Abstract
Many people who have cirrhosis are undiagnosed. The diagnosis may not become evident until they develop multiorgan failure after an invasive procedure. Patients with cirrhosis are unusually fragile and can be easily harmed and even set into a fatal down-spiral by seemingly innocuous treatments including medications and invasive procedures. There is much confusion regarding the care of these patients. For example, what medications can be used safely to treat pain, what sedatives are safe and effective, which medications are to be avoided, what diet should be prescribed, and which invasive procedures are safe. This paper provides the author's advice regarding clues to the presence of cirrhosis and the dos and do nots in the general care of these patients, based on his 30 years of experience in a liver-failure-focused academic practice.