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Liver Cirrhosis and Portal Hypertension

Liver Cirrhosis and Portal Hypertension - How to prevent?

Liver Cirrhosis and Portal Hypertension - Treatments

Patients with liver cirrhosis will benefit from the following treatment which include:

Treatment of the underlying cause of liver cirrhosis

  • Patients with alcoholic liver cirrhosis must stop all intake of alcohol
  • Patients with chronic hepatitis B and C should be started on antiviral treatment if there are no contraindications
  • Patients with autoimmune hepatitis may require treatment with steroids

Treatment of portal hypertension to reduce risk of variceal bleeding by:

  • Non-selective beta blocker medication (e.g. propranolol) for lowering of portal pressure to reduce risk of variceal bleeding
  • Endoscopic ligation (banding) of esophageal varices to treat acute bleeding or prevent future variceal bleeding
  • Endoscopic sclerotherapy (histoacryl injection) of gastric varices to treat acute bleeding

Treatment and prevention of ascites include:

  • Maintenance of a strict low salt diet
  • Maintenance diuretic medication (e.g. spironolactone or furosemide) to remove excess fluid from the body
  • Patients who have persistent ascites that do not respond to medications may require paracentesis, Transjugular Intrahepatic Portosystemic Shunt (TIPS) or liver transplant.

Treatment and prevention of hepatic encephalopathy include:

  • Regular bowel clearance in order to reduce build-up of toxins in the bloodstream that may precipitate encephalopathy
  • Avoidance of sedatives that may worsen encephalopathy

Surveillance for liver cancer

  • Patients with cirrhosis should undergo regular abdominal ultrasound and alfa-fetoprotein (AFP) blood tests at least once every six months Diseases Gastroenterology

Treatment of cirrhosis-related infections

  • Cirrhotics need to be closely monitored for infections (e.g. spontaneous bacterial peritonitis) and should be referred for early treatment with antibiotics

Early assessment for liver transplant

  • Cirrhotic patients who develop decompensation events should be referred for liver transplant

Liver Cirrhosis and Portal Hypertension - Preparing for surgery

Liver Cirrhosis and Portal Hypertension - Post-surgery care

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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