8 million lost hours of household work. Acute liver failure is a rare, life-threatening, potentially reversible condition defined by jaundice, coagulopathy, and hepatic encephalopathy. ) Apr 23, 2016 · Causes of Vomiting of Blood in Dogs. Signs that a dog has liver disease can vary and include loss of appetite, vomiting, stomach ulceration, diarrhea, seizures or other neurologic problems, fever, blood clotting problems, jaundice (a yellow tinge noticeable in the skin, mucous membranes, and eyes), fluid collection in the abdomen, excessive urination and thirst, changes in liver Nov 20, 2023 · Liver disease caused by alcohol and cirrhosis. Light-headedness. The Mallory–Weiss tear usually occurs after retching or vomiting, and is often associated with heavy alcohol ingestion. A healthcare provider might suspect that you have esophageal varices if they see other signs suggesting portal hypertension or chronic liver disease. Black, tar-like stool. In some cases, streaks of blood showing up in the vomit may be a sign of simple irritation in the throat. Mar 15, 2023 · Symptoms of bleeding esophageal varices include: Vomiting large amounts of blood. Oct 29, 2018 · GO TO THE EMERGENCY ROOM! (or call 911, say you have cirrhosis, and tell them what is happening) BLEEDING: My stools are black and tarry. This is called liver failure. The metabolism of carbohydrates (glycogen storage and control), protein (metabolism of albumin and many other proteins which play essential roles in homeostasis and the immune system), drugs and toxins (metabolism based on the activity of cytochrome enzymes, etc Mar 14, 2024 · Portal Vein Thrombosis. The main symptoms of cirrhosis include: tiredness and weakness. Swelling of the abdomen due to fluid accumulation. Mar 1, 2024 · Feeling nauseous. nausea and vomiting. The liver can be damaged in a variety of ways. The liver typically contains some fat, but excessive buildup can cause fatty liver disease. About cirrhosis. Complications of cirrhosis can include: High blood pressure in the veins that supply the liver. Adverse reactions to certain prescription and herbal medications. Less urine output that normal. While many of these symptoms are vague and not unique to liver failure, the combination of newly yellow (jaundiced) skin or eyes, abdominal distension and altered consciousness is particularly classic for liver failure. Symptoms can range from confusion and disorientation to erratic behavior and personality changes. Vomiting. Get the facts on the treatments, outlook, and more. These may include: Blood tests. I'm vomiting blood. Vomiting blood always needs to be checked out by a doctor and may need emergency treatment in hospital. Diagnostic method. Acute liver failure is a serious condition. The damage caused by cirrhosis can’t be reversed and can eventually become so extensive that your liver stops functioning. Yellowing of the skin and eyes (jaundice) Deep, dull pain in the right upper abdomen. Purple-colored spots on the skin (called purpura) Red, itchy rash, usually on the legs. Over 4 million women suffer with NVP each year and the condition results annually in approximately 8. The MELD score is based on three blood tests: international normalized ratio (INR)-tests the clotting tendency of blood. To date, there are at least 3 cases of black cohosh implicated in liver failure. “Encephalopathy” is brain dysfunction, and “hepatic” means liver-related. Paleness. In some cases, depending on the cause of liver disease, these symptoms may come on suddenly. The portal vein supplies the liver with blood. The source is generally the upper gastrointestinal tract, typically above the suspensory muscle of duodenum. Dry skin and nails are also a Feb 5, 2020 · Outlook. They Mar 13, 2023 · Fatty liver disease generally has no obvious symptoms. Causes of liver damage and failure include: viral infections, such as: hepatitis A. Sleepiness. Yellowish eyes, tongue, or gums ( jaundice) Signs of weakness. Black cohosh (Cimicifuga racemosa) is a popular herbal supplement for women having menopause symptoms. FEVER: I have a fever and I can't stop shaking. (extreme liver scarring and damage). Jan 29, 2020 · Signs and symptoms of alcohol-related liver disease include: abdominal pain and tenderness; excessive thirst; dry mouth; blood in vomit that can appear red or look like coffee grounds; Patients with liver disease may have varices, a source of bleeding. It is also possible Common causes of vomiting blood include: gastritis. If you don't have liver cirrhosis yet, your liver can actually heal itself Esophageal varices are dilated blood vessels within the walls of the lower part of the esophagus that are prone