Symptoms of ESLD

Patients with ESLD (End-Stage Liver Disease) experience a wide array of symptoms which most caregivers are unfamiliar with and do not know how to handle. Over the next few weeks we will attempt to cover all of the major symptoms and complications that ESLD patients face. It is our hope that by providing this information in a simple non-technical language, we can calm the fears of the patient and arm the caregiver(s) with the tools they need to be able to care for their loved one and maintain their own sanity at the same time.

Symptoms of ESLD include:

     *portal hypertension
     *esophageal varices
     *ascites
     *hepatic encephalopathy
     *asterixis
     *fetor hepaticus

Along the way I will be sharing some of the experiences that my family and I have had while caring for my mother. My mom's doctor told us in the beginning that this diaease is too much for family members to handle and that we would eventually have to let outside professionals take over with her care. He was right. I hope that families dealing with this disease in the future will read this and hopefully be better prepared for what they will face than we were. If I can help one family have an easier time coping with ESLD then all of the pain and stress will have been well worth it and hopefully others can learn from what my mother has gone through.

Esophageal Varices

Esophageal varices occur in patients with severe liver damage and portal hypertension. Because blood can no longer flow into the liver, it is forced back through the portal vein and into the smaller blood vessels that wrap around the stomach and esophagus. These blood vessels are meant to handle small volumes of blood at a time and when blood is forced into them backwards it causes them to fill and balloon outward. The walls of these smaller blood vessels are much thinner than the walls of larger veins and arteries. This makes it very likely that with little force they will bust open and bleed. This condition can be very dangerous and must be treated quickly to avoid shock and possibly death.

Signs of Esophageal Varices

     *paleness
     *light-headedness
     *bloody stools
     *black, tarry stools
     *vomiting and/or coughing up blood

If any of the above symptoms are noticed, the patient should seek medical attention immediately. A medical professional will be able to take steps to control and stop the bleeding.

In order to stop the bleeding, a doctor may use an instrument called an endoscope. An endoscope is a small lighted tube that is inserted through the mouth and into the esophagus to allow a physician to identify which blood vessels are bleeding. They can then inject a drug used to induce clotting directly into the bleeding varices. They can also wrap small bands around the blood vessels to stop the flow of blood. Doctors may then administer drugs, such as vasopressin, which tightens blood vessels to control future occurrences of bleeding.

My Story

When my mother began to experience problems with esophageal varices we had no idea what was happening. She would wake up in the middle of the night, vomiting up large amounts of blood. She lost so much blood she became very weak. Within a couple of days esophageal banding was done at the hospital and we were able to bring my mom home that same afternoon. From this point, her doctor began evaluating her for the TIPS (Transjugular Intrahepatic Portoststemic Shunt) procedure to prevent any further occurrences of esophageal varices due to portal hypertension.

If you or a loved one are experiencing bleeding or any of the other symptoms listed above, please do not waste any time. When losing large amounts of blood, time is not on your side.