Materiały źródłowe

• #1 Cirrhosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cirrhosis/diagnosis-treatment/drc-20351492

  Treatment for cirrhosis depends on the cause and extent of liver damage. The goals of treatment are to slow the progression of scar tissue in the liver and to prevent or treat symptoms and complications of cirrhosis. For severe liver damage, hospitalization may be needed. […] In early cirrhosis, it may be possible to minimize damage to the liver by treating the underlying cause. The options include: […] Treatment for alcohol dependency. People with cirrhosis caused by excessive alcohol use should try to stop drinking. If stopping alcohol use is difficult, a healthcare professional may recommend a treatment program for alcohol addiction. For people with cirrhosis, it is very important to stop drinking since any amount of alcohol is toxic to the liver. […] Weight loss. People with cirrhosis caused by metabolic dysfunction-associated steatotic liver disease may become healthier if they lose weight and control their blood sugar levels.

• #2 Cirrhosis

  https://www.nhs.uk/conditions/cirrhosis/

  Cirrhosis cannot be cured, but there are treatments that can help slow it down or stop it getting worse. […] This usually involves treating the cause, for example, antiviral medicines if it’s caused by hepatitis B or C. […] You usually also have treatment to help prevent and treat complications of cirrhosis. This may include: laxative medicine to help remove toxins from your body, medicines such as beta blockers to reduce bleeding, medicine to make you pee more and help reduce swelling, antibiotics to help treat or prevent infections and treat internal bleeding, treatment for weakened bones, a liver transplant, if your cirrhosis is very severe. […] It’s also strongly recommended to make healthy lifestyle changes, including to stop drinking alcohol. […] You’ll be supported by different healthcare professionals. This may include a liver specialist (hepatologist), digestive system specialist (gastroenterologist), nutrition specialists (nutritionist or dietician), and alcohol support services.

• #3 Treatment for Cirrhosis – NIDDK

  https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis/treatment

  Doctors do not have specific treatments that can cure cirrhosis and reverse damage to the liver. However, treating the causes of cirrhosis may prevent cirrhosis or slow the liver damage. Treating the complications of cirrhosis may keep them from getting worse and prevent liver failure. […] To treat the causes of cirrhosis, doctors often recommend lifestyle changes or prescribe medicines to prevent more liver damage. […] For people who have alcohol-associated liver disease, or damage to the liver and its function from drinking too much alcohol, doctors will recommend that they completely stop drinking alcohol and may refer them for alcohol treatment. […] To treat nonalcoholic fatty liver disease (NAFLD), doctors may recommend weight loss. […] To treat a chronic, or long-term, infection of the hepatitis C virus, doctors may prescribe one or more antiviral medicines that attack the virus.

• #4 Cirrhosis of the Liver: Symptoms, Causes & Treatments

  https://liverfoundation.org/liver-diseases/complications-of-liver-disease/cirrhosis/

  Cirrhosis is the scarring of the liver hard scar tissue replaces soft healthy tissue. It is caused by swelling and inflammation. […] Treatment options for cirrhosis depend on the cause and the level of liver damage. Depending on the disease causing cirrhosis, medications or lifestyle changes may be used for treatment. The goals of treatment are to prevent further liver damage and reduce complications. […] When cirrhosis cannot be treated, the condition is known as End-Stage Liver Disease, or ESLD. ESLD includes a subgroup of patients with cirrhosis who have signs of decompensation that is generally irreversible with medical management other than transplant. […] It is possible to prevent further liver damage with proper management of cirrhosis. […] Will I need a liver transplant?

• #5 Cirrhosis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cirrhosis/symptoms-causes/syc-20351487

  Cirrhosis is usually a result of liver damage from conditions such as hepatitis B or C, or chronic alcohol use. […] But if caught early enough and depending on the cause, there is a chance of slowing it with treatment. […] Although the damage caused by cirrhosis is not reversible, treatment can slow the progression of the disease, alleviate symptoms, and prevent complications. […] In cases of early cirrhosis, it is possible to minimize damage to the liver by tackling the underlying causes. […] Once the liver stops functioning, an organ transplant may be an option. […] In fact, cirrhosis is one of the most common reasons for a liver transplant. […] The liver damage caused by cirrhosis generally can’t be undone. But if liver cirrhosis is diagnosed early and the underlying cause is treated, further damage can be limited. […] Studies investigating new treatments that can slow and even reverse the scarring that leads to cirrhosis are currently underway.

• #6 Cirrhosis of the Liver: Symptoms, Stages, and Treatment

  https://www.webmd.com/fatty-liver-disease/understanding-cirrhosis-basic-information

  If you develop liver cancer, the main treatments are surgery, radiation, or chemotherapy. […] Cirrhosis can damage your liver to the point where it no longer works. This is called liver failure. In a transplant, your damaged liver is replaced with a healthy one from a donor. […] You generally can’t reverse the damage that cirrhosis does to your liver. But with a prompt diagnosis and treatment for the issue that’s causing your cirrhosis, you can protect against further damage. […] Depending on the cause of the cirrhosis, there can actually be improvement if you take away the offending agent, Su says. […] Your doctor can treat symptoms such as fatigue and itching with medications.