to bleeding. You may not realize you have PVT until complications like portal hypertension develop. mild pain or discomfort over the liver in the upper right side of the abdomen, or belly. Encephalopathy affects your central nervous system and how you think, feel and act. Feb 11, 2023 · Not everyone with chronic hepatitis will develop cirrhosis, but it's one of the world's leading causes of liver disease. They’ll look for visible signs and ask about your symptoms. Inflammation of your esophagus or stomach lining can cause bleeding from the arteries underneath. Hepatic encephalopathy can cause a range of symptoms, such as: sleep disturbances. Ask about known varices or cirrhosis, alcoholism, and previous hepatitis. damage to your food pipe from being sick or coughing a lot. red patches on your palms and small, spider-like blood vessels on your skin (spider angiomas) above waist level. Signs and symptoms of acetaminophen-induced liver damage may include nausea, vomiting, kidney failure, bleeding disorders, coma, and death. Swelling in the legs and ankles. 4. These veins (called varices) are present in people with severe liver damage. Swollen veins in the walls of the lower part of the esophagus, and sometimes the stomach, may begin to bleed. NVP affects the great majority of pregnancies. Alcohol itself may dry out the Signs that a dog has liver disease can vary and include loss of appetite, vomiting, stomach ulceration, diarrhea, seizures or other neurologic problems, fever, blood clotting problems, jaundice (a yellow tinge noticeable in the skin, mucous membranes, and eyes), fluid collection in the abdomen, excessive urination and thirst, changes in liver Aug 17, 2018 · Blood in the vomit can be a sign of a major health problem. Jan 8, 2024 · Vomiting blood; Fever; Nonalcoholic fatty liver disease treatments. abdominal pain, especially in the upper right side. Blood in their pee or poop. They may also ask about your diet, lifestyle and health history. ) Mar 27, 2023 · Causes of liver damage and failure. The liver is one of the most complex organs in the human May 10, 2024 · Short-term symptoms such as nausea, vomiting, or fever may occur while the immune system fights the infection. Gastritis (acute, chronic, or hemorrhagic gastroenteritis) Inflammatory bowel disease. Red, pink or brown urine. May 6, 2024 · Loss of appetite. Your doctor might suspect esophageal varices if you have signs of liver disease or been diagnosed with liver cirrhosis, including: Signs that a cat has liver disease can vary and include loss of appetite, vomiting, stomach ulceration, diarrhea, fever, blood clotting problems, jaundice, abdominal swelling, excessive urination and thirst, changes in liver size, weight loss, and occasionally gastrointestinal bleeding. As the disease gets worse, however, you may also become confused and extremely sleepy. Nov 16, 2022 · Vomiting blood can sometimes be a result of vomiting for a long time, which can affect blood vessels in the throat or the lining of the GI tract (the stomach, esophagus or feeding tube, and intestines). Acute symptoms may also be more severe at first or occur in brief bursts in some other forms of liver disease. You may have fatigue, weakness, and liver pain. Alpha1-antitrypsin deficiency is a genetic (inherited) disorder that can cause liver and lung disease in individuals of any age. Their pathophysiology is complex and probably involves factors related to liver disease severity, psychological distress, and gut dysfunction. Complications. Ingestion of poisonous wild mushrooms. These occur when scarring or clots in your liver block normal blood flow. Bile flow can be obstructed, for example, by cholestasis. Hemochromatosis (an inherited disorder that causes the body to absorb and store too much iron). com – Vomiting blood is one of the symptoms liver disease the final stadium to watch out for. It can be confused with hemoptysis (coughing up blood) or epistaxis (nosebleed), which are more common. The liver can fail due to many different types of injury or disease. Vomiting and Diarrhea. Also, many disorders that cause jaundice, particularly severe liver disease, cause other symptoms or serious problems. Abdominal distension caused by fluid in the belly known as ascites. Belly pain and swelling. There are usually significant neuromuscular symptoms, multisystem involvement, and Jan 25, 2019 · Some other possible causes of coffee ground vomitus include: stomach and esophageal problems related to cirrhosis from alcohol abuse, viral hepatitis, autoimmune diseases, or fatty liver disease Some signs are strongly suggestive of liver disease, most notably jaundice, which appears as