Table 3:

Screening questions and treatment options for common disabling symptoms in cirrhosis.

Symptom	Sample Questions	Therapeutic options
Muscle Cramps	How often during the last two weeks have you had muscle cramps?	Normalize electrolytes and fluid balance Taurine (3 grams daily) Vitamin E (300 mg three times a day) Baclofen (5–10 mg three times a day as needed)
Pruritus	How much of the time have you been troubled by itching during the last two weeks?	Moisturizing cream for dry skin Cholestyramine (4 grams daily) Naltrexone (50 mg daily) Sertraline (75–100 mg daily) Ursodeoxycholic acid (13–15 mg/kg/day in 2 doses)
Sleep disturbance	Have you had difficulty sleeping at night? Have you felt sleepy during the day?	Optimize treatment for HE Optimize sleep hygiene Referral to sleep specialist to assess for sleep apnea Mindfulness training Melatonin (3–5 mg daily)
Sexual Dysfunction	Have you had any sexual activity in the past few weeks? How satisfied were you with your sexual function during the past few weeks?	Phosphodiesterase inhibitors (e.g. sildenafil 25–100 mg as needed) Sex therapy referral Referral to Urology

HE = Hepatic Encephalopathy