• #7 Cirrhosis of the Liver: Symptoms, Stages, and Treatment

  https://www.webmd.com/fatty-liver-disease/understanding-cirrhosis-basic-information

  Cirrhosis isn’t curable, but its treatable. Doctors have two main goals in treating this disease: to stop the damage to your liver and prevent complications. Your doctor will personalize your treatment based on what caused your cirrhosis and how much liver damage you have. […] They may recommend: […] Your liver breaks down and removes toxins from your body. Alcohol is a toxin. When you drink too much, your liver has to work extra hard to process it. […] To protect your liver, you must stop drinking. That can be hard to do, especially if you’ve become dependent on alcohol. Ask your doctor about things you can try that may help you stop drinking, such as: […] Treatments for hepatitis can help prevent liver damage. For hepatitis C, there are antiviral treatments that lead to a cure in the vast majority of people.

• #8 Cirrhosis: Causes, Signs, & Treatment

  https://www.medicinenet.com/cirrhosis/article.htm

  What are treatment options for cirrhosis? […] Treatment of cirrhosis includes: […] Preventing further damage to the liver […] Treating the complications of cirrhosis […] Preventing liver cancer or detecting it early […] Liver transplantation. […] Avoid medications (including alcohol) that cause liver damage. All patients with cirrhosis should avoid alcohol. Most patients with alcohol-induced cirrhosis show an improvement in liver function with abstinence from alcohol. Patients with chronic hepatitis B and C can substantially reduce liver damage and slow the progression toward cirrhosis with abstinence from alcohol. […] Treat hepatitis B and hepatitis C virus by using antiviral medications. Not all patients with cirrhosis due to chronic viral hepatitis are candidates for medication treatment. Some patients may experience serious deterioration in liver function and/or intolerable side effects during treatment. The decision to treat viral hepatitis need to be individualized, after consulting with doctors experienced in treating liver diseases (gastroenterologists, hepatologists).

• #9 Cirrhosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cirrhosis/diagnosis-treatment/drc-20351492

  Medicines to control hepatitis. Medicines may limit further damage to liver cells caused by hepatitis B or C through specific treatment of these viruses. […] Medicines to control other causes and symptoms of cirrhosis. Medicines may slow the progression of certain types of liver cirrhosis. For example, for people with primary biliary cholangitis that is diagnosed early, medicine may significantly delay progression to cirrhosis. […] Other medicines can relieve certain symptoms, such as itching, fatigue and pain. Nutritional supplements may be prescribed to treat malnutrition associated with cirrhosis. Supplements also can help prevent weak bones, known as osteoporosis. […] A healthcare professional will work to treat any complications of cirrhosis, including: […] A buildup of fluid in the body. A low-sodium diet and medicine to prevent fluid buildup in the body may help control ascites and swelling. More-severe fluid buildup may need procedures to drain the fluid or surgery to relieve pressure.

• #10 Treatment for Cirrhosis – NIDDK

  https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis/treatment

  To treat a chronic infection of the hepatitis B virus, doctors may prescribe antiviral medicines that slow or stop the virus from further damaging your liver. […] Doctors treat autoimmune hepatitis with medicines that suppress, or decrease the activity of, the immune system. […] Doctors usually treat diseases that damage, destroy, or block bile ducts using medicines or medical procedures to open bile ducts that have become narrow or blocked. […] Treatment of inherited liver diseases depends on the disease. Treatments may help prevent, improve, or manage symptoms and complications such as cirrhosis. […] If taking certain medicines causes cirrhosis, the only treatment is usually to stop taking the medicines that caused the problem. […] Treatments for the complications of cirrhosis may include the following.

• #11 Core Concepts – Treatment of HCV in Persons with Cirrhosis – Treatment of Hepatitis C Infection – Hepatitis C Online

  https://www.hepatitisc.uw.edu/go/treatment-infection/treatment-cirrhosis/core-concept/all

  Multiple studies, most from the interferon era, have shown that successful treatment of HCV in persons with compensated cirrhosis will decrease the incidence of subsequent cirrhosis-related complications, including hepatic failure, hepatocellular carcinoma, and liver-related deaths. […] The most important immediate goal of treatment is to achieve a sustained virologic response, which is required before observing the subsequent benefit in liver-related and other outcomes. […] The immediate treatment goal for individuals with decompensated cirrhosis differs based on candidacy for liver transplantation. […] The efficacy of DAAs in patients with decompensated cirrhosis is lower than in those with compensated disease, ranging from 70 to 90% depending on the study size and the severity of liver disease.

• #12 Cirrhosis of the Liver: Symptoms, Stages, and Treatment

  https://www.webmd.com/fatty-liver-disease/understanding-cirrhosis-basic-information

  The best way to combat a non-alcohol-related cause of liver damage is to lose excess weight with the help of diet and exercise. […] The core treatments of MASH include getting the best management for any diabetes, high blood pressure, or high lipids. […] In March 2024, the FDA approved a drug to help treat MASH. It is called resmetirom (Rezdiffra). This is used for some people with MASH in combination with diet and exercise. […] Doctors treat autoimmune hepatitis with steroid drugs and other medicines that stop the immune system from attacking the liver. […] The main treatment for primary biliary cirrhosis is to slow liver damage with the drug ursodiol (Actigall, Urso). […] Treatments are available for many of the main complications of cirrhosis: […] Your doctor can prescribe medicines called diuretics to help your body get rid of the extra fluid.