yellow discoloration of the skin, eyes and mucous membranes, and ascites, which appears as swelling of the abdomen due to build-up of fluid. CONFUSION: My head is cloudy. Ascites, a buildup of fluid in your abdomen. The aetiology and the interval from onset of jaundice to the Apr 26, 2016 · Cirrhosis. Less common causes include: oesophageal cancer or stomach cancer. Bleeding can range from mild to severe and can be life-threatening. Mar 22, 2019 · Symptoms of liver disease may vary depending on the underlying cause. Extra thirst. The blood will redirect to these Loss of Appetite and Weight Loss. Endoscopy. JAUNDICE: My eyes are suddenly turning yellow. Differential diagnosis. Anyone who vomits blood should seek immediate Liver involvement, a common feature in childhood mitochondrial hepatopathies, particularly in the neonatal period, may manifest as neonatal acute liver failure, hepatic steatohepatitis, cholestasis, or cirrhosis with chronic liver failure of insidious onset. You may then have symptoms like vomiting blood and rectal bleeding. Blood flow to the liver may be compromised. Oct 20, 2020 · Multiple types and stages of liver disease can lead to liver failure. It turns into a persistent infection if it is not treated. Hematemesis is the vomiting of blood. Epistaxis, hemoptysis. They connect your liver, gallbladder, pancreas and small Nov 1, 2023 · M etabolic dysfunction-associated steatotic liver disease vomiting, belly pain, and jaundice (yellowish skin Your doctor may order the following blood tests: Liver function and liver Alcoholic liver disease: This is liver damage that occurs when excessive alcohol use causes the buildup of fat in the liver, Rectal bleeding or blood in urine; Vomiting of blood; Doctors can usually diagnose liver failure based on symptoms and results of a physical examination and blood tests. Blood in your vomit or stool may also be a sign your liver is not working properly — if this occurs, seek prompt medical assistance. This condition is known as portal hypertension. Coughing up or vomiting blood or material that looks like coffee grounds. Confusion. Stage 2: Fibrosis/scarring. alcohol-related liver disease. As the liver becomes more severely damaged, more obvious and serious symptoms can develop, such as: yellowing of the skin or whites of the eyes (jaundice) swelling in the legs, ankles and feet caused by a build-up of fluid (oedema) swelling in your abdomen caused by a build-up of fluid known as ascites. Heavy vaginal bleeding. Acetaminophen (Tylenol) overdose. Most often, chronic liver failure is the result of cirrhosis, a condition in which scar tissue replaces healthy liver tissue until the liver cannot function adequately. Stool may look black or tarry. Learn more here. Mar 6, 2016 · 1. Black, tarry or bloody stools. chronic hepatitis C. Feb 8, 2023 · In many cases, fatty liver disease is diagnosed after blood tests show elevated liver enzymes. These are some of the most likely: Ulcers. You tend to get symptoms if your liver becomes more severely damaged. About 2 million people suffer from a tear Nov 11, 2021 · As a result of the prevalence of liver biochemical tests ordered and abnormal results, we will be writing this review to increase the knowledge about liver tests to clinicians and improve the interpretation of these tests. Itching all over your body, especially at night. The most important part of treatment is to stop drinking alcohol completely. Fatty liver disease can decrease liver function and cause pain, weight loss, fatigue Nov 15, 2023 · Coffee ground vomitus is dark-colored vomit that has blood in it. Sophisticated imaging technology, when needed, […] Alcoholic liver disease also can affect your brain and nervous system. May 10, 2024 · Alcoholic ketoacidosis, also known as alcoholic ketosis or alcoholic acidosis, tends to occur when people who chronically use alcohol and who have co-occurring liver disease suddenly stop drinking. Swelling in your legs and feet ( edema ). Some known causes of acute (sudden) liver failure include: Viruses, such as herpes (HSV), Epstein-Barr virus (EBV), cytomegalovirus (CMV) or hepatitis A, B and E. (See also Overview of Liver Disease. In turn, your hair can become dry and frizzy. Other symptoms include bruising or bleeding easily, vomiting blood, and a buildup of fluid in your abdomen. Physical examination and laboratory findings in most Apr 17, 2023 · Common Symptoms: Poor appetite, vomiting and/or diarrhea, yellowing of the gums and other mucous membranes (jaundice), unexplained bruising (from loss of liver clotting factors), lethargy, weight loss, swollen abdomen from fluid (ascites), excessive drinking of water (polydipsia) Diagnosis: Bloodwork including liver clotting factors, x-rays Jun 4, 2024 · Joint pain. Elevated liver enzymes can be a sign of liver inflammation. Your liver produces bile and delivers it to your digestive system through a network of vessels called bile ducts. muscle loss and weakness. The liver is one of the most important organs of the body since it plays important roles in several functions (1, 2). This matters because if the inflammation continues unabated for long enough, you could develop scarring in the liver, known as fibrosis. Finally, they’ll use lab tests and imaging scans to check for liver disease. Blood in poop. Symptoms and signs of moderate hepatic encephalopathy may include: difficulty thinking. Why you get nausea and vomiting. Yellowing of the skin might be harder to see on Black or brown skin. Doctors can usually diagnose liver failure based on symptoms and results of a physical examination and blood tests. Occurs in patients with no pre-existing liver disease and may result in severe liver impairment and rapid clinical deterioration. Cirrhosis can lead to nausea and vomiting, easy bruising and bleeding, and jaundice. Sometimes, acid reflux can damage the esophagus, which can cause bleeding, and liver damage can also lead to coughing up blood. Heavy alcohol use, aspirin and NSAIDs, and severe acid reflux are common causes. Although some will come back, too much alcohol can damage the liver permanently. Often, a cause cannot even be found. 6 million lost hours of paid employment and 5. Feb 20, 2024 · These sores can damage an artery, causing you to vomit blood. hepatitis E. Apr 2, 2024 · Liver function tests (LFTs): This is a battery of blood tests that detects high liver enzymes, a sign of liver disease. Damage to the Trachea, Stomach, and Esophagus When a person is ill and coughing a lot, the force can cause damage to the windpipe (trachea) , stomach, and esophagus. How is acute liver failure diagnosed? Liver failure is a serious condition that requires immediate medical attention. Portal vein thrombosis (PVT) is the formation of a blood clot in the veins of your liver. stomach ulcers. losing weight without trying. Possible causes include gastric ulcers, gastritis, liver disease, and cancer. Scar tissue replaces healthy tissue in the liver and prevents the liver from working properly. I'm so confused and sleepy I can't do anything. Swallowing blood: Oct 10, 2014 · CONCLUSION. The blood often shows up in stool or vomit but isn't always obvious. easy bruising and bleeding. Stages of fibrosis range from 0 to 4: Stage 0 means there is no scarring. Low red blood cell count (anemia) What is ascites? Ascites is fluid buildup in the belly (abdominal) cavity caused by fluid leaks from the surface of the liver and intestine. A firm or swollen feeling belly. Dec 19, 2022 · Cholestasis is the slowing or stalling of bile flow from your liver. They can appear in people with severe liver disease. Initially, a Apr 25, 2023 · The most severe case of alcohol-related liver disease, cirrhosis of the liver, is associated with vomiting blood. Apply for and This may produce streaks of blood in the vomit. Bile ducts run through your liver (intrahepatic ducts) as well as outside of it (extrahepatic ducts). Feb 7, 2023 · As patients with end-stage liver disease come closer to death, the risk of developing this complication may increase. Gastrointestinal cancer (Leiomyoma, Carcinoma, Lymphoma, Gastrinoma) This may produce streaks of blood in the vomit. These include: yellow skin and eyes ( jaundice Mar 15, 2019 · Dehydration from frequent vomiting means that your body doesn’t have enough water. itching of the skin. GI symptoms are related to reduced energy intake and, thus, may contribute to weight loss and malnutrition. which can cause vomiting blood Painless vomiting of blood. blood conditions, such as haemophilia. In people with liver disease, these symptoms may include nausea, vomiting and abdominal pain, and small spiderlike blood vessels that are visible in the skin (spider angiomas). Esophageal varices. poor appetite. Dark-colored Feb 14, 2023 · Mild to moderate elevation in liver enzymes often means there is some type of inflammation within the liver. Alcoholic liver disease is liver damage from overconsuming alcohol. Small, dilated blood vessels on the skin that are red and look like spiders (typically on the chest) As the liver damage gets worse, you may notice other signs like: Swollen ankles and legs. People with cirrhosis have a higher risk. Bloated stomach with rapid weight gain (from fluid). Nausea and vomiting can happen because your liver can’t filter the toxins in your body. The best way to combat this cause of liver damage is to lose excess weight with the help of diet and exercise. 