Alcoholic Liver Cirrhosis: Symptoms, Laboratory Results, and Prescribed Medicines

This article discusses the symptoms, laboratory results, and prescribed medicines for alcoholic liver cirrhosis. It explains how alcoholic cirrhosis leads to symptoms such as ascites, constipation, anorexia nervosa, fatigue, and indigestion. It also analyzes Mr. Cherry's laboratory results and the significance of each result. The article concludes by discussing the purposes of the prescribed medicines and their side effects.

Running Head: ALCOHOLIC LIVER CIRRHOSIS 1
Alcoholic Liver Cirrhosis
Name of Student
Institutional Affiliation

ALCOHOLIC LIVER CIRRHOSIS 2
Alcoholic Liver Cirrhosis
How Alcoholic Cirrhosis Leads to Mr. Cherry’s Symptoms
Liver cirrhosis is the main cause of ascites. Generally, ascites portrayed in Mr.
Cherry’s symptoms is a mixture of the high pressure in the veins that are found in the liver
and a reduction of liver functions caused by damaging of the liver (Glanz, Rimer and
Viswanath, 2015). A lot of the patients who are affected by the ascites develop abdominal
swelling just as portrayed by Mr. Cherry’s abdominal pains. Also, another symptom
considered to be a factor triggering encephalopathy in alcoholic cirrhosis patients is
constipation. Constipation involves the withholding of wastes in the gut and reabsorption of
harmful material such as ammonia. Anorexia nervosa is also another significant symptom of
liver cirrhosis which is characterized by weight gain. The damage of the liver with a slight
increase in hepatic enzymes is a normal steatosis and complication of the liver considered to
be the main cause (Glanz, Rimer and Viswanath, 2015). This explanation describes the
reasons for Mr. Cherry’s regular episodes of anorexia.
Generally, different liver disorders and gall bladder can disrupt the bile actions
hindering the appropriate breakdown of fats in the gut. For instance, this incidence can take
place in people with liver cirrhosis and gallstones. Consequently, the malabsorption of the
acid often leads to loose stools or diarrhoea (Foxall and Blackburn, 2008). This description
explains why Mr. Cherry had some episodes of diarrhoea. Fatigue is also one of the
debilitating and common symptoms of individuals suffering from liver cirrhosis. Fatigue is
common to different types of liver diseases which range from chronic Hepatitis C to Primary
Biliary Cirrhosis. In some patients such as Mr. Cherry, fatigue may be the main reason for
pursuing medical attention while in others fatigue may begin a number of years after they are
diagnosed with liver cirrhosis. Thus, Mr. Cherry felt unusually tired after engaging in
minimum exercise such as walking due to fatigue as a symptom of liver cirrhosis. Indigestion

ALCOHOLIC LIVER CIRRHOSIS 3
is another body function which is often affected by liver cirrhosis. This incidence occurs
because liver cirrhosis interrupts the ability of the liver to generate bile which is often used in
the digestive system to assist in vitamin and fat absorption (Foxall and Blackburn, 2008). For
this reason, indigestion may lead to the deposition of fats which eventually results in weight
gain or overweight. In Mr. Cherry’s case, alcoholic cirrhosis affected the ability of his liver to
make bile used for fat digestion and that why he had enlarged or distended abdomen.
The significance of Mr. Cherry’s Laboratory Results
The normal fasting blood sugar is about 5.6 micromol/L. Any level between 5.7
micromol/L and 7.0 micromol/L can indicate signs of pre-diabetes. Mr. Cherry’s 5.7
micromols/L may be an indication he could develop type 2 diabetes if he did not make
important changes in his lifestyle.
The normal haematocrit level of an adult male ranges from 42% to 54%. Mr. Cherry’s
39% means that the level of his red blood cells is lower than the limits of a normal male
adult.
Prothrombin time (PT/INR) refers to the clotting factors often produced by the liver.
This test analyses the function of clotting and its outcomes may be elongated by alcoholic
cirrhosis (Garcia-Tsao et al., 2016). In Mr. Cherry’s case, his PT/INR was 4.0 against the
normal range of between 0.8 and 1.2.
Bilirubin refers to a waste material that results from the breakdown of red blood cells.
Ordinarily, bilirubin is always processed by the liver. Before the excretion of bilirubin
through someone’s stool, it always passes through the liver. The normal bilirubin level
generally ranges from 2 to 17 micromol/L (Bullock & Hales, 2017). Mr. Cherry’s total
bilirubin levels were 24.3 micromol/L. Therefore, Mr. Cherry’s impaired liver could not
process the bilirubin properly leading to its high level in the blood.

