Patient-perceived barriers to lifestyle interventions in cirrhosis

Ney, Michael; Gramlich, Leah; Mathiesen, Vanessa; Bailey, Robert J.; Haykowsky, Mark J.; Ma, Mang; Abraldes, Juan G.; Tandon, Puneeta

doi:10.4103/1319-3767.203357

Cited by 32 publications

(1 citation statement)

References 34 publications

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“…The American Association for the Study of Liver Disease recommends individualized exercise rehabilitation for patients with cirrhosis ( Chen and Dunn, 2018 ). Another study ( Ney et al, 2017 ) found that exercise levels were generally low in patients with cirrhosis, with 76% spending most of their time in a sitting position, which is detrimental to recovery from liver disease. In daily life, proper scientific exercises such as Tai Chi, five animal boxing/exercise, and eight trigrams boxing can effectively improve heart and lung function and prevent the occurrence of alcoholic fatty liver disease and cirrhosis.…”

Section: Treatment Of Liver Cirrhosis Using Modern Medicinementioning

confidence: 99%

Liver cirrhosis: current status and treatment options using western or traditional Chinese medicine

Zheng,

Xue,

et al. 2024

Front. Pharmacol.

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Liver cirrhosis arises from liver fibrosis and necroinflammation caused by various mechanisms of hepatic injury. It is a prevalent condition in clinical practice characterized by hepatocellular dysfunction, portal hypertension, and associated complications. Despite its common occurrence, the etiology and pathogenesis of liver cirrhosis remain incompletely understood, posing a significant health threat. Effective prevention of its onset and progression is paramount in medical research. Symptoms often include discomfort in the liver area, while complications such as sarcopenia, hepatic encephalopathy, ascites, upper gastrointestinal bleeding, and infection can arise. While the efficacy of Western medicine in treating liver cirrhosis is uncertain, Chinese medicine offers distinct advantages. This review explores advancements in liver cirrhosis treatment encompassing non-pharmacological and pharmacological modalities. Chinese medicine interventions, including Chinese medicine decoctions, Chinese patent medicines, and acupuncture, exhibit notable efficacy in cirrhosis reversal and offer improved prognoses. Nowadays, the combination of Chinese and Western medicine in the treatment of liver cirrhosis also has considerable advantages, which is worthy of further research and clinical promotion. Standardized treatment protocols based on these findings hold significant clinical implications.

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Section: Treatment Of Liver Cirrhosis Using Modern Medicinementioning

confidence: 99%

Liver cirrhosis: current status and treatment options using western or traditional Chinese medicine

Zheng,

Xue,

et al. 2024

Front. Pharmacol.

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Nutrition and the transplant candidate

2017

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Cirrhosis is the most common indication for liver transplantation (LT) worldwide. Malnutrition is present in at least two-thirds of patients with cirrhosis awaiting LT. It negatively impacts survival, quality of life, and the ability to respond to stressors, such as infection and surgery. Muscle wasting or sarcopenia is the most objective feature of chronic protein malnutrition in cirrhosis, and this condition is associated with increased morbidity and mortality before and after LT. In addition to its objectivity, muscularity assessment with cross-sectional imaging studies is a useful marker of nutritional status in LT candidates, as sarcopenia reflects a chronic decline in the general physical condition, rather than acute severity of the liver disease. Despite the high prevalence and important prognostic role, malnutrition and sarcopenia are frequently overlooked because standards for nutritional assessment are lacking and challenges such as fluid retention and obesity are prevalent. In this review, current diagnostic methods to evaluate malnutrition, including muscle abnormalities in cirrhosis, are discussed and current knowledge regarding the incidence and clinical impact of malnutrition in cirrhosis and its impact after LT are presented. Existing and potential novel therapeutic strategies for malnutrition in cirrhosis are also discussed, emphasizing the treatment of muscle wasting in the LT candidate in an effort to improve survival while waiting for LT and to reduce morbidity and mortality after LT.Liver Transplantation 23 1451-1464 2017 AASLD.

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A Systematic Review of Medical Nutrition Therapy Guidelines for Liver Cirrhosis: Do We Agree?

et al. 2019

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Background Nutrition can play a significant role in the management of liver cirrhosis and its complications. However, adherence to the clinical practice guidelines (CPGs) is essential for the practice of evidence‐based medicine and is considered as a health‐quality indicator. Methods A systematic search was conducted in scientific databases, and retrieved CPGs fulfilling the inclusion criteria were independently reviewed and appraised from 3 experienced researchers, based on the Appraisal of Guidelines for Research and Evaluation II instrument. Results A total of 13 relevant CPGs were retrieved, published by 7 associations/societies, focusing on the nutrition management (enteral nutrition and/or parenteral nutrition) on cirrhosis, decompensated cirrhosis, liver transplantation, and cirrhosis‐related complications. Most CPGs scored low in the stakeholder, rigor of development, and applicability domains. Half of the CPGs recognized the need for counseling patients with cirrhosis on nutrition‐related issues. Small meals spread throughout the day, including a late‐night snack, were suggested, with protein intake ranging between 1.2 and 1.5 g/kg of body weight. In ascites, Na restriction recommendation appeared unanimous. Conclusions Several shortcomings and bias were recognized in cirrhosis‐related medical nutrition therapy CPGs, indicating the need of improving CPG methodology.

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Patient-perceived barriers to lifestyle interventions in cirrhosis

Cited by 32 publications

References 34 publications

Liver cirrhosis: current status and treatment options using western or traditional Chinese medicine

Liver cirrhosis: current status and treatment options using western or traditional Chinese medicine

Nutrition and the transplant candidate

A Systematic Review of Medical Nutrition Therapy Guidelines for Liver Cirrhosis: Do We Agree?

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