Liver failure, or end state liver disease (ESLD) is a devastating illness that, unfortunately, can only be cured by a liver transplant. End state liver disease (ESLD) develops for a variety of reasons including alcohol use, hepatitis C, and obesity. Patients with liver cirrhosis do not usually experience symptoms until later in the disease progression when the blood pressure in the liver increases. Complications of liver disease include ascites (liquid in the abdomen), vein dilation in the esophagus, altered mental status, infections, and gastrointestinal bleeding. The liver is a very important organ in regulating medications within the body and their excretion.
As with most end-of-life conditions, focusing on symptom management becomes important for keeping the patient comfortable. Pain, is a very common symptom that we can see in hospice patients with ESLD. Unfortunately, because of metabolism changes that come with ESLD, some of our traditional options for pain, such as morphine and acetaminophen, should be avoided or, at the very least, used cautiously. The reason for this is because when the medication cannot be cleared from the body it can build-up and become toxic, leading to overdose.
End State Liver Disease & Hospice Care
The most common complication seen with ESLD is ascites. Ascites is a very unpleasant experience in which the abdomen swells due to fluid build-up. Ascites can lead to feeling nausea, tired, short of breath, and general discomfort. The treatment of choice for ascites is diuretic therapy with multiple different water pills to drain the fluid. In some cases, if severe, the fluid can be drained through a procedure called a paracentesis. Hospice and palliative care has a huge role to play, using both medication and non-medication strategies, in keeping ESLD patients comfortable.
Call Hospice of Southern Illinois to learn more about end-of-life care and hospice services, 800-233-1708. Request a chat,
Keep Learning On Our Podcast
Together, hospices around the country are finding ways to make sure families stay safe and supported! We are launching a podcast in honor of National Hospice Month. It is an exciting extension of Hospice of Southern Illinois’ services. It is called Bringing Life to Hospice. We hope to evoke conversations without fear. It will highlight the importance of planning for a peaceful end-of-life journey. With comfort, education, and safety top of mind, Hospice of Southern Illinois is always looking for ways to support you. More information about hospice, palliative care, and advance care planning is available now. Visit our website, www.hospice.org, or from the National Hospice and Palliative Care Organization’s website, CaringInfo.org.