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Things To Consider About Treatment

There are many different options for treating liver disease and its symptoms. Your doctor will discuss which are most suitable with you and seek your consent. It is important that you ask questions about the treatment before you give your consent.

  • What are the risks and benefits of each option to me? 
  • Are there any potential side effects? 
  • Which is the most suitable for me and why? 
  • How long will the treatment last? 
  • What is the success rate? 
  • What role can I play in making the most of the treatment? 
  • When and how should I take particular medications?

If you are in any doubt, ask your medical team to explain. If you would like more time to consider a treatment, perhaps to discuss it with your family, mention this to your doctor.

It is important to remember that there is no simple cure for most liver diseases. Your doctors will do their best to find the most effective treatments for your condition. Be patient and work with them to manage your condition as much as possible. Understanding your own liver condition will help you to manage your daily life.

Relieving symptoms

There are treatments for many of the symptoms of liver disease, such as itching, ascites (fluid retention in your abdominal area), and hepatic encephalopathy (sleepiness, shaking and other mental symptoms). Tell your doctor if any symptoms are troubling you so that they can arrange effective treatment. 

New treatments

There are new medicines and treatment options in development for many liver diseases. Before these can be used routinely they have to go through rigorous tests for safety and to check they work. In some cases, it may be possible to be part of a clinical trial. This carries certain risks and you should discuss these carefully with your doctor.

An organisation called NICE (National Institute for Health and Clinical Excellence) looks at new medicines and other techniques, and produces recommendations to the NHS. It has produced guidance on several treatments for hepatitis B and hepatitis C. If one of these treatments is recommended by NICE and is suitable for you, you are entitled to be prescribed it regardless of cost. There are other bodies producing guidance for Wales (All Wales Medicines Strategy Group) and Scotland (Scottish Medicines Consortium).

Patients often find information about treatments on the internet or in the media. It is important to be cautious about the promises these make. Some have not passed the tests for safety, quality and effectiveness that the UK requires. In other cases, the treatments may not be safe or appropriate for your condition. If you find information about a treatment which you have not been offered but you think could help, discuss it with your medical team. 

Medicines

Your liver processes all the medicines and drugs that come into your body. Medicines that are normally safe may be dangerous to someone with liver problems because the liver is not able to cope. Always check with your liver specialist and the pharmacist whether a medicine is safe for you.

  • It is essential that before taking any medicines, whether prescribed by your doctor or bought ‘over the counter’ from a shop, that you tell the pharmacist you have a liver problem and check they are safe for you to take
  • If you were prescribed any medicines before you were diagnosed with liver disease, your doctor should review whether these are still safe for you to take
  • If you are seeing a dentist, or a doctor for another health problem, they would not necessarily know that you have liver disease, unless you tell them, and could prescribe something that is dangerous for you
  • It is particularly important not to share any else's medication

Often liver patients are prescribed a number of different medications. It can be quite complex remembering when and what to take and what each medication is for. This can be a particular problem when the packaging, appearance of the tablets and even the brand name may change with each prescription. Make sure you are clear on what you have to take and when. If you are confused or unclear at any time, check with your doctor or pharmacist.

Painkillers

Common painkillers such as aspirin and ibuprofen can be dangerous for people with liver disease. These can sometimes be found in everyday items such as creams for muscle aches, cold remedies and cough syrups. It is a good idea to ask your doctor what medications you can take for pain relief and check the content of any medicines that you buy from a pharmacist.

Top tips for taking your medication

  1. Write out a table of all the medicines you are taking, their name (the long chemical name and the brand name), the dose, when you take them and what they are for. Your doctor or nurse can help you with this
  2. If you go into hospital, see a pharmacist or a different healthcare professional, always give them a list of your medications so they can see clearly what medicines you are taking. It is a good idea to take this information with you if you plan to travel away from home
  3. It is important that you take all your medications at the right time. You may find it helpful to buy a pill dispenser box (available from pharmacies) so you can load up your medicines for the week. You can then easily see if you have remembered to take each dose. It also prevents you from taking too many if your memory is not good
  4. If you miss a dose, take the next one as soon as you remember, but do not take a double dose unless you are told to do so. If there is a problem or you forget more than one dose, ask your medical team for advice. Make sure you have enough supplies of your medicines, particularly over bank holiday periods or if you plan to travel away from home. Order repeat prescriptions well in advance in case the pharmacy runs out of stock.
  5. It is also useful to know what side-effects you might experience and whether you should be worried about these. Talk to your doctor about this when the medicines are first prescribed. Mention any side-effects to your doctor at the next appointment, or if these are a problem, call your doctor as soon as they occur. It is important not to stop taking your medicines without speaking to your medical team first.

Complementary and alternative therapies  

Some people wish to take herbal remedies to relieve the symptoms of illness. Again, most of these are processed by the liver, so can be toxic to people with liver problems. Some can damage the liver and make you more ill. Some people believe that milk-thistle can be helpful for people with liver disease. However it is not licensed as a medicine, and there is no regulation of milk-thistle products, which means you cannot be sure how much of the active ingredient you are getting and how pure it is. It is wise to be cautious about claims made for herbal remedies, particularly those advertised on the internet, as they can offer false hope. It is a good idea to discuss the use of these remedies with your doctor and your pharmacist.