ACG Issues New Preventive Care Guideline for Cirrhosis

The American College of Gastroenterology published a guideline, developed by a hepatology writing group using GRADE methodology, offering 18 recommendations and 6 key concept statements across four domains: cirrhosis-specific complications, infection prevention, lifestyle factors, and non-liver conditions. Strong recommendations include carvedilol or variceal ligation for high-risk esophageal varices, semiannual hepatocellular carcinoma surveillance, hepatitis A testing and vaccination, influenza/COVID-19/RSV immunization, and smoking-cessation counseling, while conditional recommendations cover lactulose for minimal hepatic encephalopathy, rifaximin, antibiotic prophylaxis for GI bleeding, alcohol use disorder therapy, nutrition, exercise, and bisphosphonates; the guideline notes most underlying evidence was of low certainty.

Most relevant for: Patients with cirrhosis, including those with decompensated disease or at risk for variceal bleeding, hepatic encephalopathy, hepatocellular carcinoma, infections, or osteoporosis.

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Informational only. Not medical advice. Not a substitute for clinical judgment. Always consult current guidelines and your own clinical judgment.