• #13 FDA Approves First Treatment for Patients with Liver Scarring Due to Fatty Liver Disease | FDA

  https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-patients-liver-scarring-due-fatty-liver-disease

  Today, the U.S. Food and Drug Administration approved Rezdiffra (resmetirom) for the treatment of adults with noncirrhotic non-alcoholic steatohepatitis (NASH) with moderate to advanced liver scarring (fibrosis), to be used along with diet and exercise. […] Previously, patients with NASH who also have notable liver scarring did not have a medication that could directly address their liver damage, said Nikolay Nikolov, M.D., acting director of the Office of Immunology and Inflammation in the FDAs Center for Drug Evaluation and Research. Todays approval of Rezdiffra will, for the first time, provide a treatment option for these patients, in addition to diet and exercise. […] At 12 months, liver biopsies showed that a greater proportion of subjects who were treated with Rezdiffra achieved NASH resolution or an improvement in liver scarring as compared with those who received the placebo.

• #14 Cirrhosis: Causes, Signs, & Treatment

  https://www.medicinenet.com/cirrhosis/article.htm

  In patients with hemochromatosis, phlebotomy to remove blood from the body may reduce the levels of iron and prevent further damage to the liver. In Wilson’s disease, medications can be used to increase the excretion of copper in the urine to reduce the levels of copper in the body and prevent further damage to the liver. […] in autoimmune hepatitis. medications like prednisone and azathioprine (Imuran) can suppress the immune system and decrease inflammation of the liver. […] Patients with PBC can be treated with a bile acid preparation, ursodeoxycholic acid (UDCA), also called ursodiol (Actigall). Results of an analysis that combined the results from several clinical trials showed that UDCA increased survival among PBC patients during four years of therapy. The development of portal hypertension also was reduced by the UDCA. It is important to note that despite producing clear benefits, UDCA treatment primarily retards progression and does not cure PBC. Other medications such as colchicine and methotrexate also may have benefits in subsets of patients with PBC.

• #15 Treatment of Liver Cirrhosis – Wockhardt

  https://www.wockhardthospitals.com/articles/liver-treatment/treatment-of-liver-diseases-cirrhosis/

  Cirrhosis is a liver disease where the normal healthy tissue is replaced by scar tissue. Due to this the liver is not able to perform its regular functions. […] Treatment for liver cirrhosis depends on the cause and extent of liver damage. The main aim of liver disease treatment is to slow the progression of scar tissue in the liver and to prevent or treat symptoms and complications of liver cirrhosis. AS PART OF treatment for cirrhosis hospitalization maybe recommended. […] Some modalities in cirrhosis treatments are: Conservative treatment of liver cirrhosis, For Treatment of liver cirrhosis, reduce alcohol dependency through support groups in case of addiction or refraining from alcohol, Weight loss and control blood sugar levels, Medications to control hepatitis can be given to prevent hepatitis infections, Drugs to control other causes and symptoms of cirrhosis as support line are given in the cirrhosis of the liver treatment, Nutritional supplements can be given as well.

• #16 Treatment for Cirrhosis – NIDDK

  https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis/treatment

  Doctors treat portal hypertension with medicines to lower high blood pressure in the portal vein. […] To treat ascites, doctors may prescribe medicines that remove fluid from the body. […] To treat swelling in the legs, ankles, or feet called edema, doctors may prescribe medicines that remove fluid from the body. […] To treat varices, doctors may prescribe medicines to lower the blood pressure in the veins. […] Doctors may prescribe medicines that help lower the levels of toxins in the brain and improve brain function. […] Doctors will prescribe antibiotics to treat bacterial infections. […] If you have cirrhosis, your doctor may suggest blood tests and an ultrasound or another type of imaging test to check for liver cancer. […] For people who develop liver cancer, doctors may treat the cancer with medical procedures that remove or destroy cancer cells, such as surgery, radiation therapy, and chemotherapy.

• #17 Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0901/p767.html

  Major complications of cirrhosis include ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, portal hypertension, variceal bleeding, and hepatorenal syndrome. […] Therapy consists of sodium restriction, diuretics, and complete abstention from alcohol. […] Patients with ascitic fluid polymorphonuclear leukocyte counts of 250 cells per mm3 or greater should receive empiric prophylaxis against spontaneous bacterial peritonitis with cefotaxime and albumin. […] Treatment of hepatic encephalopathy is directed toward improving mental status levels with lactulose; protein restriction is no longer recommended. […] Endoscopic banding is the standard treatment, but sclerotherapy with vasoconstrictors (e.g., octreotide) also may be used. […] Prophylaxis with propranolol is recommended in patients with cirrhosis once varices have been identified.

• #18 Cirrhosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cirrhosis/diagnosis-treatment/drc-20351492

  Portal hypertension. Certain blood pressure medicines may control increased pressure in the veins that supply the liver, called portal hypertension, and prevent severe bleeding. An upper endoscopy may be done on a regular basis to look for enlarged veins in the esophagus or stomach that may bleed. These veins are known as varices. […] If someone develops varices, medicine will likely be prescribed to lower the risk of bleeding. If there are signs that the varices are bleeding or are likely to bleed, a procedure known as band ligation may be needed. Band ligation can stop the bleeding or reduce the risk of further bleeding. In severe cases, a small tube called a transjugular intrahepatic portosystemic shunt may be placed in the vein to reduce blood pressure in the liver. […] In advanced cases of cirrhosis, when the liver stops working properly, a liver transplant may be the only treatment option. A liver transplant is a procedure to replace the liver with a healthy liver from a deceased donor or with part of a liver from a living donor. Cirrhosis is one of the most common reasons for a liver transplant. Candidates for liver transplant have extensive testing to determine whether they are healthy enough to have a good outcome following surgery.

