answer.
Detailed Answer:
Hi again,
A low protein diet or No protein diet is to be taken initially,Carbohydrates can be taken in normal quantity fat and salt should ber restricted.
If the condition remain untreated as told above levels of toxins and ammonia will increase in blood ultimately damaging brain and other vital organs causing death of patient.
Regards
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Kampana
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