Navigating Cirrhosis: Presentation, Outcomes, and Treatments in Adulthood and Beyond

Cirrhosis is a highly prevalent condition with significant economic and overall burden to patients, caregivers, and the health systems. It is most commonly caused by excessive alcohol use, viral infection, obesity or autoimmune disease. Very frequently the disease evolves from an asymptomatic (compensated) phase to decompensated phase with complications. We provide a concise overview of the presentation, outcomes and current management options of this highly prevalent disease in adult populations, with particular emphasis on older adults.

The management of cirrhosis is focused on the primary cause, with abstinence as the main option for alcohol related liver diseases, and physical activity for metabolic associated liver diseases. Several recent treatment options are summarized, and we have included symptom management, HCC, and updates on liver transplantation in adults.

Management of cirrhosis aims to reverse disease cause, delay hepatic decompensation, monitor for hepatocellular carcinoma and esophageal varices, manage complications, determine prognosis, and assess for liver transplantation.

Management of this complex multisystem disease is focused on the primary cause and complications. Liver transplantation is the ultimate option for end stage disease. Systemic therapies for HCC have evolved. Newer treatment options for MAFLD are emerging. Future efforts should focus on controlling the primary cause, early detection, nutritional management and education, and prevention or delay of complications.