• #19 Cirrhosis: Causes, Signs, & Treatment

  https://www.medicinenet.com/cirrhosis/article.htm

  Immunize patients with cirrhosis against infection with hepatitis A and B to prevent a serious deterioration in the liver. There are currently no vaccines available for immunizing against hepatitis C. […] Treatment for bleeding from varices complications […] Treatment is necessary to prevent both the first bleed and subsequent bleeding episodes. Treatments include medications, procedures to decrease the pressure within the portal vein, and procedures to destroy the varices. […] Propranolol (Inderal), a beta-blocker, is effective in lowering the pressure in the portal vein and is used to prevent initial bleeding and rebleeding from varices in patients with cirrhosis. […] Octreotide (Sandostatin) also decreases portal vein pressure and has been used to treat acute variceal bleeding. […] During upper endoscopy (EGD), sclerotherapy or band ligation can be performed to obliterate varices, stop active bleeding, and prevent rebleeding.

• #20 Cirrhosis: Causes, Signs, & Treatment

  https://www.medicinenet.com/cirrhosis/article.htm

  Transjugular intrahepatic portosystemic shunt (TIPS) is a non-surgical, radiologic procedure to decrease the pressure in the portal vein. […] A surgical operation to create a shunt (passage) from the high-pressure portal vein to veins with lower pressure can lower blood flow and pressure in the portal vein and prevent varices from bleeding. […] Treatment for hepatic encephalopathy […] In mild encephalopathy treatment begins with a low-protein diet and lactulose, an oral medication. […] Lactulose is a liquid that traps toxic compounds in the colon so they cannot be absorbed into the bloodstream and then cause encephalopathy. […] Rifaximin (Xifaxan) is an antibiotic taken by mouth that is not absorbed into the body and remains in the intestines. It is the preferred mode of treatment for hepatic encephalopathy.

• #21 Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0901/p767.html

  Transjugular intrahepatic portosystemic shunt has been effective in reducing portal hypertension and improving symptoms of hepatorenal syndrome, and can reduce gastrointestinal bleeding in patients with refractory variceal hemorrhage. […] When medical therapy for treatment of cirrhosis has failed, liver transplantation should be considered. […] First-line treatment of patients with cirrhotic ascites consists of sodium restriction (i.e., no more than 2,000 mg per day) and diuretics (e.g., oral spironolactone [Aldactone] and furosemide [Lasix]), as well as complete abstention from alcohol. […] Patients who survive an episode of spontaneous bacterial peritonitis should receive long-term antibiotic prophylaxis with norfloxacin (Noroxin) or trimethoprim/sulfamethoxazole (Bactrim, Septra).

• #22 Back to Basics: Outpatient Management of Cirrhosis | AASLD

  https://www.aasld.org/liver-fellow-network/core-series/back-basics/back-basics-outpatient-management-cirrhosis

  In patients who have refractory ascites (i.e., no response to maximum tolerated dose of diuretics or development of adverse effects on diuretics), large-volume paracentesis with albumin replacement (for 5L fluid removed) is considered first-line treatment. […] Patients with refractory ascites can be considered for transjugular intrahepatic portosystemic shunt (TIPS) placement. […] First line therapy is lactulose, titrated to 2-3 bowel movements (BMs) per day. […] If a patient has persistent struggles with hepatic encephalopathy despite use of lactulose, or has recurrent admissions for encephalopathy, rifaximin can be added to the regimen. […] Patients with compensated cirrhosis are at highest risk of hepatic decompensation once they develop CSPH, which is defined by portal pressure gradients 10 mmHg.

• #23 Back to Basics: Outpatient Management of Cirrhosis | AASLD

  https://www.aasld.org/liver-fellow-network/core-series/back-basics/back-basics-outpatient-management-cirrhosis

  The 2023 AASLD guidelines state that NSBBs should be considered in patients with compensated cirrhosis and CSPH to prevent decompensation. […] Patients with cirrhosis should undergo endoscopic variceal surveillance if they are not a candidate for empiric NSBB. […] The 2023 AASLD guidelines recommend that patients with cirrhosis and subset populations of patients with chronic hepatitis B undergo HCC screening every 6 months with abdominal ultrasound and alpha-fetoprotein (AFP) testing. […] Recent AASLD guidelines recommend screening patients with cirrhosis for micronutrient deficiencies annually. […] AASLD guidelines recommend a goal daily protein intake of 1.2-1.5 g/kg ideal body weight. […] Sodium restriction will prevent fluid retention but may decrease the palatability of food, creating a barrier to adequate oral intake.

• #24 Cirrhosis: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/1215/p759.html

  Patients with clinically apparent (i.e., moderate to severe) ascites should be managed with salt restriction and spironolactone with or without loop diuretics. […] Patients with cirrhosis who have medium, large, or high-risk varices (red wale markings) should be treated with nonselective beta blockers and/or endoscopic band ligation for primary prevention of variceal bleeds. […] Persistent hepatic encephalopathy that does not respond to conservative measures should be treated with lactulose and/or rifaximin (Xifaxan). […] Oral antibiotic prophylaxis against spontaneous bacterial peritonitis should be initiated in patients with a history of spontaneous bacterial peritonitis or ascitic fluid protein 1.5 g per dL (15 g per L) and advanced liver disease (Child-Pugh score 9 or bilirubin 3 mg per dL) or kidney disease (serum creatinine 1.2 mg per dL, serum sodium 130 per mmol per L). […] Treatment of alcohol use disorder, chronic hepatitis B or C virus infection, and nonalcoholic fatty liver disease can prevent progression and complications of liver disease and can improve fibrosis levels, even in patients with cirrhosis.

