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What are some of the declining stages of Cirrhosis. My husband has cirrhosis and when I ask the Dr. what to expect and watch for he gives me very little answers. He did say balance would be a factor, which he already has trouble walking due to balance, but he, nor the internet, give me much more information. If anyone out there has been through this, please let me know what to watch for. I have noticed he gets confused a lot and can't see something right in front of him. Does this possibly lead to Alzheimer's or Dementia? Thank you.

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Yes, your husband could have Dementia type symptoms because of the toxins being released from the liver. A Neurologist cannot help with this because it not Neurological. The final stage is the stomach extending and he will look pregnant. At a point Hospice should be called in.

So sorry you and your husband are going thru this.
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lealonnie1 Sep 2022
True, a neurologist is not what is needed, but a Hepatologist. Ascites is the fluid build up in the abdomen between the two layers of the peritoneum that causes the stomach to distend, but can happen before the final stages of cirrhosis, too. That fluid can be treated with a low salt diet and diuretics, or sometimes Paracentesis is required to remove the fluid build up if the other treatment doesn't work; Paracentesis is a short surgical procedure whereby a needle is inserted into the abdomen to remove the fluid. Our group members had quite a few of those procedures done successfully.

OP, watch out for your DH's stomach to distend and his ankles/legs (and nausea/vomiting) to get swollen which is a sign of ascites building up in his abdomen. Call the doctor if you see that happening.
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There is a massive amount of information on the internet. The key is to type in the correct search words about exactly what you want to know. When you seach title your search: "Prognosis in cirrhosis of the liver".
This will tell you about the course of the disease, the symptoms to expect, the averages in life expectancy.
Do know that your husband's own doctor is the best judge of his particular course or the disease due to the fact he is the one who has the overall knowledge of your husband's health, age, condition, muscle strength and tone, current symptoms of disease, lifestyle and etc.
Every patient, no matter WHAT disease they are dealing with, will have a course of that disease that matches and often bears NO resemblance to the course of the disease in another person. Patients are as individual as their own fingerprints in the manner in which they themselves and their own bodies deal with disease.
I sure do wish you both good luck. Be proactive in a healthy lifestyle to the extent you are able; that will help ever so much.
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My DH had cirrhosis (non alcoholic) and had a liver transplant at the Mayo Clinic in April. He was still fairly asymptomatic, but had enough symptoms to where his lifestyle was compromised. Ie: chronic gas, diarrhea, body/breath odor, varices that weren't yet to the stage where surgery was needed, anemia, and very low blood platelet counts to the point where he needed a few transfusions. His cirrhosis had also caused liver cancer which was ablated successfully, but it was just a matter of time before it returned. If your DH is having mental confusion, that is known as hepatic encephalopathy in some cirrhosis patients and isn't defined as 'dementia' per se, but something related TO the cirrhosis.

Here is an article about the stages of cirrhosis and what to expect:

https://www.medicinenet.com/what_are_the_4_stages_of_cirrhosis_of_the_liver/article.htm

And an article from The Mayo Clinic on Cirrhosis, and the care & management of it:

https://www.mayoclinic.org/diseases-conditions/cirrhosis/diagnosis-treatment/drc-20351492

While at the Mayo, we had a group of about 12 of us, 6 being liver transplant patients with cirrhosis, some alcoholic cirrhosis patients, who all had quite horrible stories about their disease prior to coming to Mayo for a transplant. One gentleman had such bad encephalopathy incidents that he crashed his car 3x while driving due to blacking out. 2 were wheelchair bound and wearing Depends due to being on Lactulose and having uncontrolled diarrhea. Several were hospitalized many times for surgical removal of varices in the esophagus which are common with cirrhosis.

At the very least, your DH (and you) need a Hepatologist  who will help you understand this disease, manage it, treat it, and deal with it as it's terminal if he's not transplanted. My DH was on the transplant list for over 1 year before we were called down to Phoenix to wait for a donor. IDK if your DH is a viable candidate for transplant at his age *and if he's willing to stop drinking 100%*? Has he spoken to his Hepatologist about it? Does he have a course of treatment lined up? You need to have that lined up, and a doctor you both trust to answer your questions about the difficult road ahead.

Wishing you the best of luck and Godspeed as you navigate this journey together.
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MACJHB Sep 2022
The Mayo site helped me know what to watch for. He refuses to quit drinking and got upset when I told him I had talked to his Dr. asking what to expect. We aren't married but have been together 22 years and call each other husband and wife and I think I overstepped when I talked to the Dr. but the Dr. talked to me in general about cirrhosis and what happens. I believe he may be getting into dementia. This is what I went through this morning. His light was on, I went in to check on him, he’s laying in bed propped up on his elbow smoking a cigarette.  I ask if he’s ok.  He said yes and then asked me “doesn’t anyone work here?”  I said what and he said it again.  I asked what he was talking about and he said “I haven’t seen a waitress since I’ve been here.”  I told him he was at home not at a restaurant and asked what’s wrong with him and he said “I don’t know, I must be going crazy.”  I'm a very light sleeper and don't go to sleep until he's asleep. My dog actually alerts me to his light coming on if I am asleep. If anyone knows of other affects I need to watch for, please let me know.
Martha
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If his doctor hasn’t suggested it, you should bring it up - a consult with a neurologist.
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