Liver cirrhosis is commonly encountered in general practice. Although cirrhosis can result from various causes, it most often has a toxic (alcohol), metabolic (nonalcoholic steatohepatitis [NASH]), or infectious (hepatitis B and C) origin. The initial evaluation includes a blood test and an abdominal ultrasound. The diagnosis can be confirmed with non-invasive quantification of fibrosis, using either biological markers (FibroTest®) or transient elastography (FibroScan®). A liver biopsy is only rarely required. Therapeutic management of cirrhosis involves the treatment of the underlying disease, along with the management of complications. Complete alcohol abstinence, weight loss, and the control of risk factors, such as the metabolic syndrome, are some examples. In case of confirmed cirrhosis, abdominal ultrasound and alpha-fetoprotein measurements should be performed every 6 months to screen for hepatocarcinoma. It is also recommended to conduct a gastroscopy every 2-3 years to assess the presence of esophageal varices.
What does this article bring up for us?
This article provides a practical summary of the diagnostic approach and the principles of cirrhosis management in general medicine.
Key Words
Cirrhosis, esophageal varices, hepatocarcinoma, FibroTest, FibroScan