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==Secondary Prevention==
==Secondary Prevention==
* Abstinence from [[alcohol]] and heaptotoxic drugs prevents further [[liver]] damage in patients with [[cirrhosis]].<ref name="pmid23638982">{{cite journal |vauthors=Lewis JH, Stine JG |title=Review article: prescribing medications in patients with cirrhosis - a practical guide |journal=Aliment. Pharmacol. Ther. |volume=37 |issue=12 |pages=1132–56 |year=2013 |pmid=23638982 |doi=10.1111/apt.12324 |url=}}</ref><ref name="pmid6971772">{{cite journal |vauthors=Borowsky SA, Strome S, Lott E |title=Continued heavy drinking and survival in alcoholic cirrhotics |journal=Gastroenterology |volume=80 |issue=6 |pages=1405–9 |year=1981 |pmid=6971772 |doi= |url=}}</ref><ref name="pmid12640727">{{cite journal |vauthors=Pessione F, Ramond MJ, Peters L, Pham BN, Batel P, Rueff B, Valla DC |title=Five-year survival predictive factors in patients with excessive alcohol intake and cirrhosis. Effect of alcoholic hepatitis, smoking and abstinence |journal=Liver Int. |volume=23 |issue=1 |pages=45–53 |year=2003 |pmid=12640727 |doi= |url=}}</ref><ref name="pmid21814145">{{cite journal |vauthors=Alvarez MA, Cirera I, Solà R, Bargalló A, Morillas RM, Planas R |title=Long-term clinical course of decompensated alcoholic cirrhosis: a prospective study of 165 patients |journal=J. Clin. Gastroenterol. |volume=45 |issue=10 |pages=906–11 |year=2011 |pmid=21814145 |doi=10.1097/MCG.0b013e3182284e13 |url=}}</ref><ref name="pmid4362373">{{cite journal |vauthors=Brunt PW, Kew MC, Scheuer PJ, Sherlock S |title=Studies in alcoholic liver disease in Britain. I. Clinical and pathological patterns related to natural history |journal=Gut |volume=15 |issue=1 |pages=52–8 |year=1974 |pmid=4362373 |pmc=1412935 |doi= |url=}}</ref><ref name="pmid9098014">{{cite journal |vauthors=Luca A, García-Pagán JC, Bosch J, Feu F, Caballería J, Groszmann RJ, Rodés J |title=Effects of ethanol consumption on hepatic hemodynamics in patients with alcoholic cirrhosis |journal=Gastroenterology |volume=112 |issue=4 |pages=1284–9 |year=1997 |pmid=9098014 |doi= |url=}}</ref>  
* Abstinence from [[alcohol]] and heaptotoxic drugs prevents further [[liver]] damage in patients with [[cirrhosis]].<ref name="pmid23638982">{{cite journal |vauthors=Lewis JH, Stine JG |title=Review article: prescribing medications in patients with cirrhosis - a practical guide |journal=Aliment. Pharmacol. Ther. |volume=37 |issue=12 |pages=1132–56 |year=2013 |pmid=23638982 |doi=10.1111/apt.12324 |url=}}</ref><ref name="pmid6971772">{{cite journal |vauthors=Borowsky SA, Strome S, Lott E |title=Continued heavy drinking and survival in alcoholic cirrhotics |journal=Gastroenterology |volume=80 |issue=6 |pages=1405–9 |year=1981 |pmid=6971772 |doi= |url=}}</ref><ref name="pmid12640727">{{cite journal |vauthors=Pessione F, Ramond MJ, Peters L, Pham BN, Batel P, Rueff B, Valla DC |title=Five-year survival predictive factors in patients with excessive alcohol intake and cirrhosis. Effect of alcoholic hepatitis, smoking and abstinence |journal=Liver Int. |volume=23 |issue=1 |pages=45–53 |year=2003 |pmid=12640727 |doi= |url=}}</ref><ref name="pmid21814145">{{cite journal |vauthors=Alvarez MA, Cirera I, Solà R, Bargalló A, Morillas RM, Planas R |title=Long-term clinical course of decompensated alcoholic cirrhosis: a prospective study of 165 patients |journal=J. Clin. Gastroenterol. |volume=45 |issue=10 |pages=906–11 |year=2011 |pmid=21814145 |doi=10.1097/MCG.0b013e3182284e13 |url=}}</ref><ref name="pmid4362373">{{cite journal |vauthors=Brunt PW, Kew MC, Scheuer PJ, Sherlock S |title=Studies in alcoholic liver disease in Britain. I. Clinical and pathological patterns related to natural history |journal=Gut |volume=15 |issue=1 |pages=52–8 |year=1974 |pmid=4362373 |pmc=1412935 |doi= |url=}}</ref><ref name="pmid9098014">{{cite journal |vauthors=Luca A, García-Pagán JC, Bosch J, Feu F, Caballería J, Groszmann RJ, Rodés J |title=Effects of ethanol consumption on hepatic hemodynamics in patients with alcoholic cirrhosis |journal=Gastroenterology |volume=112 |issue=4 |pages=1284–9 |year=1997 |pmid=9098014 |doi= |url=}}</ref>  
* Vaccination against [[Hepatitis A]] and [[Hepatitis B|B]] help prevent superimposed insult to the cirrhotic [[liver]].
* Vaccination against [[Hepatitis A]] and [[Hepatitis B|B]] help prevent superimposed insult to the cirrhotic [[liver]].
==Tertiary Prevention==
===Overview===
Tertiary prevention in [[Patient|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]].<ref name="pmid20536715">{{cite journal |vauthors=Muntaner L, Altamirano JT, Augustin S, González A, Esteban R, Guardia J, Genescà J |title=High doses of beta-blockers and alcohol abstinence improve long-term rebleeding and mortality in cirrhotic patients after an acute variceal bleeding |journal=Liver Int. |volume=30 |issue=8 |pages=1123–30 |year=2010 |pmid=20536715 |doi=10.1111/j.1478-3231.2010.02287.x |url=}}</ref>
* Judicious use of [[Diuretic|diuretics]] and [[Prophylaxis|prophylactic]] [[Antibiotic|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 [[Patient|patients]] with [[cirrhosis]].
*  Adequate [[nutrition]] in patients with [[Cirrhosis|alcoholic cirrhosis]] decreases the risk of major complications, such as [[ascites]], [[encephalopathy]], and [[Infection|infections]].
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Latest revision as of 14:27, 26 December 2017