ALCOHOLIC LIVER CIRRHOSIS 4
Alkaline Phosphatase (ALP) refers to the enzyme found in bile ducts, liver, and
bones. Typically, the test of ALP is usually carried out in conjunction with other tests. The
normal level of ALP ranges from 30 to 120 U/L (Bullock & Hales, 2017). Mr. Cherry’s level
of ALP is 288 U/L. The higher level of his ALP indicates that there may have been blockage
of bile ducts and liver inflammation.
Aspartate transaminase (AST) is an enzyme located in different parts of the body, the
liver being inclusive. Since there are no specific levels of AST that indicate liver impairment,
it is always tested in conjunction with ALT to identify if there are any liver damages (Wigen,
Fumiko and Karacas, 2016). Mr. Cherry’s AST was 54 U/L against the normal AST level
which ranges from 0 to 35 U/L. These results indicate that the damage to Mr. Cherry’s liver
led to the release of AST into his blood stream.
Alanine transaminase (ALT) is used by the body in protein metabolism. Mr. Cherry’s
Alanine transaminase (ALT):56 U/L is elevated. The normal level of Alanine transaminase
(ALT) ranges from 0 to 45 U/L (Wigen, Fumiko and Karacas, 2016). The reason for this
elevation is due to the damage of the liver by alcoholic cirrhosis hence impairing its proper
functioning. The malfunctioning of the liver releases the ALT into the blood hence the
elevation. Thus, the higher level of Mr. Cherry’s ALT in blood indicates a sign of liver
impairment.
Serum albumin refers to the main protein generated by the liver. It has several
functions which encompass tissue nourishment, conveyance of vitamins, hormones and other
substances in the body, and stopping fluid leakages in the blood vessels (Glanz, 2008). Mr.
Cherry’s Serum albumin level was 22 g/L (Glanz, 2008). However, the normal level of
Serum albumin ranges from 40 to 60 g/L. A test for albumin usually indicates the ability of
the liver to generate particular proteins. Therefore, Mr. Cherry’s low Serum albumin results
indicate that his liver was not functioning properly.

ALCOHOLIC LIVER CIRRHOSIS 5
Purposes of the Prescribed Medicines for Mr. Cherry
The B-Dose 2millilitres injection has vitamins B1, B2, B3, B5, B6, and B12. The
respective vitamins have ingredients as shown below:
B1, B2, B3, B5, B6, and B12 contain Thiamine hydrochloride, Riboflavine sodium
phosphate, Nicotinamide, Dexpenthenol, Pyridoxine hydrochloride, and Cynocobalamin
respectively (Sami et al., 2014). The body requires the B vitamins for normal metabolism in
the cells encompassing energy production. Alcoholism can result in a diet that lacks the B
vitamins. The efficient metabolism of alcohol in liver cells needs the B vitamins, particularly
the thiamine hence the prescription of thiamine 100 milla igrams per day after the IV infusion
of the B-Dose was ceased.
Aldactone is used to treat edema (fluid retention) which may be caused by liver
problems, heart failure and kidney disorders (Das, McGuire & Rangasamy, 2015). Aldactone
also treats hypertension by lowering the blood pressure.
Hydrochlorothiazide is part of the medications called diuretics (Qavi, Kamal and
Schrier, 2015). It also treats hypertension and is used to reduce edema (fluid retention) often
caused by cirrhosis of the liver, heart failure, and kidney problems. It lowers the blood
pressure (Garcia-Tsao et al., 2016). Mr. Cherry’s blood pressure was pre-high (136/76 mm
Hg) and that is the reason why hydrochlorothiazide and aldactone were prescribed for him.
Folic acid was prescribed for Mr. Cherry because it is used for conditions related to
folate deficiency which is often caused by alcoholism, liver disease, kidney dialysis, and
ulcerative colitis. Thiamine pyrophosphate, on the other hand, is a biologically active
thiamine form and is an important cofactor used in glucose aerobic breakdown (Qavi, Kamal
and Schrier, 2015). The wernicke-korsakoff syndrome is a common neurologic condition
associated with thiamine deficiency (Isenberg-Grzeda et al., 2016). The chronic use of