• #25 Cirrhosis of the Liver: Signs & Symptoms, Causes, Stages

  https://my.clevelandclinic.org/health/diseases/15572-cirrhosis-of-the-liver

  Cirrhosis involves permanent scarring in your liver, which can’t be undone. […] While your liver has great healing powers in general, cirrhosis is a stage of disease where it doesn’t have enough healthy cells left to heal itself with. But you may be able to slow or stop cirrhosis from progressing further. This depends on what’s causing it, how treatable the cause is, and how well you respond to the treatment. […] Treatment for cirrhosis of the liver includes: managing the cause, if possible, to slow or reduce the damage; general diet and lifestyle measures to reduce stress on your liver; managing or screening for complications of cirrhosis; as a last resort, liver transplantation. […] Medications can treat certain types of liver diseases, with varying levels of success. […] If you have toxic or alcohol-related liver disease, eliminating those toxins from your life is the only treatment.

• #26 A therapy for liver disease that you can do at home | Otsuka Pharmaceutical Co., Ltd.

  https://www.otsuka.co.jp/en/health-and-illness/liver-cirrhosis-nutritional-therapy/nutritional-therapy/

  Liver cirrhosis nutritional therapy […] A therapy for liver disease that you can do at home […] Nutritional condition determines the prognosis of liver cirrhosis […] Taking a late evening snack is a simple measure to help prevent liver cirrhosis […] In addition to the low protein diet + BCAA intake discussed here, there are low protein diets to help prevent encephalitis, meals that contain a lot of dietary fiber (such as vegetables and seaweed) to prevent constipation, and sodium-restricted diets to prevent ascites (an accumulation of fluid around the abdomen) and swelling […] Muscles are also known as the secondary liver because, like the liver, they function to carry out ammonia detoxification and energy production […] It is recommended to maintain a healthy light-exercise routine, such as going for regular walks

• #27

  https://www.laparoscopyhospital.com/forum/forum.php?p=&cat_id=&tid=3600

  Liver cirrhosis is a serious condition that requires medical supervision. While lifestyle changes cannot cure cirrhosis, they may help manage symptoms and improve overall health. Here are some general recommendations: Diet: Limit Sodium Intake: Reduce salt in your diet to help prevent fluid retention and swelling. Maintain a Healthy Weight: If overweight, aim for gradual weight loss through a balanced diet and regular exercise. Moderate Protein Intake: Consult with your healthcare provider to determine the appropriate level of protein intake for your condition. Avoid Alcohol: If alcohol is a factor in your cirrhosis, it’s crucial to completely eliminate alcohol consumption. Fluid Intake: Monitor Fluid Intake: Be mindful of your fluid intake, especially if you have ascites (fluid buildup in the abdomen). Limit Caffeine: Excessive caffeine intake may contribute to fluid loss, so moderation is key. Medication Management: Follow Medication Instructions: Take prescribed medications as directed by your healthcare provider. Avoid Certain Medications: Some medications can be harmful to the liver; ensure your healthcare provider is aware of all medications, including over-the-counter drugs and supplements. Exercise: Engage in Regular Physical Activity: Moderate exercise, as recommended by your healthcare provider, can contribute to overall well-being. Avoid Strenuous Activities: Depending on the severity of cirrhosis, your healthcare provider may advise against strenuous exercise. Monitoring and Regular Check-ups: Regularly Monitor Vital Signs: Keep track of your weight, blood pressure, and any other parameters your healthcare provider recommends. Attend Follow-up Appointments: Regular check-ups are essential for monitoring the progression of cirrhosis and adjusting the treatment plan as needed.

• #28 Cirrhosis Treatment – Eau Claire – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/locations/eau-claire/services-and-treatments/gastroenterology-and-hepatology/digestive-disorders/cirrhosis

  – Procedures An esophagogastroduodenoscopy, or scope test, is recommended, usually every one to two years, to check for esophageal varices; a paracentesis (tap) may be done to drain abdominal fluid; an ultrasound of the liver is recommended every six months for liver cancer screening. […] – Vaccinations If not immune, vaccinations against hepatitis A and B are recommended.

• #29 Cirrhosis in Children: Symptoms & Treatment | Children’s Pittsburgh

  https://www.chp.edu/our-services/transplant/liver/education/liver-disease-states/cirrhosis

  In general, cirrhosis cannot be cured or reversed, doctors treat it with the following goals: […] Your child’s doctor may prescribe drugs to treat the underlying cause of the liver disease. Other medications may be used to control symptoms or fight infections. Some medications are prescribed to get rid of excess fluid in the body or reduce the risk of a blood vessel breaking. Others help your child’s body cut down on its absorption of harmful waste products or toxins. […] If the complications of cirrhosis can no longer be controlled, or if the liver is in danger of no longer functioning, a liver transplant is often the best option. […] Balanced nutritional intake is important for people who already have cirrhosis of the liver can prevent or slow further liver damage by following their doctor’s instructions regarding diet. […] Due to increased risk of infections, doctors recommend vaccines against flu, pneumonia, and hepatitis for people with cirrhosis.

