Diagnosed with cirrhosis, sleeplessness, ammonia levels abnormal. What can be done?
Patient: Hello I have a sister who was diagnosed with cirrhosis, was hospitalized for over 2 months. was doing well and all of a sudden she has gotten out of control, crazy like, not sleeping for days, running around like a crazy person. Know one can say anything without her being defensive. We don't know what to do? Is it her meds? She has had some problems with her ammonia level. How can we help her and what should we do? We are desperate. Can you help me understand what could be wrong and what I should do? Doctor: Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM).The symptoms your sister is having, along with increased ammonia levels suggest that she is having hepatic encephalopathy (HE). For treatment of HE you should know the factors that leads to HE in stable patient of cirrhosis like overuse of diuretics like lasix or spironolactone if she is on them, Gastrointestinal bleed, low potassium levels, medications like benzodiazepine, dehydration, low sodium levels, infection, constipation and diarrhoea.Treatment is correction of the precipitating factorI will like to advise that you should visit a gastroenterologist before the thing worsen.I hope I have answered your query and this will help you. Remain in touch