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British Society of Gastroenterology Best Practice Guidance: outpatient management of cirrhosis – part 1: compensated cirrhosis

The prevalence of cirrhosis has risen significantly over recent decades and is predicted to rise further. Widespread use of non-invasive testing means cirrhosis is increasingly diagnosed at an earlier stage. Despite this, there are significant variations in outcomes in patients with cirrhosis across...

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Autores principales: Mansour, Dina, Masson, Steven, Shawcross, Debbie L, Douds, Andrew C, Bonner, Emily, Corless, Lynsey, Leithead, Joanna A, Hammond, John, Heneghan, Michael A, Rahim, Mussarat Nazia, Tripathi, Dhiraj, West, Rebecca, Johnson, Jill, Botterill, Gemma, Hollywood, Coral, Ross, Valerie, Donnelly, Mhairi, Compston, Juliet E, McPherson, Stuart, Grapes, Allison
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10579555/
https://www.ncbi.nlm.nih.gov/pubmed/37862444
http://dx.doi.org/10.1136/flgastro-2023-102430
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author Mansour, Dina
Masson, Steven
Shawcross, Debbie L
Douds, Andrew C
Bonner, Emily
Corless, Lynsey
Leithead, Joanna A
Hammond, John
Heneghan, Michael A
Rahim, Mussarat Nazia
Tripathi, Dhiraj
West, Rebecca
Johnson, Jill
Botterill, Gemma
Hollywood, Coral
Ross, Valerie
Donnelly, Mhairi
Compston, Juliet E
McPherson, Stuart
Grapes, Allison
author_facet Mansour, Dina
Masson, Steven
Shawcross, Debbie L
Douds, Andrew C
Bonner, Emily
Corless, Lynsey
Leithead, Joanna A
Hammond, John
Heneghan, Michael A
Rahim, Mussarat Nazia
Tripathi, Dhiraj
West, Rebecca
Johnson, Jill
Botterill, Gemma
Hollywood, Coral
Ross, Valerie
Donnelly, Mhairi
Compston, Juliet E
McPherson, Stuart
Grapes, Allison
author_sort Mansour, Dina
collection PubMed
description The prevalence of cirrhosis has risen significantly over recent decades and is predicted to rise further. Widespread use of non-invasive testing means cirrhosis is increasingly diagnosed at an earlier stage. Despite this, there are significant variations in outcomes in patients with cirrhosis across the UK, and patients in areas with higher levels of deprivation are more likely to die from their liver disease. This three-part best practice guidance aims to address outpatient management of cirrhosis, in order to standardise care and to reduce the risk of progression, decompensation and mortality from liver disease. Here, in part one, we focus on outpatient management of compensated cirrhosis, encompassing hepatocellular cancer surveillance, screening for varices and osteoporosis, vaccination and lifestyle measures. We also introduce a compensated cirrhosis care bundle for use in the outpatient setting. Part two concentrates on outpatient management of decompensated disease including management of ascites, encephalopathy, varices, nutrition as well as liver transplantation and palliative care. The third part of the guidance covers special circumstances encountered in managing people with cirrhosis: surgery, pregnancy, travel, managing bleeding risk for invasive procedures and portal vein thrombosis.
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spelling pubmed-105795552023-10-18 British Society of Gastroenterology Best Practice Guidance: outpatient management of cirrhosis – part 1: compensated cirrhosis Mansour, Dina Masson, Steven Shawcross, Debbie L Douds, Andrew C Bonner, Emily Corless, Lynsey Leithead, Joanna A Hammond, John Heneghan, Michael A Rahim, Mussarat Nazia Tripathi, Dhiraj West, Rebecca Johnson, Jill Botterill, Gemma Hollywood, Coral Ross, Valerie Donnelly, Mhairi Compston, Juliet E McPherson, Stuart Grapes, Allison Frontline Gastroenterol Guideline The prevalence of cirrhosis has risen significantly over recent decades and is predicted to rise further. Widespread use of non-invasive testing means cirrhosis is increasingly diagnosed at an earlier stage. Despite this, there are significant variations in outcomes in patients with cirrhosis across the UK, and patients in areas with higher levels of deprivation are more likely to die from their liver disease. This three-part best practice guidance aims to address outpatient management of cirrhosis, in order to standardise care and to reduce the risk of progression, decompensation and mortality from liver disease. Here, in part one, we focus on outpatient management of compensated cirrhosis, encompassing hepatocellular cancer surveillance, screening for varices and osteoporosis, vaccination and lifestyle measures. We also introduce a compensated cirrhosis care bundle for use in the outpatient setting. Part two concentrates on outpatient management of decompensated disease including management of ascites, encephalopathy, varices, nutrition as well as liver transplantation and palliative care. The third part of the guidance covers special circumstances encountered in managing people with cirrhosis: surgery, pregnancy, travel, managing bleeding risk for invasive procedures and portal vein thrombosis. BMJ Publishing Group 2023-07-28 /pmc/articles/PMC10579555/ /pubmed/37862444 http://dx.doi.org/10.1136/flgastro-2023-102430 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Guideline
Mansour, Dina
Masson, Steven
Shawcross, Debbie L
Douds, Andrew C
Bonner, Emily
Corless, Lynsey
Leithead, Joanna A
Hammond, John
Heneghan, Michael A
Rahim, Mussarat Nazia
Tripathi, Dhiraj
West, Rebecca
Johnson, Jill
Botterill, Gemma
Hollywood, Coral
Ross, Valerie
Donnelly, Mhairi
Compston, Juliet E
McPherson, Stuart
Grapes, Allison
British Society of Gastroenterology Best Practice Guidance: outpatient management of cirrhosis – part 1: compensated cirrhosis
title British Society of Gastroenterology Best Practice Guidance: outpatient management of cirrhosis – part 1: compensated cirrhosis
title_full British Society of Gastroenterology Best Practice Guidance: outpatient management of cirrhosis – part 1: compensated cirrhosis
title_fullStr British Society of Gastroenterology Best Practice Guidance: outpatient management of cirrhosis – part 1: compensated cirrhosis
title_full_unstemmed British Society of Gastroenterology Best Practice Guidance: outpatient management of cirrhosis – part 1: compensated cirrhosis
title_short British Society of Gastroenterology Best Practice Guidance: outpatient management of cirrhosis – part 1: compensated cirrhosis
title_sort british society of gastroenterology best practice guidance: outpatient management of cirrhosis – part 1: compensated cirrhosis
topic Guideline
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10579555/
https://www.ncbi.nlm.nih.gov/pubmed/37862444
http://dx.doi.org/10.1136/flgastro-2023-102430
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