The prevalence of cirrhosis has risen significantly over recent decades and is predicted to rise further. Widespread use of non-invasive testing means cirrhosis is increasingly diagnosed at an earlier stage. Despite this, there are significant variations in outcomes in patients with cirrhosis across the UK, and patients in areas with higher levels of deprivation are more likely to die from their liver disease. This three-part best practice guidance aims to address outpatient management of cirrhosis, in order to standardise care and to reduce the risk of progression, decompensation and mortality from liver disease. Here, in part one, we focus on outpatient management of compensated cirrhosis, encompassing hepatocellular cancer surveillance, screening for varices and osteoporosis, vaccination and lifestyle measures. We also introduce a compensated cirrhosis care bundle for use in the outpatient setting. Part two concentrates on outpatient management of decompensated disease including management of ascites, encephalopathy, varices, nutrition as well as liver transplantation and palliative care. The third part of the guidance covers special circumstances encountered in managing people with cirrhosis: surgery, pregnancy, travel, managing bleeding risk for invasive procedures and portal vein thrombosis.
Endoscopy
Quality Improvement
British Society of Gastroenterology Endoscopic Retrograde Cholangiopancreatography (ERCP) Quality Improvement Programme: minimum service standards and good practice statements
clinical-resource/ERCP-Quality-Improvement-Programme
In 2014, the British Society of Gastroenterology (BSG) published a standards framework outlining key performance indicators for ERCP practitioners and services.
Guidance
AGIP
AGIP Proposed Standardised Testing Protocol for Hydrogen/Methane Breath Testing (HMBT) to Assess Small Intestinal Bacterial Overgrowth (SIBO) and Carbohydrate Malabsorption
clinical-resource/AGIP-Protocol-for-Hydrogen-Methane-Breath-Testing
This document was published in January 2019.