5 The condition seems to occur with higher frequency in people who are dehydrated and haven’t eaten for 1-3 days; this can result in the low blood Feb 13, 2024 · Edema (swelling) in the ankles, feet, and legs. Acute liver failure causes fatigue, nausea, loss of appetite, discomfort on your right side, just below your ribs, and diarrhea. But there are a few common signs that often point to some kind of liver issue. Nov 23, 2020 · pale stool. Mar 3, 2022 · Mallory-Weiss syndrome is a disorder that develops when blunt trauma or powerful eruption of the stomach causes a tear in the upper portion of the stomach as well as the mucous membrane of your esophagus. genetic conditions Dec 11, 2012 · Common causes of throwing up blood include: A stomach ulcer. Only a doctor can perform a proper physical exam and order appropriate testing to determine if a person has cirrhosis of the liver or any other condition or disease for that matter. feeling sick (nausea) and loss of appetite resulting in weight loss. The liver's reduced capacity to metabolize nutrients and toxins can lead to gastrointestinal disturbances. Ascites (a buildup of fluid in the belly) If your dog's liver Dec 19, 2023 · Hepatic encephalopathy is brain dysfunction caused by liver dysfunction. There are numerous different conditions that could cause your dog to vomit blood. The MELD score was developed to predict the 90-day survival of people with advanced cirrhosis. It can cause a buildup of fats, inflammation, and scarring. Apr 13, 2023 · Gastrointestinal bleeding is common among people with cirrhosis due to a complication called portal hypertension. Red or black, tarry stools. See full list on healthline. Portal hypertension, a consequence of cirrhosis, causes increased pressure in your abdominal veins. slurred speech. GI symptoms are common in patients with liver cirrhosis. Vomiting and nausea are often reported in patients with liver disease. Sep 5, 2023 · Serious Eliquis side effects include: Joint pain or swelling. Cirrhosis is Symptoms of cirrhosis may not appear until the liver is badly damaged. With any Oct 12, 2020 · Gastrointestinal (GI) bleeding is a symptom of a disorder in your digestive tract. These veins (called varices) may be present in people with severe liver damage. A tear in your gullet (oesophagus) caused by prolonged retching. tears, irritation, or tissue loss Septicemic plague. This may produce streaks of blood in the vomit. If there are symptoms of liver disease, they may include: Yellowing of the skin and the whites of the eyes, called jaundice. People with severe hepatitis, usually caused by drinking too much alcohol, may have: Vomit blood, or vomit that looks like coffee grounds. pain under the ribs on the right side of the body. heart burn and acid reflux. Only with an upper endoscopy can a doctor see the lining of your upper GI tract which will help them determine what is causing your vomiting. Complications can be life-threatening. You may even experience hair loss. ³ Liver failure can happen to children of any age. Oct 13, 2023 · Gastrointestinal (GI) bleeding is a sign of a disorder in the digestive tract. Repeated vomiting and retching may cause bleeding and damage to the lower esophagus called Mallory Weiss tears. Sep 21, 2020 · Irritation. Seizures. Chest pain or tightness. Cirrhosis slows the regular flow of blood through the liver. A general sense of feeling unwell (malaise) Disorientation or confusion. personality Four stages of liver failure define the progression of the disease: Stage 1: Inflammation. This condition usually develops after the patient is exposed to liver disease in a matter of months or years. Patients may not have any symptoms at this stage, but some people may have tenderness on the right side of their abdomen. End-stage Liver Disease (ESLD) Chronic liver failure, also called end-stage liver disease, progresses over months, years, or decades. Acute liver failure happens when your liver suddenly starts to not work. feeling tired or weak. Aug 20, 2022 · Increased need to pee. Liver-related symptoms include unexplained liver disease or elevated liver enzymes, eyes and skin turning yellow (jaundice), swelling of the abdomen (ascites) or legs, and vomiting blood (from enlarged veins in the Oct 4, 2023 · A healthcare provider checking for liver disease will begin by physically examining you. chronic hepatitis B. Lightheadedness due to blood loss. vigorous vomiting. The level of bleeding can range from mild to severe and can be life-threatening. A yellow color to your skin or the white parts of your eyes. 2 