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British Society of Gastroenterology Best Practice Guidance: outpatient management of cirrhosis - part 1: compensated cirrhosis

Lookup NU author(s): Dr Dina Mansour, Dr Steven MassonORCiD, John Hammond, Professor Stuart McPhersonORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


© 2023 BMJ Publishing Group. All rights reserved.The prevalence of cirrhosis has risen significantly over recent decades and is predicted to rise further. Widespread use of non-invasive testing means cirrhosis is increasingly diagnosed at an earlier stage. Despite this, there are significant variations in outcomes in patients with cirrhosis across the UK, and patients in areas with higher levels of deprivation are more likely to die from their liver disease. This three-part best practice guidance aims to address outpatient management of cirrhosis, in order to standardise care and to reduce the risk of progression, decompensation and mortality from liver disease. Here, in part one, we focus on outpatient management of compensated cirrhosis, encompassing hepatocellular cancer surveillance, screening for varices and osteoporosis, vaccination and lifestyle measures. We also introduce a compensated cirrhosis care bundle for use in the outpatient setting. Part two concentrates on outpatient management of decompensated disease including management of ascites, encephalopathy, varices, nutrition as well as liver transplantation and palliative care. The third part of the guidance covers special circumstances encountered in managing people with cirrhosis: surgery, pregnancy, travel, managing bleeding risk for invasive procedures and portal vein thrombosis.

Publication metadata

Author(s): Mansour D, Masson S, Shawcross DL, Douds AC, Bonner E, Corless L, Leithead JA, Hammond J, Heneghan MA, Rahim MN, Tripathi D, West R, Johnson J, Botterill G, Hollywood C, Ross V, Donnelly M, Compston JE, McPherson S, Grapes A

Publication type: Article

Publication status: Published

Journal: Frontline Gastroenterology

Year: 2023

Volume: 14

Issue: 6

Pages: 453-461

Print publication date: 01/11/2023

Online publication date: 10/10/2023

Acceptance date: 02/04/2023

Date deposited: 22/02/2024

ISSN (print): 2041-4137

ISSN (electronic): 2041-4145

Publisher: BMJ Publishing Group


DOI: 10.1136/flgastro-2023-102430


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