Ascites with cirrhosis

  1. Hi all! I am not sure where to ask this question, so general forum seemed like a good place to start. I am still in my pre-nursing part of my studies so some of this info is unfamiliar to me.

    My FIL has been admitted to the hospital again, this time he began passing blood with BM, reddish in color, not black. Dr advise the family of Ascites, a complication of his cirrhosis. They drained fluid from his abdomen today, and will know more in the AM. I am researching ascites in relation to cirrhosis on the web, and the info I am finding is pretty bleak. Several references I have found indicated a 40% mortality rate in 2 years after hospitilization for ascites. I am curious, from a nursing perspective, is this fairly accurate? Can anyone share any sites that can give a clear picture of the disease progression from this point? It seems to me this is becoming an end stage in his disease progression from what I have read.

    Thanks in advance.
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    About WickedRedRN

    Joined: Feb '04; Posts: 999; Likes: 341
    RN, ER; from US
    Specialty: 4 year(s) of experience in ER/Trauma

    7 Comments

  3. by   leslie :-D
    hi lori,

    very sorry about your fil.
    and yes, it is true, the development of ascites in cirrhosis is indicative of the liver decompensating....prognosis is poor.
    i don't have any stats and there are temporary interventions such as paracentesis and shunts but these are only temporary measures.
    is he on a transplant list?

    again, i'm sorry if this isn't the answer you were looking for.

    wishing you and yours peace.

    leslie
  4. by   WickedRedRN
    Leslie,

    Thanks for the reply, sadly, he is in his 70's which excludes him from the list. He is in good spirits, but has had 2 other hospitilizations in since November, both times he was extremely disoriented. I think after some of my reading this was related to his disease process, but I will ask the doctor next time we see him.
  5. by   leslie :-D
    Quote from LoriRN2B
    Leslie,

    Thanks for the reply, sadly, he is in his 70's which excludes him from the list. He is in good spirits, but has had 2 other hospitilizations in since November, both times he was extremely disoriented. I think after some of my reading this was related to his disease process, but I will ask the doctor next time we see him.
    in advanced liver disease, it can cause a 'hepatic encephalopathy' which you might want to ask your doctor about...
  6. by   Tony35NYC
    Today I took care of a patient who has this same condition. According to the doc, ascites from cirrhosis has about a 3-year mortality rate of 50% or less. If it is refractory, the time drops to about 1 year. The doc is convinced that this pt will not leave the hospital alive, and that he really doesn't have too much longer to go. No matter how much fluid they take off the guy it comes back, and his abdomen is so overdistended that you would have to see it with your own eyes to believe it. This pt is doing so bad that they brought him from med-surg to the ICU several days ago, and nothing the MDs do seems to make even a bit of difference.

    But, I doubt there's a quick and easy explanation about the progress of cirrhosis with ascites because it can present with different complictions in different people, depending on the exact cause and the pt's overall health status.
  7. by   Tweety
    I'm sorry about your FIL. My experience is similar in that I've seen ascites, especially if it's large enough to need to be drained, to be and end-stage condition. At this point md's usually just treat symptoms and try to keep the patient comfortable. The process of course is different in different patients, many live somewhat comfortablly for extended periods of time.
  8. by   WickedRedRN
    Everyone thank you for the responses! The Dr was very helpful and very straightforward with the family in understanding the condition. He will be dc'd on Friday, new meds to help improve liver function, more dietary restrictions, etc. but as MD said, no guarantee in this disease. He did say the previous admissions with the disorientation were most likely hepatic encephalopaty. He said the most they can do is treat his symptoms as they occur and some pts can live for a good length of time. They will be having a Visting Nurse coming in to keep check on him, the goal is to let him be at home for as long as possible.

    My husband feels as though he has been given a gift of time, and I have no doubt they will make the best use of it they can.

    Thank you to all for the prayers and words of kindness. Words cannot express how wonderful a group this is. Peace to everyone.
  9. by   leslie :-D
    i'm so sorry lori.
    the watching, waiting and wondering are so stressful but can also be extremely bonding and memorable.

    these and other situations always remind me of everyone of us being on borrowed time.
    if it's any consolation, hepatic encephalopathy is a very peaceful way to go.

    again, my heartfelt prayers to you and yours.

    leslie

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