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Monitoring and follow-up
Another measure to maintain a longer life expectancy is complying with the follow-ups recommended by your doctor. A common mistake in patients with compensated cirrhosis is neglecting their condition under the thought that they only have mild symptoms. Sometimes they don’t even realize that their symptoms are progressing because they change slowly, and patients get used to the change. So, instead of trusting in your own judgment, schedule your follow-ups, and do not miss the date.
The most basic monitoring of cirrhosis patients is completing liver chemistry tests, a complete blood count, and coagulation times. This should be done 3 or 4 times every year. So, every 3 or 4 months, you need to get the same exams and check how your liver is doing.
Besides blood tests, it is also vital to perform imaging tests every year. Ultrasonography is not invasive and not as expensive as CT scans or MRI, so it is widely used to evaluate patients with cirrhosis and rule out hepatocellular carcinoma. That’s why your doctor is likely to recommend a liver ultrasound every 6 months. This is to make sure that you’re not developing liver cancer, and if there’s a suspicious nodule, you might need a CT scan or MRI.
Finally, one of the most lethal complications of portal hypertension is the rupture of esophageal varices. Thus, doctors recommend an endoscopy every 2 years to detect esophageal varices and give the patients treatment when they show up.
In a nutshell, medical knowledge is set up to evaluate and improve the patient’s life expectancy. You only need to follow the instructions and recommendations and do not neglect your condition if you’re asymptomatic or only have mild symptoms.
References
Pugh, R., Murray‐Lyon, I. M., Dawson, J. L., Pietroni, M. C., & Williams, R. (1973). Transection of the oesophagus for bleeding oesophageal varices. British journal of surgery, 60(8), 646-649.
Salerno, F., Merli, M., Cazzaniga, M., Valeriano, V., Rossi, P., Lovaria, A., … & Riggio, O. (2002). MELD score is better than Child–Pugh score in predicting 3-month survival of patients undergoing transjugular intrahepatic portosystemic shunt. Journal of hepatology, 36(4), 494-500.
D’amico, G., Pagliaro, L., & Bosch, J. (1995). The treatment of portal hypertension: a meta-analytic review. Hepatology, 22(1), 332-354.
Bruix, J., & Sherman, M. (2011). Management of hepatocellular carcinoma: an update. Hepatology (Baltimore, Md.), 53(3), 1020.
