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. Part 1 addresses outpatient management of compensated cirrhosis: screening for hepatocellular cancer, varices and osteoporosis, vaccination and lifestyle measures. Part 2 concentrates on outpatient management of decompensated disease including management of ascites, encephalopathy, varices, nutrition as well as liver transplantation and palliative care. In this, the third part of the guidance, we focus on special circumstances encountered in managing people with cirrhosis, namely surgery, pregnancy, travel, managing bleeding risk for invasive procedures and portal vein thrombosis.
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Clinical Resources
Allurion Gastric Balloon: Updated safety information due to the risks of gastric outlet obstruction, small bowel obstruction and gastric perforation (DSI/2026/004)
clinical-resource/MHRA-DSI-on-the-Allurion-Gastric-Balloon
In rare instances, the Allurion Gastric Balloon has not transited through the stomach or bowel as intended, leading to complications.

Guidance
Endoscopy
British Society of Gastroenterology and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland guidance on best practice for upper gastrointestinal endoscopy
clinical-resource/Best-practice-for-upper-GI-endoscopy
National root cause analysis of post-endoscopy upper gastrointestinal (UGI) cancer in England has found wide variations in UGI endoscopy quality.