### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
HI ! My mother is suffering from Cirrhosis of liver ! Its been three months that she has been suffering from acute pain in her back due to ascetic fluid accumulations. She cannot sleep at night due to pain and uneasyness in her abdomen and back. Her 80% liver has been scarred as per the doc and inspite of all the possible tests the main cause has not been found as in why her liver is self destructing ! We have extracted fluid for some relief but it accumulates again in couple of days and the entire process of pain restarts. Now the doc have suggested TIPS procedure and this symptomatic treatment will help fluid not to accumulate and the fluid will pass via urine in a normal way. I want to know a)What are the side effects of this TIPS procedure which are bound to happen?? b)And as the fluid will pass via urine then will she lose protein contents severely?? c)Is it life threatning procedure?? d)Once its done is it possible that the fluid accumulation can start once again ?? e)Will the stent be placed permanently and if yes then will it cause discomfort f)How will it effect the day to day activity g)what are the post treatment cautions or caring required?? I am sorry to have asked numerous but apt questions whicChatDoctores to my mind immediately..i will be glad if these are answered in details so that i can take necessary decision around it. Thanks for understanding and wish you all keep helping people like us on a daily basis. regrds Anand

### output:

Dear Anand! Many thanks for the query. I have gone through your mail in detail and could grasp the salient points regarding your mothers' illness. I understand that she has decompensated cryogenic cirrhosis. Her tense ascites is troubling her and prevents her from lying on the bed comfortably and requires periodic removal of the fluid in the abdomen. TIPS is a good and acceptable procedure for intractable ascites and gives good comfort to the patient. This procedure should ideally be done in a center experienced in TIPS. There will be increased urination, but there will not be any loss of protein through the urine. Hypoproteinemia (low protein in the blood) is essentially due to decreased production of protein by the diseased liver. TIPS is not a life threatening procedure but can cause hepatic encephalopathy(altered sensorial / irrelevant actions and talk etc.) over a period of time and occasionally this TIPS stent can get blocked. You need to check with your hepatologist whether she is a candidate for an early liver transplantation. If so you can wait for a while before TIPS. Regards