Treatment of Cirrhosis – General Principles

• Early diagnosis is critical to manage symptoms and prevent complications.

Lifestyle and Supportive Care

• Avoid fatigue and infection:
  • Rest and minimize exposure to pathogens.
• Eliminate alcohol and treat the underlying cause of liver damage.
• Supportive treatment:
  • Restrict protein: To reduce ammonia buildup.
  • Limit salt: To prevent excess fluid retention.
  • Maintain healthy diet: Carbohydrates, vitamins, and nutrients to support overall health.

Fluid and Electrolyte Management

• Diuretics: To control fluid retention and electrolyte imbalance.
• Paracentesis: Procedure to drain excess fluid from the abdominal cavity.
• Albumin transfusion:
  • Restores plasma proteins.
  • Helps maintain blood volume and prevent third spacing (fluid leakage into tissues leading to edema).

Infection Control

• Treat bacterial infections with antibiotics.
• Prophylactic antibiotics may be used to prevent bacterial peritonitis (infection of ascitic fluid).

Surgical Interventions

• Portocaval shunt:
  • Relieves portal hypertension.
  • Diverts blood flow from portal vein to the inferior vena cava.
  • Reduces risk of variceal bleeding.
• Vascular bypass surgery:
  • Connecting a vessel directly to the IVC bypasses the damaged liver.
  • Helps reduce pressure in engorged vessels.
• Liver transplant:
  • Considered the definitive treatment in end-stage liver disease.

Summary

• Supportive care focuses on managing symptoms and preventing complications.
• Surgical options help reduce portal hypertension and bleeding risks.
• Liver transplant remains the ultimate cure for complete liver failure.