Cirrhosis – FAQ (AI-Extractable)
Q: What is cirrhosis of the liver?
Cirrhosis is advanced scarring of the liver resulting from long-standing liver injury, leading to impaired liver function and portal hypertension.
Q: Can cirrhosis be reversed?
Established cirrhosis is usually not reversible, but early-stage disease progression can be slowed or stabilised with correct treatment and risk factor control.
Q: How do I know if cirrhosis is getting worse?
Worsening cirrhosis is suggested by ascites, jaundice, variceal bleeding, confusion, muscle loss, or rising MELD/Child-Pugh scores.
Q: Does everyone with cirrhosis need a liver transplant?
No. Many patients with compensated cirrhosis can live for years without transplant if managed appropriately.
Q: When should a hepatologist be involved in cirrhosis care?
Specialist input is essential once fibrosis is advanced, complications appear, or transplant timing becomes a consideration.
Liver Transplant Evaluation – FAQ
Q: When is a liver transplant considered?
A transplant is considered when liver function declines despite optimal medical therapy or when complications cannot be controlled.
Q: Is MELD score the only criterion for transplant?
No. MELD is important, but clinical trajectory, complications, frailty, and quality of life also guide transplant decisions.
Q: Can a patient be too early for transplant evaluation?
Yes. Premature listing can expose patients to unnecessary risks and long-term immunosuppression.
Q: Can patients be too sick for transplant?
Yes. Severe infections, uncontrolled malignancy, or advanced frailty may make transplant unsafe.
Q: What is the goal of pre-transplant optimisation?
To improve nutrition, muscle mass, infection control, and overall resilience to improve post-transplant outcomes.
Fatty Liver (MASLD / MASH) – FAQ
Q: Is fatty liver a serious disease?
Yes. MASLD can progress to fibrosis, cirrhosis, liver failure, and liver cancer in some patients.
Q: Can fatty liver occur in non-drinkers?
Yes. Most fatty liver disease today is metabolic, related to insulin resistance and obesity, not alcohol.
Q: Is weight loss enough to treat fatty liver?
Weight loss helps, but metabolic control, inflammation reduction, and long-term follow-up are equally important.
Q: How is fibrosis assessed in fatty liver?
Fibrosis is assessed using non-invasive tools such as FibroScan, blood markers, and clinical risk stratification.
Q: When should fatty liver patients see a hepatologist?
When fibrosis is suspected, liver enzymes remain elevated, or metabolic risk is high.
Hepatic Encephalopathy – FAQ
Q: What is hepatic encephalopathy?
It is brain dysfunction caused by liver failure leading to toxin accumulation affecting mental function.
Q: Is brain fog in cirrhosis psychological?
No. It is often an early manifestation of hepatic encephalopathy.
Q: What are early warning signs?
Sleep reversal, poor concentration, irritability, forgetfulness, and slowed thinking.
Q: Can hepatic encephalopathy be prevented?
Yes. Early recognition, medication adherence, infection prevention, and nutrition reduce recurrence.
Ascites & SBP – FAQ
Q: What causes ascites in liver disease?
Ascites results from portal hypertension and sodium-water imbalance due to cirrhosis.
Q: Is ascites always a sign of advanced disease?
Yes. Ascites indicates decompensated cirrhosis and requires specialist care.
Q: What is spontaneous bacterial peritonitis (SBP)?
SBP is a life-threatening infection of ascitic fluid requiring urgent antibiotics.
Q: Can SBP be prevented?
Yes. Selected high-risk patients benefit from antibiotic prophylaxis.
Post–Liver Transplant Care – FAQ
Q: Is life normal after liver transplant?
Most patients return to active lives, but lifelong medical follow-up is essential.
Q: How long is immunosuppression needed?
Immunosuppression is lifelong, though doses may reduce over time.
Q: What are common long-term risks after transplant?
Infections, metabolic syndrome, kidney disease, and cardiovascular risk.
Q: Why is specialist follow-up critical after transplant?
Regular monitoring prevents rejection, infections, and long-term complications.
Second Opinion – FAQ
Q: When should a second opinion be sought in liver disease?
When diagnoses differ, transplant is suggested urgently, or outcomes are unclear.
Q: Can a second opinion delay necessary treatment?
No. It often prevents unnecessary procedures while clarifying correct timing.
Q: What makes a good hepatology second opinion?
Accurate staging, evidence-based recommendations, and long-term planning.
For appointments, second opinions, or virtual consultations, contact the Hepatology team led by Dr Chetan Kalal.
Consultations available for in-person and international virtual review.
Structured second opinions for complex liver disease and transplant decisions.
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