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Confusion, Mood Swings Due To Fluctuating Ammonia Levels. Have Cirrhosis, Diabetes And Hepatic Encephalopathy. Suggestions?
My husband has cirrhosis,diabetes & hepatic encephalopathy. He is in the hospital for high blood sugars (now under control) But he also has high ammonia levels, he was 95 at admission, then 47, 29, 60, 40 he was like his old self at 29 but the next day the levels went up & he was mean, confused & threatening. Can he be stable or will he continue to have his levels go up & down? How can I his wife & caregiver take care of him with his mental staus changing from nice to violent? Does this mean his liver is worse & not processing the lactulose?
posted on
Wed, 3 Jul 2013
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Wed, 3 Jul 2013
Answered on
Thu, 4 Jul 2013
Last reviewed on
Hi,
Your problem is of real concern, as cirrhosis is a chronic disease and the condition that you are mentioning is called hepatic encephalopathy and denotes advanced liver failure. Episodes of hepatic encephalopathy are common in chirrotic patients and can be prevented by mesures like avoiding constipation, monitoring the electrolytes level and and avoiding low pottasium levels, daily recommended protein intake control, prompt identification and treatment of any infection and most importantly by preventing gastrointestinal bleedinf by applying band nligation to the dilated veins in the esophagus (Varices)
Your problem is of real concern, as cirrhosis is a chronic disease and the condition that you are mentioning is called hepatic encephalopathy and denotes advanced liver failure. Episodes of hepatic encephalopathy are common in chirrotic patients and can be prevented by mesures like avoiding constipation, monitoring the electrolytes level and and avoiding low pottasium levels, daily recommended protein intake control, prompt identification and treatment of any infection and most importantly by preventing gastrointestinal bleedinf by applying band nligation to the dilated veins in the esophagus (Varices)
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sorry, my answer was given earlier by mistakenly pressing the go button.
So, I was talking about the varices...The most important way to prevent bleeding from them is to apply band ligation by a gastroenterologist. Lactulose is the most effective medicine in hepatic encephalopathy. It is not absorbed by the gut and therefore doesn't reach liver. Rather it acts locally in the gut to prevent ammonia absorption. At this point when the ammonia levels are no coming down it should be given 30 ml thrice a day at least. Hope all the best for your sincere efforts.
Greatest regards
So, I was talking about the varices...The most important way to prevent bleeding from them is to apply band ligation by a gastroenterologist. Lactulose is the most effective medicine in hepatic encephalopathy. It is not absorbed by the gut and therefore doesn't reach liver. Rather it acts locally in the gut to prevent ammonia absorption. At this point when the ammonia levels are no coming down it should be given 30 ml thrice a day at least. Hope all the best for your sincere efforts.
Greatest regards
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