• #30 Drug Considerations for Medication Therapy in Cirrhosis

  https://www.uspharmacist.com/article/drug-considerations-for-medication-therapy-in-cirrhosis

  Cirrhosis results when chronic insults to the liver finally cause irreversible fibrosis. […] Since the liver is the primary site of drug metabolism, the disposition and clinical effects of drugs can be altered in patients with cirrhosis. […] Pharmacists can play a key role in modifying medications based on liver function to ensure safe medication use in patients with cirrhosis. […] This article will provide pharmacists a practical overview of the impact of cirrhosis on medication therapy and considerations to help prevent adverse drug reactions. […] While these classification schemes may assist in categorizing the severity of liver disease, they were not designed to reliably estimate the relationship between hepatic impairment and the pharmacokinetics and pharmacodynamics of medications.

• #31 Drug Considerations for Medication Therapy in Cirrhosis

  https://www.uspharmacist.com/article/drug-considerations-for-medication-therapy-in-cirrhosis

  However, most drugs, even those that are potentially hepatotoxic, can be used safely in patients with cirrhosis as long as the patient is frequently monitored. […] A clear understanding of how these impacts may affect drug dosing is crucial so that pharmacists can appropriately optimize medications to avoid adverse drug reactions or toxicities.

• #32 Liver Failure – End Stage Liver Disease – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/liver-diseases-hepatology/liver-failure

  Your treatment will depend on the cause of your liver failure. However, in many cases, the best treatment for advanced liver disease is a liver transplant. […] At UChicago Medicine, our liver disease team helps hundreds of patients each year with cirrhosis. We focus on controlling or slowing the progression of cirrhosis with lifestyle changes, medicines and other treatments. […] Once cirrhosis progresses to this advanced stage, the definitive treatment is a liver transplant. […] In many cases, the only treatment for a failing liver is a liver transplant. But sometimes, an acute or hereditary cause can be treated to reverse the condition. […] The Molecular Adsorbent Recirculating System (MARS) is a liver dialysis machine used to perform some of the function of the liver. […] Waiting for a donor liver is not the only option available to liver failure patients. Living liver donors can give part of their healthy liver to a transplant patient and end their long wait for treatment.

• #33 Patient education: Cirrhosis (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/cirrhosis-beyond-the-basics

  COMPLICATIONS OF CIRRHOSIS […] When it is healthy, the liver has many jobs, including filtering toxins out of the blood, breaking down certain drugs and alcohol, and making proteins that are important in clotting or digestion. Cirrhosis can lead to many complications, some of which happen because the liver is no longer able to do these jobs well, and some of which happen because blood flow through the liver is disrupted. […] LIVER TRANSPLANT FOR CIRRHOSIS […] Liver transplant involves replacing a diseased liver with a healthy liver. It is the definitive treatment for people with advanced cirrhosis. Still, not everyone with advanced cirrhosis is a good candidate for a transplant. Some of the reasons why people might not be good candidates include liver cancer that has spread outside the liver, or significant heart or lung disease. Liver transplant is a complicated, major surgery, so people undergoing the surgery need to be healthy enough to survive the surgery and recovery. What’s more, even people who are good candidates must wait for a compatible liver to be available. […] More than 80 percent of people will be alive one year after a liver transplant, and the majority of these will be alive five years after the transplant. This is compared with an extremely high death rate in patients with very advanced cirrhosis who do not receive a liver transplant.

• #34 Cirrhosis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/cirrhosis/

  Provide supportive care to: […] Avoid further liver damage […] Potentially reverse fibrosis or early cirrhosis. […] Conduct regular staging of cirrhosis (see Staging of cirrhosis). […] Consider workup for liver transplantation, depending on stage and etiology. […] A liver transplant is the only curative option in patients with cirrhosis. […] Indications for liver transplant evaluation include: […] Occurrence of an index complication: i.e., ascites, hepatic encephalopathy, variceal hemorrhage. […] Hepatocellular dysfunction resulting in a MELD score of 15.

• #35 Cirrhosis | Conditions and Treatments | Center for Liver Disease & Transplantation | Columbia University Department of Surgery

  https://columbiasurgery.org/conditions-and-treatments/cirrhosis

  Cirrhosis cannot be reversed with treatment. In fact, the only treatment that can cure cirrhosis is a liver transplantation. However, treating the underlying cause of cirrhosis can slow or even stop additional liver damage. This can help prevent liver failure later on. […] Those with early-stage cirrhosis can especially benefit from stopping its underlying cause. This may involve the following treatment options: […] When cirrhosis is severe enough to cause liver failure, a liver transplantation may be necessary. This procedure involves removing the entire diseased liver and replacing it with a healthy donor liver. Potential candidates will need to go through an extensive evaluation process to determine if they are mentally and physically ready for this procedure. […] If liver damage is severe, a liver transplantation may be necessary. In this case, a MELD score is used to determine the patients priority on the liver transplant waiting list.

• #36 Cirrhosis: Causes, Signs, & Treatment

  https://www.medicinenet.com/cirrhosis/article.htm

  Treatment for edema, acites, and hypersplenism complications […] Doctors often advise patients with cirrhosis to restrict dietary salt (sodium) and fluid to decrease edema and ascites. […] Diuretics are medications that work in the kidneys to promote the elimination of salt and water in the urine. […] Another treatment for refractory ascites is a procedure called transjugular intravenous portosystemic shunting (TIPS). […] Treatment for spontaneous bacterial peritonitis complications […] Most patients with spontaneous bacterial peritonitis are hospitalized and treated with intravenous antibiotics such as cefotaxime, ceftriaxone or ciprofloxacin. […] In some patients, oral antibiotics may be prescribed to prevent spontaneous bacterial peritonitis. […] Liver transplantation may be the only option for treatment. Recent advances in surgical transplantation and medications to prevent infection and rejection of the transplanted liver have greatly improved survival after transplantation.

