Hepatitis C
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Articles by
Dr. Zhang
 
TCM and MCM Theory Related to Common Liver Disease Blood Test Markers

Low Dose Interferon Patient Experiment

Hepatitis A Prevention Reminder

Hepatitis: Causes of Pain in Liver Region 

The Need to Monitor Your Chronic Hepatitis

Liver Enzyme Fluctuation during Allergy Season 

What are the Serum Markers of Hepatitis B and What do They Mean?

Enterogenous Endotoxemia in Chronic Hepatitis–
Part 2

Enterogenous Endotoxemia in Chronic Hepatitis–
Part 1
 

Chronic Hepatitis and "Blood Activating and Stasis Expelling" (BASE) Therapy -
Part 2

Chronic Hepatitis and "Blood Activating and Stasis Expelling" (BASE) Therapy
Part 1

What Causes Gastrointestinal Bleeding in Cirrhotic Liver Disease

Dietary Support for Cirrhotic Liver Diseases

Ascites - A Complication of De-Compensated Liver Cirrhosis

Liver Cirrhosis - Portal Vein Hypertension Complications

Liver Cirrhosis Overview

PG-IFN and Ribavirin Treatments

Antibiotics and Chronic Liver Diseases

Why is Alcohol Harmful for People with Hepatitis?

Co-infections and Super-infections of Viral Hepatitis

Beware of Medications That Can Cause Liver Damage

Bile Retention and Its Clinical Manifestations (MCM) part 4

Modern Chinese Medicine (MCM) Part 3 
Jaundice and Chronic Viral Hepatitis

Modern Chinese Medicine (MCM) Anti-Liver-Fibrosis Treatments - Part 2

Modern Chinese Medicine (MCM) Anti-Liver-Fibrosis Treatments - Part 1

What is Liver Fibrosis and How is It Different from Cirrhosis?

How does the liver change as we get older?

How is that my LFTs are so good when my viral load is seemly so high?

Comprehensive Care for Chronic Viral Hepatitis

What can Cause Liver Inflammation?  

What Are the Major Functions that the Liver Carries?


 





What Causes Gastrointestinal Bleeding in Cirrhotic Liver Disease?

In advanced stage of cirrhotic liver disease, upper gastrointestinal bleeding is the most serious and life-threatening complication and must be treated immediately. For those patients already found to have varices in the esophagus and stomach, prevention of bleeding is very important. In order to prevent this serious complication, we must know what the major causes are.

The following is a general list:

1. Rupture of varices in the esophagus and stomach -
When this happens, the level of bleeding can be quite severe and ensue in large quantities. The physical sign that often occurs is a sudden vomiting of blood and stools becomes a shiny black color. The patient may experience hypotensive shock and hepatic encephalopathy. Without immediate medical attention, the condition can turn fatal. Some preventive measures for a patient with varices are to eat soft foods, eat slowly, and chew very thoroughly before swallowing.
In addition, avoid excessive coughing, sudden increases of pressure in the stomach, and keep regular bowel movements.

2. Refluxing esophagitis -
The sphincters in the lower end of the esophagus can become loose during ascitic cirrhotic disease. As a result, refluxing esophagitis is a common complication of cirrhotic liver disease and inflammation of the esophagus can trigger varices bleeding. To prevent this condition, ascites and acid reflux must be actively treated.

3. Acute stomach membrane lesion (AGML) -
AGML is an acute erosive inflammation of the stomach membrane and cirrhotic liver disease can often cause this condition. When there is hypertension in the portal vein, there are excessive H+ ions that diffuse to the lower end of esophagus that can cause rupture of the varices. It is very important to actively treat AGML to prevent the possibility of bleeding.

4. Peptic ulceration -
Portal hypertension changes the microcirculation and dynamics of blood circulation in the stomach membrane. These changes cause blood stagnancy in the stomach membrane as the inflow of blood from the arteries become greater than the outflow through veins in the stomach membrane. This stagnancy of blood can cause thrombosis, swelling, and ischemia. Stomach acids and infectious agents can then attack and erode the membrane, causing ulceration and bleeding.

5. Reduction in blood coagulation factors -
Damaged liver functions can interfere with the synthesis of blood coagulation factors. As a result, blood coagulation factors such as factor VII and VIII will drop in number and prolong the PT and PTT. An enlarged spleen causes a decrease in platelet count and even minor bleeds can lead to severe bleeding, as the coagulation mechanism cannot function properly.

Since bleeding is a serious condition, the patient should be rushed to the nearest hospital for emergency care.
For preventative care, we use Yunan Paiyao Capsule for general gum and nose bleeds. For bleeds in the esophagus and stomach, we use Rhubarba (Rhei Rhizoma) and Bletilla (Bletillae Rhzoma).

 

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About HCV
Overview
Causes and Transmission

 
Diagnostic Tests
Antibody
HCV RIBA
HCV RNA 
Viral Load

Viral Genotyping

 
Major Signs
Liver Inflammation
Fibrosis
Cirrhosis

 
Peripheral Signs and Symptoms
Fatigue
Jaundice
Bile Retention
Joint Pains and Skin Rashes
Blood Sugar Instability
Portal Vein Hypertension
Ascites

 
Important Liver Function Test Markers
Overview
ALT and AST
ALP and GGT
Albumin
Bilirubin
PT (Prothrombin Time)
 
Liver Biopsy
Overview
Procedure
Inflammation Grade
Fibrosis Stage
 
Interferon Based Treatment
Overview
Ideal Candidate
Possible Side-effects
 
Liver Support with TCM
Overview
Liver Enzymes
Serum Albumin
Blood Clotting Factors
Bile metabolism
GGT
 
Dietary Considerations
Overview
Proteins
Essential Fats
Carbohydrates
Vitamins
 
 

 


 

 

Medical Information Sources:
http://www.nih.gov/
http://www.nlm.nih.gov/

http://nccam.nih.gov/
http://www.medlineplus.org/


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