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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Treatment For Ascites

Hi, My husband has abused alcohol for over 25 years. He was admitted into hospital 2 years ago with liver failure but has now started drinking again? He has horrendous ascites and seems to be swelling by the week. He wont get any medical help. What is his prognosis?
Tue, 30 Aug 2016
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General Surgeon 's  Response
Hallo,

Difficult to say just by ascites. All depends on the function of the liver at this moment. Is there cirrhosis or not,etc...

But to give you an idea, in medicine for live problems we use the MELD score (The Model for End-Stage Liver Disease, or MELD, is a scoring system for assessing the severity of chronic liver disease) which is a pretty complex scoring system.

We also use the older Child-Phugh score: is used to assess the prognosis of chronic liver disease, mainly cirrhosis.

It gives points to some questions:

1) ascites or not?
2) encephalopathy or not (= brain damage I would say)
3) PTT INR level ( gives you an idea how well your blood can form cloths)
4) Albumine level ( = level of a specific proteine in your body)
5) Bilirubine level ( = product of the liver)

Scoring table:

Measure      1 point      2 points 3 points

Total bilirubin, μmol/L (mg/dL)     50 (>3)

Serum albumin, g/dL      >3.5      2.8-3.5      Prothrombin time, prolongation (s) 6.0
Ascites      None      Mild     Moderate to
Severe

Hepatic encephalopathy      None     Grade I-II      Grade III-IV


Results:

Child A: 5-6 points     100% you live 1 year if not treated     85% 2 years
Child B: 7-9          81%      57%
Child C: 10-15          45%      35%


Hope this gave you an idea
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Treatment For Ascites

Hallo, Difficult to say just by ascites. All depends on the function of the liver at this moment. Is there cirrhosis or not,etc... But to give you an idea, in medicine for live problems we use the MELD score (The Model for End-Stage Liver Disease, or MELD, is a scoring system for assessing the severity of chronic liver disease) which is a pretty complex scoring system. We also use the older Child-Phugh score: is used to assess the prognosis of chronic liver disease, mainly cirrhosis. It gives points to some questions: 1) ascites or not? 2) encephalopathy or not (= brain damage I would say) 3) PTT INR level ( gives you an idea how well your blood can form cloths) 4) Albumine level ( = level of a specific proteine in your body) 5) Bilirubine level ( = product of the liver) Scoring table: Measure 1 point 2 points 3 points Total bilirubin, μmol/L (mg/dL) 50 ( 3) Serum albumin, g/dL 3.5 2.8-3.5 Prothrombin time, prolongation (s) 6.0 Ascites None Mild Moderate to Severe Hepatic encephalopathy None Grade I-II Grade III-IV Results: Child A: 5-6 points 100% you live 1 year if not treated 85% 2 years Child B: 7-9 81% 57% Child C: 10-15 45% 35% Hope this gave you an idea