• #37 New cell therapy shows progress in treating advanced liver disease | Institute for Regeneration and Repair

  https://regeneration-repair.ed.ac.uk/news-and-stories/news/new-cell-therapy-progress-treating-liver-disease

  A new type of cell therapy to treat patients with liver scarring, or cirrhosis, shows promise of being the first medical treatment for this common and lethal condition. […] The innovative new approach to treating cirrhosis uses macrophage immune cells the cells associated with tissue repair derived from the patients own cells. […] The results indicate the treatment might help delay the need for a liver transplant, which is currently the only treatment option available to patients with advanced liver disease, but is a highly invasive procedure severely limited by organ availability, patient eligibility and complex aftercare. […] This trial shows the treatment is well tolerated, and is associated with reducing the clinical complications in patients with end-stage liver disease. […] The results of this trial of a novel macrophage cell therapy show great promise and if successfully built upon should provide lasting benefit for patients with chronic liver disease, an area of significant and unmet clinical need.

• #38 Autologous macrophage therapy for liver cirrhosis: a phase 2 open-label randomized controlled trial | Nature Medicine

  https://www.nature.com/articles/s41591-024-03406-8

  Cirrhosis is a major cause of morbidity and mortality; however, there are no approved therapies except orthotopic liver transplantation. […] In a multicenter, open-label, parallel-group, phase 2 randomized controlled trial (ISRCTN10368050) in n=51 adult patients with compensated cirrhosis and Model for End-Stage Liver Disease (MELD) score 10 and 17, we evaluated the efficacy of autologous monocyte-derived macrophage therapy (n=27) compared to standard medical care (n=24). […] This study reinforces the safety and potential efficacy of macrophage therapy in cirrhosis, supporting further investigation. […] There are no approved medicines for the treatment of cirrhosis. […] However, for patients with cirrhosis in whom cure or suppression of the primary disease is not possible, standard medical care is limited to the use of non-selective beta-blockers to mitigate risk of decompensation and death, treatment of incident cirrhosis-related complications and liver transplantation if indicated.

• #39 Efficacy and safety of mesenchymal stem cell therapy in liver cirrhosis: a systematic review and meta-analysis | Stem Cell Research & Therapy | Full Text

  https://stemcellres.biomedcentral.com/articles/10.1186/s13287-023-03518-x

  In conclusion, MSC transplantation is a potential strategy for LC treatment. […] The results showed that MSC infusion significantly improved liver function in LC patients, as was indicated by the reduced MELD score and increased ALB levels. […] Remarkably, no significant adverse effects were reported in the included studies, which suggested the safety of MSC therapy for LC. […] Therefore, clinical double-blind randomized controlled trials with more graded cell doses need to be carried out in the future. […] In conclusion, MSC is safe and effective for treating LC. However, it is urgent to establish a standard treatment protocol to fully maximize the potential of MSC, which involves the optimization of re-infusion time point, route, frequency of infusion, and dose of cells. […] Collectively, these may facilitate further understanding of MSC treatment for LC and its pathophysiology, thus further improving the therapeutic effects.

• #40 Cirrhosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cirrhosis/diagnosis-treatment/drc-20351492

  For transplant to be an option if you have alcoholic cirrhosis, you would need to: […] Find a program that works with people who have alcoholic cirrhosis. […] Meet the requirements of the program. These would include lifelong commitment to alcohol abstinence as well as other requirements of the specific transplant center. […] Scientists are working to expand current treatments for cirrhosis, but success has been limited. Because cirrhosis has a variety of causes and complications, there are many potential avenues of approach. A combination of increased screening, lifestyle changes and new medicines may improve outcomes for people with liver damage, if started early. […] Researchers are working on therapies that will specifically target liver cells, helping to slow or even reverse the fibrosis that leads to cirrhosis. However, no targeted therapy is quite ready.

• #41 Promising Therapies for Liver Cirrhosis Treatment in the Pipeline

  https://www.delveinsight.com/blog/liver-cirrhosis-treatment

  Liver cirrhosis treatment strategies involve lifestyle changes, such as abstaining from alcohol, maintaining a healthy diet, and regular exercise to manage the symptoms and prevent the progression of liver damage. […] No approved therapies have been available to treat NASH, fibrosis, or liver cirrhosis. However, in recent years, there have been multiple companies and academic centers that are examining various agents for liver cirrhosis treatment. Significant advancements have been made in developing emerging liver cirrhosis therapies bringing new hope to patients with this debilitating condition. […] Therapies that can effectively reverse fibrosis and prevent the progression of cirrhosis are a high unmet medical need. […] The liver cirrhosis treatment market is witnessing promising advancements, with several emerging drugs that have shown potential to revolutionize the current market.

• #42 Promising Therapies for Liver Cirrhosis Treatment in the Pipeline

  https://www.delveinsight.com/blog/liver-cirrhosis-treatment

  Madrigal MGL-3196 (Resmetirom), Akeros Efruxifermin (EFX), Bristols BMS-986263, and Galectins Belapectin are a few therapies focused on the NASH cirrhosis population while CymaBays Seladelpar is being developed for PBC cirrhosis patients and ALBUTEIN 20% injectable solution for decompensated cirrhosis associated with HBV and HVC patients. […] The current liver cirrhosis treatment has significant toxicity and side effects. They are limited to managing the complications, not the cure. Emerging therapies appear to have the potential to address these unmet medical needs of patients by providing improved efficacy, reduced toxicity, disease modification, and improving the overall treatment experience for patients. […] Despite promising developments, challenges lie ahead, including ensuring the safety and efficacy of these drugs, navigating regulatory hurdles, and addressing the high cost of these therapies. The potential benefits of these emerging therapies for liver cirrhosis treatment, including improved outcomes and quality of life for patients, make it an exciting time in research and treatment.

