Talk:Cirrhosis

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This was the original source citation:

I removed it after I had began editing. RJFJR 22:52, Dec 25, 2004 (UTC)

The text Original text from was added back in. I removed and replaced it with an attribution. I don't feel that referring to it as an original source of material is appropriate once we begin editing it. During our editing we will add material from other sources, delete, or reword; all of these could introduce inaccuracies in spite of our best efforts and intentions. It is inappropriate to state the source is material for our own mistakes. RJFJR 03:51, Dec 31, 2004 (UTC)

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[edit] Cirrhosis

Hi

I have been suffering from a increased level of Gamma GT levels (125+ consistently against a norm of <45). This has been on for the last 4 years. Every other parameters in the LFT are under acceptable limits. Have been taking medication for the last 4 years but the level of Gamma GT does not go down. Even tested for other conditions like Wilson, Iron etc, but everything else is normal Im worried as to whether this might lead to further complications of the Liver. If anyone is suffering from a similar condition, request u to let us know

Regards

Kedhari Sundaram

Ask your doctor, please. This is a public forum where anyone impersonating a health professional can give you misguided information. JFW | T@lk 07:44, 21 November 2005 (UTC)
Here's a little more, but see your doctor [1] -- Samir (the scope) धर्म 07:55, 14 May 2006 (UTC)

Greetings Kedhari, it is interesting that you have only the mildly elevated γ-GT, as I too, have the same condition, although in my case it is as a result of Primary Sclerosing Cholangitis and Auto-Immune Hepatitis, which overlays the PSC. I have had this condition for 10 years now, and will require a liver transplant or it will lead to an early grave. It took 2 years of constant searching, several specialists and consultations before the actual cause of the γ-GT elevation, in combination with other symptoms clearly associated with hepatic problems along with it, to diagnose the problem I had. As it turns out, this may provide you with further avenues to explore, although it is my most fervent wish that they do NOT lead to a similar diagnosis. The cause of both my PSC/AIH is from an inherited genetic mutation of Chromosome 14, which causes a depletion of the protease-inhibitor ά-1 Anti-Tripsyn (A1AT). This particular protein can be easily tested to find out if you are indeed insufficient, or normal, a positive finding on this test would be insufficiency. Being affected by A1AT deficiency causes two significant problems (depending on whether you are a carrier, indicated on your results by a return of a PiMS, PiSS, or PiMZ finding)meaning you carry the defective Chromosome but are not subject to the ill-effects, the one to watch out for is the homozygous 'PiZZ', which means you are amongst the tiny number of patients with the ZZ homozygous phenotype, and a sufferer of this chronic insufficiency. A finding of PiZZ generally means that you have less than 15% of normal levels of A1AT. This leads to BOTH liver AS WELL AS pulmonary problems (have you ever heard of "Genetic Emphysema"? Whilst the diagnosis of Primary Sclerosing Cholangitis cannot be achieved by a mere A1AT test, it can certainly lead your physician down the proper road of diagnosis, focusing on the liver and your lungs, to ensure there are no problems. I had the elevated γ-GT for about 3 years WITHOUT any other symptoms, as PSC is a silent disease, often not found until the damage is irreversible, and usually caught with the onset of symptoms of Cirrhosis. The golden standard of diagnosis for things such as PSC is LIVER BIOPSY in conjunction with an ERCP (Endoscopic Retrograde Cholangio-Pancreatography), as well as ACCURATE histological results of the biopsy specimen. Again, diagnosis of severe liver problems such as these is not an easy road, but the presence of an elevated γ-GT, even though not alarmingly elevated, is an indication that your liver HAS suffered some injury or insult, as in past tense, it is only indicative of massive damage in higher numbers of γ-GT, transaminases, pTT and INR results, among a plethora of other simple blood chemistry panel results. The dog is barking in your case, you need to discover up which tree, and it is to your benefit to do so sooner, rather than later, and don't let anyone tell you it is nothing until you have an explanation for it. PATIENCE is key. If I can be of further assistance, please look me up, anytime. Sincerely, AirMed95 04:51, 3 December 2006 (UTC) AirMed95 "Ken"

[edit] Images requested

It is requested that this article be expanded with images. The more disgusting and frightening, the better wikipedia will be able to deter people from drinking their livers into oblivion!

I have images of my ERCP, or Endoscopic Retrograde Cholangiopancreatography confirming the diagnosis of Primary Sclerosing Cholangitis, that show what is left of my biliary tree, normally seen on angiography of this type as clearly defined, sharp edged "spagetti noodles" all over the place. In my case, there are nothing left but mere wisps of biliary tracts, upon a very black background. Now if someone can help me with getting these images a)into my computer, and b)onto this site, I would be more than happy to oblige!! AirMed95 05:31, 3 December 2006 (UTC)"Ken" somethings are good though so i will try to keep my head up

[edit] Empty talk

>Signs and symptoms of cirrhosis >Liver size. Can be enlarged, normal, or shrunken.

The information content of this sentence in the article is exactly ZERO...

—The preceding unsigned comment was added by 195.70.32.136 (talk • contribs).
No, there is direct information - a small or large liver may be associated with cirrhosis, but not always; similarly enlarged neck lymph nodes may or may not occur with sore throats, but that does not equal an absence of information nor that doctors should not examine for enlarged lymph nodes. If cirrhosis is the scaring up of the liver and eventual loss of liver function, then one might reasonable wonder if the liver enlarges with the initial assault upon it or shrivels up as it scars. The fact that the liver size may or may not be altered in size therefore is of note. Also examining a patient to identify possible enlargement (liver edge extends below the rib cage), or the size of the liver reported on ultrasound scans will not in itself therefore indicate the severity of cirrhosis that has occured. David Ruben Talk 16:33, 6 June 2006 (UTC)

[edit] Coffee

Coffee postitively modifies the risk profile[2]. JFW | T@lk 22:26, 12 June 2006 (UTC)

More links: http://www.forbes.com/forbeslife/health/feeds/hscout/2006/06/13/hscout533237.html

[edit] Number One on Google

http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis/ ranks #1 on Google for "Cirrhosis"NumberOneGoogle 18:29, 25 November 2006 (UTC)

Well, there's a link to it here. NIDDK is a good resource. JFW | T@lk 14:13, 1 March 2007 (UTC)

[edit] Copyedit

I've done some copyediting. It involved removing all the boldface (WP:MOS), adding the hepato-pulmonary vascular disorders (glaringly absent) and removing the speculative hype about sulfasalazine. I'm much more interested in endothelin antagonism, especially if one considers that sulfasalazine itself can be hepatotoxic.

I suspect we should we mention something about decompensation of cirrhosis - what is done urgently in terms of examinations and treatments. We should talk about fluid management, sodium retention, maintaining nutrition (already briefly covered) and perhaps even acetylcysteine and pentoxifylline.

We need to refer to guidelines more. For example, the BSG have a very good ascites guideline authored mainly by Kevin Moore. JFW | T@lk 14:13, 1 March 2007 (UTC)

[edit] Useful review articles for expansion

Link for my own personal use while working on this article:

Some papers I don't have fulltext access to:

I'm planning some work on this article. Stop me if I get too engrossed. JFW | T@lk 16:53, 1 March 2007 (UTC)

[edit] Sleep

Cirrhotics sleep poorly, especially when minimally encephalopathic. DOI:10.1111/j.1572-0241.2006.01028.x suggests Hydroxyzine should be tried. JFW | T@lk 14:37, 1 April 2007 (UTC)

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