Treatments for Primary biliary cirrhosis
Treatments for Primary biliary cirrhosis
The list of treatments mentioned in various sources
for Primary biliary cirrhosis
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Vitamin supplements
- Calcium supplements
- Hormone therapy
- Symptomatic medicinations
- The goals of treatment are to slow the progression rate of the disease and to alleviate the symptoms (eg, pruritus, osteoporosis, sicca syndrome). Liver transplantation appears to be the only life-saving procedure
Primary biliary cirrhosis: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Primary biliary cirrhosis may include:
Hidden causes of Primary biliary cirrhosis may be incorrectly diagnosed:
Primary biliary cirrhosis: Research Doctors & Specialists
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Drugs and Medications used to treat Primary biliary cirrhosis:
Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment
or change in treatment plans.
Some of the different medications used in the treatment of Primary biliary cirrhosis include:
Medical news summaries about treatments for Primary biliary cirrhosis:
The following medical news items
are relevant to treatment of Primary biliary cirrhosis:
Discussion of treatments for Primary biliary cirrhosis:
Treatment may include taking vitamin and
calcium supplements, hormone therapy, and medicines to relieve symptoms. A
liver transplant may be necessary if the liver is severely damaged.
(Source: excerpt from
Primary Biliary Cirrhosis: NIDDK)
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Ascites:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Treatment is directed at underlying cause
-
Bed rest, fluid, sodium restriction is the first line
-
Diuretics: Careful use in selected cases
-
Chylous ascites
–High-protein, low-fat diet supplemented with medium-chain triglycerides
–Parenteral nutrition may be needed to decrease lymph flow and supplement nutrition
–Laparotomy may be indicated for failed dietary management, to seal leak site
-
Surgical intervention: Bile or urine ascites
-
Therapeutic paracentesis: May be repeated to relieve respiratory distress or impending umbilical rupture
-
Portacaval shunt or a peritoneovenous shunt (LeVeen) for intractable ascites
–Shunt between peritoneal cavity and superior vena cava
-
Transjugular intrahepatic portosystemic shunt (TIPSS) for cirrhosis while awaiting transplantation
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Cirrhosis and fibrosis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment is designed to remove or alleviate the underlying cause of cirrhosis or fibrosis, prevent further liver damage, and prevent or treat complications. The patient may benefit from a high-calorie and moderate- to high-protein diet, but developing hepatic encephalopathy mandates restricted protein intake. In addition, sodium is usually restricted to 200 to 500 mg/day and fluids to 1 to 1½ qt (1 to 1.5 L)/day.
If the patient’s condition continues to deteriorate, he may need tube feedings or total parenteral nutrition. He may also need supplemental vitamins — A, B complex, D, and K — to compensate for the liver’s inability to store them and vitamin B12, folic acid, and thiamine for deficiency anemia. Rest, moderate exercise, and avoidance of exposure to infections and toxic agents are essential.
Drug therapy requires special caution because the cirrhotic liver can’t detoxify harmful substances efficiently. When absolutely necessary, vasopressin may be prescribed for esophageal varices, and diuretics may be given for edema. However, diuretics require careful monitoring because fluid and electrolyte imbalance may precipitate hepatic encephalopathy. Encephalopathy is treated with lactulose. Antibiotics are used to decrease intestinal bacteria and reduce ammonia production, which causes encephalopathy. Coagulopathy may be treated with blood products or vitamin K.
Low-protein diets are controversial. They aid in managing acute hepatic encephalopathy but are rarely necessary in chronic conditions because of the underlying protein-calorie malnutrition.
Paracentesis and infusions of salt-poor albumin, in addition to fluid and salt restriction, may alleviate ascites. Surgical procedures include treatment of varices by upper endoscopy with banding or sclerosis, splenectomy, esophagogastric resection, and splenorenal or portacaval anastomosis to relieve portal hypertension. (See Portal hypertension and esophageal varices, page 758, and Circulation in portal hypertension, page 759.)
Alert If cirrhosis progresses and becomes life-threatening, a liver transplant should be considered.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Cirrhosis:
Treatment
(Handbook of Diseases)
The goals of treatment include removing or alleviating the underlying cause of cirrhosis or fibrosis, preventing further liver damage, and preventing or treating complications.
Dietary measures
The patient may benefit from a high-calorie and moderate- to high-protein diet, but if the patient develops hepatic encephalopathy, protein intake must be restricted. In addition, sodium is usually restricted to 400 to 800 mg/day; fluids, to 1,000 to 1,500 ml/day.
If the patient’s condition continues to deteriorate, he may need tube feedings or hyperalimentation. Other supportive measures include supplemental vitamins — A, B complex, D, and K — to compensate for the liver’s inability to store them and vitamin B, folic acid, and thiamine for deficiency anemia. Rest, moderate exercise, and avoidance of exposure to infections and toxic agents are essential.
Drug therapy
With cirrhosis, drug therapy requires special caution because the cirrhotic liver can’t detoxify harmful substances efficiently. Alcohol is prohibited; sedatives should be avoided or prescribed with great care. Acetaminophen is especially hepatotoxic, particularly when combined with alcohol.
When absolutely necessary, an antiemetic, such as trimethobenzamide or benzquinamide, may be given for nausea; vasopressin, for esophageal varices; and a diuretic, such as furosemide or spironolactone, for edema. However, if the patient receives a diuretic, careful monitoring is necessary; fluid and electrolyte imbalance may precipitate hepatic encephalopathy.
Vitamin K may be given for bleeding tendencies due to hypoprothrombinemia. Transfusion of blood and fresh frozen plasma may also be necessary.
A beta-adrenergic blocker may be given to decrease pressure from varices.
Lactulose may be given orally or rectally to reduce a high ammonia level. If lactulose therapy alone is inadequate, neomycin may be used.
Other treatment
Paracentesis and infusions of salt-poor albumin may alleviate ascites. Surgical procedures include ligation of varices, splenectomy, esophagogastric resection, and splenorenal or portacaval anastomosis to relieve portal hypertension.
Clinical tip Transjugular intrahepatic portosystemic shunt is an alternative to surgical shunting in patients with variceal bleeding refractory to standard therapy. It’s also helpful in patients with severe ascites. The technique involves insertion of an expandable metal shunt between a branch of the hepatic vein and portal vein over a catheter inserted via the jugular vein. This is usually a bridging mechanism to control variceal bleeding or ascites until liver transplantation can be performed.
Hepatorenal and hepatopulmonary syndromes may occur. Treatment is ineffective except in patients who are acceptable candidates for liver transplantation.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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