ALCOHOLIC LIVER CIRRHOSIS 6
alcohol is among the common influencing factors for Wernicke-Korsakoff syndrome and this
explains why Thiamine pyrophosphate was prescribed for Mr. Cherry. Mylanta 20 ml po qid,
is always used in the treatment of stomach acid accumulation such as acid indigestion,
heartburn, and stomach upset symptoms. The drug has magnesium and aluminium that work
rapidly to reduce the stomach acid (Brown, 2014). Generally, antacids which are in liquid
form work more efficiently that capsules or tablets. Pheniramine maleate (Avil)) 1 tablet po
tds is used for bowel sounds and that was why it was prescribed for Mr. Cherry who had a
distended abdomen with decreased bowel sounds in all quadrants.
Side Effects
The B-Dose injection assists most of the patients but it can also lead to some
undesirable side effects in some people. Mr. Cherry could experience the following side
effects of the B-Dose injection. First, he could be susceptible to fatigue, heartburn, sore
throat, headache, hives, sleepiness, skin irritation and bruising around the injection area,
numbness in the feet or hands and slight vomiting, nausea, appetite loss, and abdominal pain.
Also, the B-Dose injection has some serious side effects which encompass muscular
paralysis, bleeding, extended stomach pain, failure to focus eyes, scaling of the skin
especially in the face area, blue skin discolouration, severe hypersensitive reactions,
prolonged vomiting and nausea, low blood pressure and prolonged drowsiness or dizziness
(Isenberg-Grzeda et al., 2016). The side effects are normally mild but they can be severe.
Spironolactone also has some side effects which include diarrhoea, vomiting, mild
nausea, breast tenderness or swelling, leg cramps, impotence, dizziness, mild drowsiness, and
headache. Spironolactone has no specific and complete list of side effects and therefore, the
patient should always contact the doctor for further advice (Akpek et al., 2015).
The common side effects of hydrochlorothiazide include muscle spasms, constipation,
diarrhoea, headache, dizziness, appetite loss, vomiting, and nausea while the serious side

ALCOHOLIC LIVER CIRRHOSIS 7
effects of thiamine include bloody, tarry or black stools, the feeling of inadequate breath,
chest pains, and blue coloured lips (Momeni et al., 2013). The patient may also vomit or
cough up blood that appears like coffee grounds. The less serious side effects of thiamine
encompass restless feelings, slight itching or rashes, a hard lump or tenderness at the site of
thiamine injection, warmth feeling, sweating, tight throat feeling and nausea. Just like the
other drugs, the thiamine side effects are not exact and others may also occur (Brown, 2014).
Folic acid is possibly safe for most of the patients when orally ingested through the
mouth into the body. Most of the adults do not have any side effects when they use doses of
less than 1000 mcg per day (Huo et al., 2015). However, the drug is possibly not safe when
orally ingested in long-term large doses. Some of the side effects of high doses of folic acid
include behaviour changes, stomach upset, skin reactions, excitability, seizures, gas, nausea,
sleep disorders, confusion, diarrhoea, rash, and abdominal cramps. Therefore, it is highly
risky to take high doses of folic acid. For instance, doses ranging from 800 to 1200 mcg may
increase the vulnerability of heart attack in patients with heart difficulties (Huo et al., 2015).
Also, the high doses of folic acid may increase the risk of cancer cases such as prostate and
lung cancer.
Pheniramine maleate (Avil) has some serious side effects which encompass
hallucinations, vision difficulties, irregular heartbeats, serious restlessness, confusion, and
sedation. The drugs can also change the mood of a person, result in fainting, hives, jaundice,
and swelling of the mouth, throat, lips, and face. Swelling of the throat may lead to problems
in breathing and swallowing (Colak et al., 2014). The drug also has some common side
effects which include vomiting, nausea, dizziness, drowsiness, tinnitus, irritability,
nervousness, lack of concentration and incoordination (Colak et al., 2014). In the case of
serious side effects, the patient should seek urgent medication from the doctor.

ALCOHOLIC LIVER CIRRHOSIS 8
Just like the other drugs discussed above, Mylanta has various serious side effects
which include blood problems including reduced platelet count, reduced the count of white
blood cells and escalated levels of eosinophils. Also, Mylanta may result in delayed or
immediate allergic reactions or hypersensitivity, serious and possible life threatening skin
allergies like the Stevens-Johnson syndrome and Anaphylaxis. Anaphylaxis refers to a life
threatening hypersensitive reaction that may lead to breathing difficulties, low blood pressure
problems and breaking out of the skin in hives (Lieberman et al., 2015). Mylanta also has
some common side effects which include hive or rashes, thrush (oral yeast infection),
infected or swollen tongue, black and hairy tongue, nausea, diarrhoea, and vomiting.
Conclusion
This essay has addressed Mr. Cherry’s alcoholic cirrhosis signs and symptoms,
elaborated the significance of his laboratory results, discussed the reasons for the prescribed
medication and lastly, addressed the overall adverse or side effects of the prescribed
medication. Some of the effects of liver cirrhosis that were portrayed by Mr. Cherry were a
distended abdomen, fatigue, indigestion, constipation, anorexia and ascites. The essay
analysed them basing on the significance of lab results and the use of the prescribed
medicine.

ALCOHOLIC LIVER CIRRHOSIS 9
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