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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31329
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Having cirrhosis and bled out 2X,TIPS procedure successful

Resolved Question:

Having cirrhosis and bled out 2X,TIPS procedure successful 1yr ago. I am having onset of daily nosebleeds and sleep is totally messed up, which is adding to anxiety. Does this mean cirrhosis is worsening.

I have 1 1/2 yr to make 5 yr remission mark from br. cancer so transplant can proceed.
Submitted: 5 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 5 years ago.



This single criteria of nose bleed (and associated sleep issue) is not likely to be pointer to worsening cirrhosis. Still it warrants prothrombin time and platelet counts and other bleeding and clotting profile to be done to look for the cause:


1) platelet count,
2) bleeding time (BT),
3) prothrombin time (PT),
4) activated partial thromboplastin time (aPTT),
5) thrombin time (TT)
6) peripheral blood smear,
7) platelet aggregation in response to ADP, epinephrine, collagen, and ristocetin;
8) platelet release assays,
9) coagulation factor assays,
10) assessment of factor XIII activity via clot solubility testing
11) Tests of fibrinolysis; measurement of fibrin split products and D-dimer levels.


Please feel free for your follow up questions.


I would be happy to assist you further, if you need any more information.


Dr. Arun

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