NVP typically consists of mild nausea and vomiting presenting during the first trimester of pregnancy. Jan 17, 2022 · KOMPAS. Apr 27, 2024 · Hematemesis, or vomiting blood, often presents with a "coffee ground" appearance and can indicate various underlying medical conditions. The model for end-stage liver disease (MELD) score measures the severity of cirrhosis. Oct 2, 2022 · The first noticeable symptoms of portal hypertension are usually related to new, enlarged, leaky and bleeding veins, such as: Blood in vomit. May 23, 2023 · They usually don’t cause symptoms at all until they bleed. muscle cramps and weakness Signs and symptoms of acute liver failure may include: Yellowing of your skin and eyeballs (jaundice) Pain in your upper right abdomen. Enlarged blood vessels that rupture. Stool microscopy : This involves the microscopic examination of a sample of stool to look for signs of a parasitic infection, such as liver flukes. Early symptoms of cirrhosis may include. Swallowed blood from a nosebleed. Feb 13, 2024 · Liver disease doesn't always cause symptoms that can be seen or felt. Imaging technology or an endoscopic investigation can usually locate the cause of the bleeding. Cells can become inflamed, for example, hepatitis. asterixis, which can cause involuntary movements like trembling and ‘hand flapping’. a high temperature and shivering attacks. Symptoms include agitation, changing mood, confusion, and pain, numbness, or a tingling sensation in your arms or legs. Nonalcoholic fatty liver disease. Treatment usually involves controlling protein consumption, limiting sodium in the diet, completely avoiding alcohol, and treating the cause, but sometimes liver transplantation is required. For example, a doctor may order the alanine aminotransferase test (ALT) and aspartate Jun 14, 2018 · Symptoms of hepatic encephalopathy differ depending on the underlying cause of the liver damage. Malnutrition. These are often accompanied by less specific signs that can be quite variable, including lethargy, changes in Jul 15, 2021 · Alcoholic liver cirrhosis is the most advanced form of liver disease that’s related to drinking alcohol. Health Conditions vomiting blood; Chronic liver diseases occur more slowly than acute ones. Ascites from liver disease often occurs Feb 14, 2024 · Tylenol liver damage (acetaminophen) can occur from accidentally ingesting too much acetaminophen, or intentionally. Cholesterol or triglycerides can accumulate, for example, in steatosis. Context. Dogs with liver disease often exhibit decreased appetite, which, over time, can result in significant weight loss. A swollen belly (ascites) Nausea. Long-term alcohol abuse. ) Mar 4, 2023 · Other liver diseases can have similar effects on the bowel. It can be caused by constipation, swelling in the belly, some of the medicines you’re taking, problems with the muscles and nerves in the stomach, or an infection. Severe or uncontrollable bleeding from an injury. A diseased liver can cause portal hypertension, which is high blood pressure in the portal vein. Several health problems can cause a person to vomit blood, such as: stomach ulcers. com May 16, 2024 · Common symptoms of severe liver disease and failure include: abdominal swelling. Sometimes, it advances to metabolic dysfunction-associated steatohepatitis and cirrhosis. Jun 10, 2024 · Passing blood in your poop or vomiting blood A few liver cells die every time the liver filters alcohol. Alcoholic liver disease. Patients with abnormal liver function who Mar 6, 2023 · Outlook. Liver function tests (LFTs) are a term commonly used for aminotransferases, alkaline phosphatase (ALP), bilirubin, and Dec 9, 2017 · 10 Black Cohosh. It can be purchased by itself or it may be part of a supplement containing several ingredients. . Liver disease's initial signs are frequently confusing. Blood or mucosal fluids then wash over the injury site, causing severe vomiting and abdominal pain. An overdose of acetaminophen is the most common cause of acute liver failure. Causes of liver disease until vomiting blood is usually due to cirrhosis, one of which is due to excessive alcohol consumption. This is elevated blood pressure in the veins that lead to your liver. Cirrhosis is scarring of the liver caused by continuous, long-term liver damage. Swelling of the face or tongue. These might include: Jaundice, a yellowing of your skin and eyes. Loss of consciousness in severe cases. Mental confusion or disorientation. The blood often appears in stool or vomit but isn't always visible, though it may cause the stool to look black or tarry. Various factors could be responsible for this. Summary. wc nr zq eg zu ds qi qo en ql