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Thanks for contacting with your health concern
1. going by your history, presently, it seems to be a case of 'macronodular cirrhosis of liver' following type B hepatitis [virus came back], and the disease is progressing and since you don't think the seriousness has set in yet probably you are in the stage of 'Compensated cirrhosis', however, to know the staging and prognosis kindly consult your physician or a Hepatologist.
2. I at most can let you know about the diet, lifestyle, and investigations which one has to follow:
i. blood examination: Hb%, TLC, DLC, ESR [ESR will be increased in presence of infection]
ii. stool for occult blood: may be positive
iii.
Rectal examination and proctoscopy for the demonstration of
internal hemorrhoids.
iv. Chest X-ray may show tuberculosis/hydrothorax.
vi. Liver function test:
- Raised Serum Bilirubin, SGOT/SGPT/
Alkaline phosphatase.
PS. keep a note that although these tests are sensitive but very nonspecific and serve to detect liver disease rather than quantitative liver function so their high values don't signify a serious complication most of the time, it is the underlying pathophysiological process which needs to be diagnosed and managed, check regularly with
Prothrombin time, INR and Serum Albumin
vii. A liver biopsy will confirm the diagnosis of cirrhosis of liver
viii. ultrasonography [or CT scan] of the liver, portal vein, any collaterals, and for any free fluid in the abdomen.
3. As virus came back, probably it is a case of
Chronic Hepatitis thus patient with chronic hepatitis need specific treatment with Interferons. [consult with Hepatologist], till then
. Adequate bed rest; [reduction of physical activity reduces metabolic demands of liver and increases renal perfusion]
. Salt- free high protein diet [protein is restricted immediately at the onset of
hepatic encephalopathy and/or
serum creatinine rises]
. control of aetiological factor: [abstinence from alcohol intake]
. the safest analgesic is paracetamol.
. In later stages, management is done in 'intensive care unit' with the experienced management team.