Hi Karen and welcome to the forum.
I’m sorry to hear that your husband is resistant to treatment and doesn’t want a transplant. This attitude could be associated with the fact that he is confused. My husband was also resistant to taking his lactulose. He hated it. The taste is terrible and the side affects are uncomfortable. He tried to convince me that it didn’t work. But, I knew better.
Ask the doctor about Xifaxin (Rifaximin). This is an antibiotic that is not absorbed into the blood stream. It works within the intestines to control bacteria. Bacteria excrete ammonia further complicating his encephalopathy (confusion). Xifaxin doesn’t replace the lactulose (he really needs to take the lactulose), but it may help clear his mind.
How long he can linger without treatment is impossible for me to predict. ESLD complications are horrible. He could suffer esophageal varices and bleed to death, his kidneys could shut down, or he may slip into hepatic coma and die, etc. These complications can be treated or prevented all together. But, he must cooperate.
Unfortunately, as the cirrhosis advances, you will be the one suffering more than your husband. Without treatment, he will eventually loose his ability to think for himself, feed himself, and forget about hygiene. You will be taking on these responsibilities. Complications arise even with treatment, but as a caregiver it is acceptable so long as there is hope for recovery.
It’s hurtful when the one you love is resistant to treatment. Where does that leave you? Has he considered you in the equation? These are the questions you are left asking yourself. My heart goes out to you. Perhaps if he cooperates enough to clear his mind you can discuss the issue and possibly change his mind.
Don’t give up. There is hope. My husband received a liver transplant January 21st. He is a shell of the man he once was, but now there is a light at the end of the tunnel. It’s a long road to recovery, but one that is worth the effort. He has a positive attitude and is working hard to restore his health.
I wish you the best. You will be in my thoughts and prayers. Keep in touch and let us know how he is doing.