Acidity and GERD: Beyond the Antacid Bottle
Reaching for an antacid several times a week is not a solution — it is a symptom. Persistent reflux damages the oesophagus and occasionally hides something more serious.
Read articleCirrhosis is permanent scarring of the liver after years of injury from alcohol, viral hepatitis or fatty liver disease. The scarring cannot be reversed, but stopping the cause and treating complications can keep a patient stable for a long time.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- Tiredness, weakness and loss of appetite
- Swelling of the abdomen with fluid, and swelling of both legs
- Yellowing of the eyes and skin
- Easy bruising and bleeding from the gums or nose
- Vomiting blood or passing black stools from varices
- Confusion, disturbed sleep pattern and slurred speech
- Marked weight and muscle loss
When to see a doctor
Do not wait these out
If any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- Vomiting blood or black tarry stools — attend the emergency department at once
- Increasing abdominal swelling, fever or abdominal pain
- Drowsiness, confusion or abnormal behaviour in a known liver patient
- Reduced urine output or rapidly worsening jaundice
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- Liver function tests and clotting profile
- Ultrasound of the abdomen with portal vein Doppler
- Upper gastrointestinal endoscopy to look for varices
- Hepatitis B and C markers
- Kidney function, electrolytes and complete blood count
- Alpha-fetoprotein and imaging surveillance for liver cancer
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- Complete and permanent stopping of alcohol
- Antiviral treatment where hepatitis B or C is the cause
- Salt restriction and diuretics for fluid in the abdomen and legs
- Endoscopic band ligation to prevent or treat variceal bleeding
- Treatment of confusion with lactulose and correction of triggers such as infection or constipation
- Nutrition support and referral for transplant assessment in selected patients
This page is general information, not a diagnosis
Cirrhosis can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the Medical Gastroenterology department. If a symptom is sudden or severe, call 9281862028.
