Home > Knowledge Hub > Clinical Articles

Clinical Articles

Management of hepatic encephalopathy: beyond the acute episode Dr McPherson and Dr Thompson provides insight into the management of hepatic encephalopathy.

First published on 13 Dec 2019

Introduction Hepatic encephalopathy is a debilitating complication of cirrhosis. It is defined as brain dysfunction caused by liver insufficiency and/or portosystemic shunting [1] and is associated with an greater risk of death than other significant hepatic decompensation events [2]. Hepatic encephalopathy manifests as […]

Management of difficult-to-treat small-intestinal bacterial overgrowth Dr Andreyev and Dr Poon highlight a case study on a difficult case of SIBO.

First published on 13 Dec 2019

Case Study A 34-year-old woman presented with a long history of abdominal bloating and diarrhoea. Her medical history included ileocaecal resection for Crohn’s disease. Blood tests, faecal calprotectin, colonoscopy to neo-terminal ileum, including random colonic biopsies, and a SeHCAT (23-seleno-25-homotaurocholic […]

Management of refractory ascites in patients with cirrhosis Professor Gleeson and Dr Min provide a guide on how to handle refractory ascites.

First published on 13 Dec 2019

Introduction About 50% of patients with cirrhosis develop ascites within 10 years of diagnosis [1,2]. The main drivers are sodium retention due to splanchnic arterial vasodilatation and perceived hypovolaemia (acting via the renin–angiotensin–aldosterone and sympathetic nervous systems) and portal hypertension [1–3]. Refractory […]

Management of difficult microscopic colitis after failure of budesonide therapy Drs Matthew Kurien and Suneil Raju offer step-by-step advice on managing a difficult case of microscopic colitis

First published on 13 Dec 2019

Introduction Microscopic colitis (MC) is a common inflammatory bowel condition that is characterised by watery diarrhoea. It can have a chronic, intermittent or chronic-recurrent course. Associated symptoms are weight loss (seen in 42% of patients), abdominal pain (41%) and nocturnal diarrhoea (27%), and quality of life (QoL) may be […]