Cirrhosis — complications to watch
Portal hypertension : esophageal varices that bleed massively, ascites, splenomegaly.. Hepatic encephalopathy : confusion, altered sleep-wake cycle, asterixis (flapping tremor), rising ammonia. Lactulose is titrated to two or three soft stools per day.. Coagulopathy : the liver makes clotting factors, so bleeding risk rises.. Hypoalbuminemia : edema and ascites. Jaundice and pruritus. Watch for a change in mental status : it is often the first sign of decompensation, and it is easy to attribute to something else.