Managing cirrhosis in the geriatric patient
Bloomer, J.R.
Geriatrics 38(11): 66-74
1983
ISSN/ISBN: 0016-867X PMID: 6605277 Document Number: 219198
Approaches used for treating cirrhosis, in general, and in the elderly, in specific, are reviewed and discussed. Cirrhosis (largely due to alcoholism) is more evident with increasing age, with an estimated 16% of the cases diagnosed over age 60. While there is no indication that cirrhosis and its manifestations differ in elderly patients, aging alters metabolism and may result in reduced drug clearance and other adverse reactions to drug therapy. The observation that the resultant complications of cirrhosis can resemble other problems associated with aging introduces a further difficulty in effective diagnosis and management of the cirrhotic state. Cirrhotic complications resulting from portal hypertension include hypersplenism, hemorrhoids, esopohageal varices, and ascites. Cholestasis also may be responsible for some of the symptoms in cirrhosis patients (e.g.: pruritus, fat malabsorption, bone disease). The metabolic effects of aging and the uncertain ability of the aging liver to regenerate require that treatment be adapted to the age and condition of the individual. (wz)