Cirrhotic Patients;

Abstract

At present time portal hypertension is perceived as one of the complications ofadvanced liver disease. It results in various vascular changes in gastrointestinal tract (GI),including esophageal varices, gastric varices and portal hypertensive gastropathy (PHG). PHGand gastric varices are a common cause of acute as well as chronic bleeding from GI tractwhich resulted in significant mortality among patients. Objectives: To determine the frequencyof gastric vascular changes in various causes of cirrhosis. Study Design: Cross sectional study.Setting: Department of Gastroenterology, Pakistan Institute of Medical Sciences, Islamabad.Period: 1st August 2007 to 31st July 2008. Materials and Methods: Patients of age ≥30 years,with clinical evidence of cirrhosis and without prior treatment of esophagiogastric varices wereincluded in the study. Results: A total of 100 patients were enrolled in the study out of which47 were male and 53 were females with mean age of 53.6 years. The most common type ofcirrhosis was turned out to be Hepatitis C affecting 50% of patients and most of the patientswere in Child class C. Portal hypertensive gastropathy was present in 74% of patients. Amongthem 24.3% have mild changes while severe changes were present in75.7% of patients. Gastricvarices were found in 40% of the patients and the most common type was IGV type I whichwas present in 29(72.5%) of the patients. Correlation of severity of PHG was seen with gradingof esophageal varices, grading of gastric varices and Child class. Conclusion: Frequency ofsevere gastropathy is higher than the mild gastropathy. It is also concluded that gastric vascularchanges are associated with cause of cirrhosis, child class and degree of portal hypertension.

Assessment of nutritional status of the cirrhotic patients on enteral and parenteral feeding

“…Almost 350,000 people have hepatitis C-related illnesses, that is, cirrhosis and end-stage liver diseases every year despite the accessibility of effective treatments in Pakistan. 150 million people develop liver cirrhosis—the patients with compensated liver cirrhosis have 1–8% annual incidence of hepatocellular carcinoma, of which 59% have been recorded to have ascites and 24% spontaneous bacterial peritonitis in Pakistan (Ahsan et al, 2019; Parkash and Hamid, 2016; Saeed et al, 2017). Protein–energy malnutrition is the most common condition among cirrhotic patients because of different factors, including inadequate dietary intake, increased intestinal protein losses, decreased hepatic protein synthesis, abnormal substrate utilization, malabsorption, and hyper-metabolism (Memon and Zaki, 2013).…”