Primary biliary cirrhosis primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]
Overview
Effective measures for the primary prevention of primary biliary cirrhosis include prevention of cirrhosis, Sjogren's syndrome, and thyroid disease.
Primary Prevention
- Methods of primary prevention of primary biliary cirrhosis (PBC) include:[1]
- Alcohol avoidance [2][3]
- Avoidance of hepatotoxic drugs[4][5][6][7]
- Physical exercise
- Smoking cessation[8]
- Adequate caloric intake[9][10][11]
- Avoid excessive consumption of:
- Education about hepatotoxins such as:
- Acetaminophen
- Benzodiazepines
- Aminoglycoside antibiotics
- Prevention of obesity
- Familial screening for PBC particularly among first degree female relatives including sisters and daughters.[12]
- Reduction of high-risk behaviors such as :
- Unprotected sexual intercourse
- Intravenous drug abuse
- Excessive alcohol intake
- Early diagnosis and treatment of chronic liver disease [13][14][15][16][17]
Hormone Replacement and Pregnancy
- Education about drugs that induce or worsen the symptoms of PBC in pregnancy such as pruritis:[18]
- Oral contraceptive pills
- Estrogen supplements
- Varices screening in second trimester
- Beta blockers for varices.
- A short second stage of labor is favorable because the valsalva maneuver may trigger variceal hemorrhage.
References
- ↑ Wiegand J, Berg T (2013). "The etiology, diagnosis and prevention of liver cirrhosis: part 1 of a series on liver cirrhosis". Dtsch Arztebl Int. 110 (6): 85–91. doi:10.3238/arztebl.2013.0085. PMC 3583179. PMID 23451000.
- ↑ Bellentani S, Saccoccio G, Costa G, Tiribelli C, Manenti F, Sodde M, Saveria Crocè L, Sasso F, Pozzato G, Cristianini G, Brandi G (1997). "Drinking habits as cofactors of risk for alcohol induced liver damage. The Dionysos Study Group". Gut. 41 (6): 845–50. PMC 1891602. PMID 9462221.
- ↑ Friedmann PD (2013). "Clinical practice. Alcohol use in adults". N. Engl. J. Med. 368 (4): 365–73. doi:10.1056/NEJMcp1204714. PMID 23343065.
- ↑ Mazoit JX, Sandouk P, Zetlaoui P, Scherrmann JM (1987). "Pharmacokinetics of unchanged morphine in normal and cirrhotic subjects". Anesth. Analg. 66 (4): 293–8. PMID 3565791.
- ↑ Tegeder I, Geisslinger G, Lötsch J (1999). "[Therapy with opioids in liver or renal failure]". Schmerz (in German). 13 (3): 183–95. doi:10.1007/s004829900019. PMID 12799931.
- ↑ Zimmerman HJ, Maddrey WC (1995). "Acetaminophen (paracetamol) hepatotoxicity with regular intake of alcohol: analysis of instances of therapeutic misadventure". Hepatology. 22 (3): 767–73. PMID 7657281.
- ↑ Kuffner EK, Dart RC, Bogdan GM, Hill RE, Casper E, Darton L (2001). "Effect of maximal daily doses of acetaminophen on the liver of alcoholic patients: a randomized, double-blind, placebo-controlled trial". Arch. Intern. Med. 161 (18): 2247–52. PMID 11575982.
- ↑ Zein CO, Unalp A, Colvin R, Liu YC, McCullough AJ (2011). "Smoking and severity of hepatic fibrosis in nonalcoholic fatty liver disease". J. Hepatol. 54 (4): 753–9. doi:10.1016/j.jhep.2010.07.040. PMC 3060962. PMID 21126792.
- ↑ Lieber CS, Rubin E (1968). "Alcoholic fatty liver in man on a high protein and low fat diet". Am. J. Med. 44 (2): 200–6. PMID 5635674.
- ↑ Modi AA, Feld JJ, Park Y, Kleiner DE, Everhart JE, Liang TJ, Hoofnagle JH (2010). "Increased caffeine consumption is associated with reduced hepatic fibrosis". Hepatology. 51 (1): 201–9. doi:10.1002/hep.23279. PMC 2801884. PMID 20034049.
- ↑ Mendenhall CL, Anderson S, Weesner RE, Goldberg SJ, Crolic KA (1984). "Protein-calorie malnutrition associated with alcoholic hepatitis. Veterans Administration Cooperative Study Group on Alcoholic Hepatitis". Am. J. Med. 76 (2): 211–22. PMID 6421159.
- ↑ Lazaridis KN, Juran BD, Boe GM, Slusser JP, de Andrade M, Homburger HA, Ghosh K, Dickson ER, Lindor KD, Petersen GM (2007). "Increased prevalence of antimitochondrial antibodies in first-degree relatives of patients with primary biliary cirrhosis". Hepatology. 46 (3): 785–92. doi:10.1002/hep.21749. PMID 17680647.
- ↑ Wedemeyer H, Hofmann WP, Lueth S, Malinski P, Thimme R, Tacke F, Wiegand J (2010). "[ALT screening for chronic liver diseases: scrutinizing the evidence]". Z Gastroenterol (in German). 48 (1): 46–55. doi:10.1055/s-0028-1109980. PMID 20072996.
- ↑ Breitling LP, Claessen H, Drath C, Arndt V, Brenner H (2011). "Gamma-glutamyltransferase, general and cause-specific mortality in 19,000 construction workers followed over 20 years". J. Hepatol. 55 (3): 594–601. doi:10.1016/j.jhep.2010.12.029. PMID 21256904.
- ↑ Claessen H, Brenner H, Drath C, Arndt V (2010). "Gamma-glutamyltransferase and disability pension: a cohort study of construction workers in Germany". Hepatology. 51 (2): 482–90. doi:10.1002/hep.23324. PMID 19967717.
- ↑ Haring R, Wallaschofski H, Nauck M, Dörr M, Baumeister SE, Völzke H (2009). "Ultrasonographic hepatic steatosis increases prediction of mortality risk from elevated serum gamma-glutamyl transpeptidase levels". Hepatology. 50 (5): 1403–11. doi:10.1002/hep.23135. PMID 19670414.
- ↑ Bell BP, Manos MM, Zaman A, Terrault N, Thomas A, Navarro VJ, Dhotre KB, Murphy RC, Van Ness GR, Stabach N, Robert ME, Bower WA, Bialek SR, Sofair AN (2008). "The epidemiology of newly diagnosed chronic liver disease in gastroenterology practices in the United States: results from population-based surveillance". Am. J. Gastroenterol. 103 (11): 2727–36, quiz 2737. doi:10.1111/j.1572-0241.2008.02071.x. PMID 18684170.
- ↑ Lindor, Keith D.; Gershwin, M. Eric; Poupon, Raoul; Kaplan, Marshall; Bergasa, Nora V.; Heathcote, E. Jenny (2009). "Primary biliary cirrhosis". Hepatology. 50 (1): 291–308. doi:10.1002/hep.22906. ISSN 0270-9139.