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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] Sudarshana Datta, MD [3]

Overview

Secondary prevention in patients with cirrhosis is aimed at preventing further damage to the liver. Avoidance of alcohol and other hepatotoxins, treatment of underlying chronic liver disease and immunization against viral hepatitis for susceptible patients are key measures of secondary prevention of cirrhosis.

Secondary Prevention

References

  1. ↑ Lewis JH, Stine JG (2013). "Review article: prescribing medications in patients with cirrhosis - a practical guide". Aliment. Pharmacol. Ther. 37 (12): 1132–56. doi:10.1111/apt.12324. PMID 23638982.
  2. ↑ Borowsky SA, Strome S, Lott E (1981). "Continued heavy drinking and survival in alcoholic cirrhotics". Gastroenterology. 80 (6): 1405–9. PMID 6971772.
  3. ↑ Pessione F, Ramond MJ, Peters L, Pham BN, Batel P, Rueff B, Valla DC (2003). "Five-year survival predictive factors in patients with excessive alcohol intake and cirrhosis. Effect of alcoholic hepatitis, smoking and abstinence". Liver Int. 23 (1): 45–53. PMID 12640727.
  4. ↑ Alvarez MA, Cirera I, Solà R, Bargalló A, Morillas RM, Planas R (2011). "Long-term clinical course of decompensated alcoholic cirrhosis: a prospective study of 165 patients". J. Clin. Gastroenterol. 45 (10): 906–11. doi:10.1097/MCG.0b013e3182284e13. PMID 21814145.
  5. ↑ Brunt PW, Kew MC, Scheuer PJ, Sherlock S (1974). "Studies in alcoholic liver disease in Britain. I. Clinical and pathological patterns related to natural history". Gut. 15 (1): 52–8. PMC 1412935. PMID 4362373.
  6. ↑ Luca A, García-Pagán JC, Bosch J, Feu F, Caballería J, Groszmann RJ, Rodés J (1997). "Effects of ethanol consumption on hepatic hemodynamics in patients with alcoholic cirrhosis". Gastroenterology. 112 (4): 1284–9. PMID 9098014.

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