• #43 Cirrhosis of the Liver: Symptoms, Treatment, and Prognosis

  https://patient.info/digestive-health/abnormal-liver-function-tests-leaflet/cirrhosis

  In severe cases, where the scarring is extensive and the liver can barely function, then a liver transplant may be the only option. […] Up until recently, the scarring process of cirrhosis was thought to be irreversible. However, recent research has led to a greater understanding of the scarring process. Some research suggests that medicines may be able to be developed that can reverse the scarring process. Stem cell or liver cell transplantation aimed at restoring liver function is also being investigated. This research continues.

• #44 Core Concepts – Treatment of HCV in Persons with Cirrhosis – Treatment of Hepatitis C Infection – Hepatitis C Online

  https://www.hepatitisc.uw.edu/go/treatment-infection/treatment-cirrhosis/core-concept/all

  The key recommendation from the guidance is that general management and treatment of all patients with decompensated cirrhosis should be performed by a medical practitioner highly experienced in managing persons with chronic HCV infection and decompensated cirrhosis. […] Treatment of HCV in persons with compensated cirrhosis (Child-Turcotte-Pugh class A) is a high priority because of the risk of developing severe liver-related complications. […] Treatment of HCV is recommended in persons with decompensated cirrhosis who are eligible for liver transplantation, since the transplanted liver will become infected with HCV in all patients who have detectable HCV RNA levels at the time of liver transplantation. […] Treatment of HCV in persons with decompensated cirrhosis should be performed only by a medical provider who has experience in treating HCV in persons with decompensated cirrhosis.

• #45 What will your health care provider do about cirrhosis? – Viral Hepatitis and Liver Disease

  https://www.hepatitis.va.gov/cirrhosis/patient/what-provider-will-do.asp

  Cirrhosis […] People with cirrhosis need to see a health care provider regularly. If you have compensated cirrhosis, these visits may be scheduled as often as every 3 to 6 months. These visits allow your provider to watch for complications. Your provider may order the screening tests that can catch these complications early. Then they can be treated or even delayed. […] If you have decompensated cirrhosis, you may need to see your provider more often so the complications that have developed can be managed. […] An important step for all patients with cirrhosis is to reduce or prevent more liver damage by controlling the underlying cause. Patients who drink alcohol should stop all alcohol intake. It often takes support from friends, family and even a medical professional who specializes in helping individuals quit drinking. Patients with chronic viral hepatitis B or hepatitis C should receive treatment that can control or cure the virus. Patients with non-alcoholic fatty liver disease should reduce calorie intake. Consultation with a dietitian or with the MOVE! Weight Management Program is often recommended. […] Some people with cirrhosis should have an upper endoscopy (pronounced en-dahs-cup-ee) procedure. This is a test in which a thin tube with a camera is passed down your esophagus (food tube) so that your provider can look for varices. If you have no varices, the endoscopy will be repeated every few years or you may be given a type of medication called a beta-blocker instead of endoscopy. If you have large varices, you will get treatment or medication to reduce the chance of bleeding. […] You also will have a blood test and an ultrasound (or sometimes a CAT scan or an MRI) to look for signs of liver cancer and ascites. It is important for your health care provider to look for cancer on a regular basis, usually every 6 months. If the cancer is caught early, there are often ways to treat it. […] If you have developed decompensated cirrhosis, your provider may discuss liver transplant with you. Your provider can answer questions and help you to decide if a transplant is right for you. Your provider will help you find out if your body can tolerate this operation, and, if it can, help you and your loved ones get ready for transplant surgery.

• #46 Back to Basics: Outpatient Management of Cirrhosis | AASLD

  https://www.aasld.org/liver-fellow-network/core-series/back-basics/back-basics-outpatient-management-cirrhosis

  Frontline management of ascites and lower extremity edema in cirrhosis includes sodium restriction and diuretics. […] Refer patients with decompensated cirrhosis or HCC to hepatology for consideration of liver transplant evaluation. […] Non-selective beta blockers are beneficial in patients with portal hypertension and can prevent/delay complications of variceal bleeding and ascites. […] Patients with cirrhosis should be screened for HCC every 6 months and malnutrition at least every 12 months.

• #47 Cirrhosis Treatment | Rush

  https://www.rush.edu/services/cirrhosis-care

  Whatever stage of cirrhosis you may have, our caring liver specialists can suggest a diet, medications and other treatments for your chronic liver disease. […] Hepatologists, gastroenterologists and other cirrhosis specialists at RUSH are here to help you address the cause of your cirrhosis. We can work with you on a cirrhosis treatment program to reduce your risks of developing liver failure. […] We can also help you prevent and manage the complications of cirrhosis, such as ascites (fluid in the abdomen), esophageal varices (enlarged veins in the esophagus), hepatic encephalopathy (loss of brain function) and liver cancer. […] Your cirrhosis treatment at RUSH may include the following strategies: Lifestyle modifications, such as eating a nutritious diet, limiting salt and maintaining a healthy weight; Medications to address the cause of your cirrhosis and manage your symptoms; Liver transplant if your liver is too damaged to function; Help with addiction, including alcohol abuse and use of illegal drugs, when needed.

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