Hi,I am Dr. Subhankar Chakraborty (Gastroenterologist). I will be looking into your question and guiding you through the process. Please write your question below.
Cirrhosis With Esophageal Varices. History Of Encephalopathy. On Lactulose. Unable To Pass Stools. Help
I have patient of cirrhosis with oesophageal varices .15 days back he had hemetemesis and landed into encephalopathy .patient recovered from encephalopathy and endoscopy revealed large bleeding eso.varices. His EVL was done and patient is fine now.there is no hemetemesis. He is on lactulose along with all other supportive therapy.for last two days despite taking lactulose 30 ml. Twice a day patient has not passed stool.should I increase the dose of lactulose or add some other laxative. His intake is not adequate also.on examination he is haemodynamically stable afebrile, no jaundice .no sign of chf/ lvf,his abdomen is soft bowel sounds normal .
Hi, Welcome to HCM, After going through the history of the patients, he is having Cirrhosis of liver with portal hypertension with Esophageal Varices.
The cause of hematemesis is varices and EVL (Endoscopic Variceal Ligation) is done to prevent the further bleeding. Blood in intestine causes ammonia level to rise he has recovered from encephalopathy. Please continue treatment lactulose is good drug can be taken 3 times a day after consulting your treating doctor. Dietary supplementation with branched-chain amino acids is useful and even addition of probiotics with advise from your doctor may help. Take care. good Luck. Dr.Akhilesh Dubey M.D.
I find this answer helpful
You found this answer helpful
Note: For further follow up on digestive issues share your reports here and Click here.
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer.
For a more detailed, immediate answer, try our premium service
[Sample answer]
We use cookies in order to offer you most relevant experience and using this website you acknowledge that you have already read and understood our
Privacy Policy
Cirrhosis With Esophageal Varices. History Of Encephalopathy. On Lactulose. Unable To Pass Stools. Help
Hi, Welcome to HCM, After going through the history of the patients, he is having Cirrhosis of liver with portal hypertension with Esophageal Varices. The cause of hematemesis is varices and EVL (Endoscopic Variceal Ligation) is done to prevent the further bleeding. Blood in intestine causes ammonia level to rise he has recovered from encephalopathy. Please continue treatment lactulose is good drug can be taken 3 times a day after consulting your treating doctor. Dietary supplementation with branched-chain amino acids is useful and even addition of probiotics with advise from your doctor may help. Take care. good Luck. Dr.Akhilesh Dubey M.D.