Outpatient management of cirrhosis: a narrative review.
Cirrhosis is the 12th leading cause of death in the United States. Individuals with cirrhosis are at risk for many potential complications. Complications can be managed or detected early with proper outpatient management. The most lethal of these complications is bleeding esophageal varices. All patients with cirrhosis should be screened for the presence of varices and treated when indicated. The most common complication seen in these patients is ascites. Ascites can be treated with dietary modifications and a diuretic regimen. Other potential complications include spontaneous bacterial peritonitis, hepatocellular carcinoma, hepatic encephalopathy, hepatorenal syndrome, and hepatopulmonary syndrome. The outpatient management of these complications will be discussed in this paper, along with the use of vaccinations, educating patients about the avoidance of hepatotoxic drugs, and when to refer a patient for liver transplant.
Mathews
Ronnie E
RE
Division of General Internal Medicine, Department of Medicine, University of Alabama at Birmingham, USA.
McGuire
Brendan M
BM
Estrada
Carlos A
CA
D000553:Ambulatory Care; D000894:Anti-Inflammatory Agents, Non-Steroidal; D019072:Antibiotic Prophylaxis; D001201:Ascites / Q000209:etiology / Q000628:therapy; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000209:etiology; D000075202:Contraindications; D004932:Esophageal and Gastric Varices / Q000209:etiology; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control; D006501:Hepatic Encephalopathy / Q000209:etiology; D006530:Hepatorenal Syndrome / Q000209:etiology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000628:therapy*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000209:etiology; D010538:Peritonitis / Q000209:etiology / Q000517:prevention & control; D012008:Recurrence
D000894:Anti-Inflammatory Agents, Non-Steroidal