What is included in the long-term monitoring of patients with fatty liver disease?

Updated: Apr 12, 2018
  • Author: Emily Tommolino, MD; Chief Editor: BS Anand, MD  more...
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Answer

Answer

All patients with chronic liver disease should be tested for hepatitis A total antibodies and vaccinated if necessary. Physicians should also consider testing for hepatitis B surface antibody and vaccinating in the appropriate clinical situations (ie, life expectancy >20 years).

All patients with chronic liver disease are at risk for liver disease progression.

Patients should be educated to avoid alcohol and other hepatotoxic substances. If patients have a liver insult from another liver problem, they may have longer recovery times than patients without fatty liver disease would.

Patients with fatty liver disease should be seen regularly by a primary care physician, who may be able to detect disease progression through physical examination findings (eg, spider telangiectasia, palmar erythema, or splenomegaly), laboratory findings (eg, decreasing platelets, elevated bilirubin, or decreasing albumin), patient complaints (eg, encephalopathy, ascites, or fatigue), or incidental imaging study findings (eg, cirrhotic liver, splenomegaly, varices, or ascites).

Provide follow-up care for patients in an outpatient facility. In patients with alcoholic steatosis, determination of blood alcohol at every outpatient visit often is helpful in determining patient’s compliance with abstinence.

Patients who have NASH cirrhosis should be screened for gastroesophageal varices as well as hepatocellular carcinoma.


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