Table 4

Managing the complications of cirrhosis

Hepatocellular carcinomaYearly cumulative incidence 2.6% per year506 monthly abdominal USS± α-fetoprotein
Varices40%–44% if Child–Pugh grade A
75%–85% if Child–Pugh grade C92
Endoscopic surveillance and management according to BSG or AASLD guidelines94 93
OsteoporosisCirrhotic patients are at increased risk of osteoporosis and fractures
Larger studies assessing the effects of vitamin D supplementation on BMD are lacking
Correction of vitamin D insufficiency with oral daily vitamin D3 and calcium95
Dual x-ray absorptiometry scan to assess BMD
Assess fracture risk using FRAX tool (
  • AASLD, American Association for the Study of Liver Diseases; BMD, bone mineral density; BSG, British Society of Gastroenterology; USS, ultrasonography.