Feature Article

Diagnosis and management of chronic liver disease

Robert Feller, Geoffrey McCaughan



Many chronic liver diseases have specific therapies according to the underlying diagnosis. This article updates GPs on the diagnosis and management of these diseases, even though GPs may not be directly involved at the acute stage.

Key Points

  • The most common causes of chronic liver disease are fatty liver, alcohol, viral hepatitis and drug toxicity.
  • A routine initial approach to investigation helps both diagnosis and treatment decisions.
  • General management includes dietary and vaccination considerations.
  • Specific treatment varies with the primary disorder and can significantly improve prognosis.
  • Sudden weight loss in patients with fatty liver can precipitate worsening LFTs.
  • Evidence of decompensation is associated with decreased survival.
  • Liver transplantation provides good outcomes in selected patients.