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Q. Is stage 2 liver fibrosis a reversible condition?

Answered by
Dr. Jagdish Singh
and medically reviewed by Dr.Nithila A
This is a premium question & answer published on Jun 10, 2019

Hello doctor,

The patient is 65 years old. Doctors have concluded liver fibrosis stage 2. In fibro scan, the lymphocytes are 95 %, amylase is 20 U/L, monocytes and macrophages is 5 %. The fluid is hazy in appearance. Can liver fibrosis be reversed?

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#

Hello,

Welcome to icliniq.com.

Interpretation of reports.

  1. It is F4 fibrosis, not F2.
  2. Ascites.
  3. No SBP (spontaneous bacterial peritonitis).
  4. Portal Hypertension.
  5. Chronic liver disease.

With this advanced fibrosis, it could not be reversed back.

Thank you doctor,

Kindly guide regarding the therapeutic procedures. Our doctor has recommended for directive and albumin injection. My father is not consuming alcohol for the last nine years. We have no idea regarding the reason for the development of ascites suddenly.

He was admitted in the hospital for five days as he was having hiccups continuously there they have inserted many bottles of fluids, glucose, etc., and after a day there was the development of ascites. He has lost much weight, but now he has gained the same due to swelling. Also, help us by guiding how to get relief from intense itching?

#

Hello,

Welcome back to icliniq.com.

As I previously mentioned, it is advanced cirrhosis and now present with ascites. Management includes,

1. Low salt (2 gm), high protein diet.

2. Diuretics.

3. IV Albumin.

4. Removal of fluid through the needle.

Thank you doctor,

Kindly guide regarding the diet to follow, what he can eat or drink for high protein?

#

Hello,

Welcome back to icliniq.com.

For protein, he can take egg white, paneer, dal, and soybean.

Can add protein powders like

1. Hepatic resources

2. Livsource

Take a salt intake of 2 gm per day.

Thank you doctor,

What is the life expectancy if we follow strict low salt diet and diuretics, albumin and water removal. And should we go for shunt placement or liver transplant?

#

Hello,

Welcome back to icliniq.com.

Because the patient is already 65 years old, a liver transplant is probably not possible. With medical treatment, he can live for two to three years if things went smoothly. Some patient can spend up to five to six years.

Thank you doctor,

TIPS or shunt will do a favor for him? Kindly provide a solution for intense itching as he is unable to sleep due to that?

#

Hello,

Welcome back to icliniq.com.

TIPS (transjugular, intrahepatic, portosystemic shunt) will be advised once ascites become resistance to medical treatment. Kindly consult your doctor, and take the treatment with consent.

Tablet Udiliv (Ursodeoxycholic acid) 450 mg twice daily.

Tablet Atarax (Hydroxyzine) 10 mg at bedtime.

Coconut oil can also be used.


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