Patient discussions

Patients with cirrhosis should be advised of the following in order to minimise any further insult to the liver:

  • Avoidance of alcohol and other hepatotoxins such as non-steroidal anti-inflammatory drugs and high doses of paracetamol (>2-3 g/day).

  • Careful nutritional intake with adequate lean protein and a carbohydrate-based snack before bed. Decompensated patients should be advised to adhere to a no-added-salt diet.[203] Late evening snacks may help improve malnutrition and maintain glucose homeostasis.[204]

  • Patients with compensated cirrhosis and obesity should be advised to lose weight.

  • Attendance for immunisation against influenza and pneumococcus.

  • Regular exercise. Exercise appears to be safe for patients with cirrhosis and can increase endurance.​[205][206][207][208]​​​​​

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