Cirrhosis tertiary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]

Overview

Tertiary prevention in patients with cirrhosis is aimed at preventing the complications that arise from cirrhosis, such as esophageal varices, spontaneous bacterial peritonitis, hepatorenal syndrome and portal vein thrombosis.

Tertiary Prevention

• Non-selective beta blockers reduce the risk of further bleeding from the esophageal varices.

• Judicious use of diuretics and prophylactic antibiotics prevent spontaneous bacterial peritonitis.

• Avoiding vigorous diuresis and nephrotoxic drugs help to prevent hepatorenal syndrome.

• Enoxaparin, a low molecular weight heparin, is effective in the prevention of portal vein thrombosis in patients with cirrhosis.
•  Adequate nutrition in patients with alcoholic cirrhosis decreases the risk of major complications, such as ascites, encephalopathy, and infections.