you have been through so much mike.if any one deserves to clear the virus its you mate.certainly been on some journey. your posts have helped loads of people with your wealth of information .am routing for you cant wait for the post when you say SVR ive arrived.god bless                                                                                                                                                                                                                                                           william

I needed a reminder too Greg. I've been sneaking some red meat into my diet lately and I ate some high sodium soup the other day. I still do baked fish and chicken occasionally. I take an iron free multivitamin daily but that's as far as I intend to go with any type of supplement right now. SVR doesn't remedy the cirrhosis but I'll feel much better after I've achieved SVR knowing I don't have this dragon pouring gas on the fire. One step at a time...

Ouch William! You were certainly too close to the edge for comfort! I'm sure glad you made it through. Possible HE coma death is a serious threat.

The "dreaded Lactulose" really has not caused me any problem in a long time. And it's even good for using to sweeten my Corn Flakes cereal in the mornings without having to use unheathy sugar LOL. If this heartburn doesn't get any worse I'll be able to manage fine until I get through with Harvoni treatment. I won't be as concerned with taking an antacid after that. My EOT will be Jan 9 2016 and I'm determined to make it there with no catastrophe like I had last treatment.

Mike, I had previously read about HE but this article was a great reminder for me.  I definitely have sleep issues and also have issues with attention and short term memory.  Thanks for bringing this up.  I need to reduce my animal protein intake.  I had done this in the past but in the last 6 months started eating more meats. 

I hadn't previously read where adding zinc to the diet or use of probiotics might help the HE.  I will definitely try adding these to my routine see if it may help.  Will also start having a good yogurt for breakfast or lunch  more often.  Strange how we forget things we've read in the past that we know we should be doing, but put out  of mind.  Reaching SVR doesn't remedy the cirrhosis.  Dragon scars are slow to heal.

meant to say am still on rifaximin.finished hep c meds last december

hi mike.im on rifaxim.havebeen since i was admitted to hospital last year with a head full of ammonia.that was some trip was a nutter and i had no idea, was in for nearly 2 wks. came to with loads of gear being put into me saline vit k etc.didnt realize how close to the edge i had been.was through that i was put on the interferon free meds on compassionate grounds.am still on it now .they also give me the dreaded laculose.cant say ive had any heartburn problems yet.but know it can be a sx effect of  meds.cant say if the rifaximin is doing anything.think since clearing the virus a lot of probs have sorted them selves out.but having a sick liver is not enhancing my life i know that.by the way mike how long have you got left on tx.cant belong mate

Yes, ammonia in the blood causes HE when it gets to the brain.  I don't have close family or anyone living with me so there is nobody to notice any difference but I have seen a major decrease in my ability to pay attention to what I'm doing. My reading comprehension has become a big problem too. I've been reading the HE information you linked for ~ an hour and don't remember hardly anything I just read.  I did save the link for future reference though. I have references for everything these days. Thanks GG!  I've been taking both Xifaxan and lactulose consistently since I was diagnosed with cirrhosis 1-2014 and my insurance has always paid with no problem. The Xifaxan is very expensive.

My hepatologist signed me up for an HE study but I was disqualified due to being stage 1 and the study was focused on stage 2+. I suspected Xifaxan might be the cause of my heartburn issue simply because the heartburn usually is the worst ~1 1/2 to 2 hours after I take it, Intelence (etravirine), and a multivitamin. I take the Intelence 3x a day but do not have any heartburn issue 1 1/2 to 2 hours after those other doses without being accompanied by Xifaxan. I guess that leaves the multivitamin which I doubt is the culprit but I will bring this up with my hepatologist at my next appointment. If I have to live with it then I will.

Mike, I have taken the rifaximin in the past.  Not sure how bad my HE was, but my ammonia levels were quite elevated.  Sorta strange, almost as though I could taste or smell the elevated ammonia levels.  It's my understanding the elevated ammonia causes the HE.  The rifaximin brings the ammonia levels down quickly.  I didn't have any se with the Rifaximin.  Most doc's prescribe lactulose which binds the ammonia and is much cheaper.  Was difficult for me to work while taking the lactulose as it caused gas and frequent trips to the bathroom.  Some insurances don't want to cover the Rifaxamin but will cover the lactulose.

Dern, maybe I do need to be taking the rifaximin and lactulose?  :)  My wife sometimes says I'm brain dead, and she's probably right  :)  Mike, do you or others notice a difference in your HE with this treatment? 

Mike, sorry for all the edits, here is a link with good info about HE.  I'm sure you've already read up on this.  This was a good refresher for me:  http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/hepatic-encephalopathy/

-- Edited by Groupergetter on Tuesday 20th of October 2015 02:01:04 AM

-- Edited by Groupergetter on Tuesday 20th of October 2015 02:20:09 AM

 I've recently been seeing advertisements for Xifaxan for treatment of irritable bowel syndrome w/diarrhea (IBS-D) on TV. As some of you with advanced liver disease know, Xifaxan can also be used for the treatment of hepatic encephalopathy (HE). It can also be used to treat travelers diarrhea (TD). I take 550MG 2x per day along with 30ml 3x per day lactulose for treatment of HE. My question to others taking Xifaxan is; do you suffer from heartburn as a side effect? Has your doctor ever decreased the dosage due to Sx's?

Xifaxan dosage and administration:

TD     / One 200 mg tablet 3 times a day for 3 days
IBS-D  / One 550 mg tablet 3 times a day for 14 days
HE     / One 550 mg tablet 2 times daily