Cirrhosis secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

Overview

Secondary prevention in patients with cirrhosis is aimed at preventing further damage in an ailing liver. Avoidance of alcohol and other hepatotoxins, treatment of any underlying chronic liver disease and immunisation against hepatitis A and B for susceptible patients are the key measure of secondary prevention of cirrhosis complication and death.

Secondary Prevention

• Abstinence from alcohol is the initial step in secondary prevention to prevent further damage to the liver in patients who already have cirrhosis. One should discuss the alcohol intake with the doctor. Patients with Hepatitis B and C should cut down on alcohol intake as alcohol aggravates fibrosis, cirrhosis, and makes liver cancer more likely.

• Vaccination against Hepatitis A and B in cirrhotic patients can help prevent superimposed insult to the live that has already been damaged.

• Avoid intake of foods and water with high concentrations of copper to prevent worsening of Wilson's disease.

Prevention of Complications

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

• Judicious use of diuretics and prophylactic antibiotics have been shown to prevent spontaneous bacterial peritonitis.

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