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] 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
- Vaccination against Hepatitis A and B help prevent superimposed insult to the cirrhotic liver.
Tertiary Prevention
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.