A Primer on Detecting Cirrhosis and Caring for These Patients without Causing Harm

Table 2

General advice regarding the care of patients with cirrhosis.

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Total abstinence from alcohol

Consider baclofen to reduce/eliminate alcohol craving and alcohol use

Minimize medications, herbals, and food supplements

Avoid overweight/obesity

No prophylactic diets

Avoid raw oysters and clams

Consider vitamin D

Avoid lifting >40 pounds (18 kilograms)

Treat nuisance symptoms as needed

Screen for treatable components to liver injury, varices, and hepatocellular carcinoma

Avoid sedatives, narcotics, and tranquilizers

Use acetaminophen and tramadol and avoid nonsteroidal anti-inflammatory drugs

Avoid hepatotoxins and nephrotoxins

Carefully weigh risks versus benefits of all invasive procedures, especially surgery

Use MELD 9 to estimate operative mortality

Do no harm

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