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Frailty is part of the normal ageing process causing decreased muscle mass and bone density. Patients with liver cirrhosis develop frailty more rapidly when compared to the average population.
In an interview with HT Lifestyle, Dr Ameet Mandot, Director – Department of Hepatology and Liver Transplant Medicine at Gleneagles Hospitals in Mumbai’s Parel, explained, “Frailty is present in patients with chronic liver disease such as cirrhosis. It is vital to identify and manage liver fragility to empower the patient to combat liver ailments, maintain muscle mass, withstand complex treatments like surgery and transplantation, prevent injuries and fractures, and enhance the overall well-being of the patient.”
Recognising early signs and risk factors can help improve outcomes through timely intervention. Dr Ameet Mandot shared, “When we think of liver disease, we often picture jaundice, swelling, or fatigue but there’s another hidden complication that often goes unnoticed which is liver frailty. This condition is becoming increasingly common, particularly in individuals with chronic liver disease or cirrhosis.”
According to him, liver frailty doesn’t just affect the liver, it weakens the entire body, reducing physical strength and increasing the risk of falls, hospitalisations and even poor transplant outcomes. Understanding what liver frailty is and how to detect and manage it can make a significant difference in a patient’s journey.
Dr Ameet Mandot highlighted, “Liver frailty is a physical decline seen in patients with advanced liver disease. It is characterised by muscle weakness, reduced endurance, and overall decreased physical performance. Unlike general frailty seen in elderly people, liver frailty is linked to liver dysfunction and leads to complications and mortality in liver patients.”
The symptoms:
Dr Ameet Mandot pointed out that the symptoms include unexplained weight loss, muscle wasting or weakness, slow walking speed, difficulty standing or rising from a chair, fatigue, low energy and poor balance.
The causes:
Dr Ameet Mandot said, “Liver frailty develops due to the progressive nature of liver disease, especially cirrhosis. As the liver becomes more damaged, the body’s ability to absorb nutrients and maintain muscle mass decreases. Chronic inflammation, poor appetite, hormonal changes and reduced physical activity all contribute to this condition.”
Risk factors:
- Long-standing liver cirrhosis
- Hepatitis B or C infection
- Alcohol-related liver disease
- Age
- Sedentary lifestyle
- Inflammation and stress
The diagnosis:
Dr Ameet Mandot informed, “The doctor will conduct an examination when it comes to strength, walking speed, and chair stand tests. He/she may also assess the Liver Frailty Index (LFI) to see the severity. Nutritional assessments and muscle mass measurements may also be part of the evaluation when it comes to conforming to the diagnosis.”
Treatment and management:
- Nutritional support: The patient will be recommended high-protein diets and supplements to rebuild muscle and enhance quality of life.
- Physical therapy and exercise: to improve strength and endurance is necessary for those struggling with this condition.
- Medical management: Treating the underlying liver condition and managing complications
- Regular monitoring: So, frequent follow-ups are necessary to track progress and prevent hospitalisations in patients.
With timely diagnosis and a multidisciplinary approach, patients with liver frailty can improve their strength, quality of life and overall liver health.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
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