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Wednesday, May 28, 2008

What is the management of early cirrhosis?


Q. DoctorNDTV’s precious information on all health topics is of unparallel importance. I am 62 years old and diabetic for the past 3 years. Of late I have had a hernia operation & gall-bladder stones removed successfully. But it seems that I am suffering from cirrhosis (has been confirmed through biopsy test) as well, though the Liver Function Tests through blood didn't show any complication. I have never touched alcohol in my life. I would like to have information on this. At this stage when the liver doesn't seem to be completely deteriorated, what’s the best way to save a diabetic’s liver? Where in India (any specific hospital, doctor) can one have his liver transplanted? How much does it cost?

A. You have asked a very pertinent question regarding guidelines for management of early cirrhosis. If I understand you correctly, your liver biopsy was performed at the time of you gall bladder surgery. This implies that your cirrhosis is incidentally detected at a relatively early stage. You have also mentioned that your liver tests are normal. Certain points that need to be looked into are as follows:

*We need to know the exact cause of cirrhosis. You must get your viral markers checked for hepatitis B and C. Besides other causes such as autoimmune liver disease, metabolic etc should be excluded.

*You should have imaging tests such as ultrasound of liver

*You should have an endoscopy done to look for esophageal/ gastric varices

*You should avoid hepatotoxic drugs, alcohol

*Keep your blood sugars well controlled

*Have a good nutritious diet

*Have serial blood liver tests at 3-6 months interval

*Check you weight monthly. Any unusual increase may mean beginning of water accumulation in your tummy which will need specific therapy.

*Liver transplant is indicated for advanced complicated cirrhosis. Limited centres in India are doing it. In north, it is done successfully at Sir Ganga Ram Hospital and Apollo. The cost at our hospital is 15 lacs.


04 July 2005
Answered by
Dr. Sanjiv Saigal
Gastroenterologist,
Sir Ganga Ram Hospital,
New Delhi
Via: http://www.doctorndtv.com


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