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Is Exercise Beneficial and Safe in Patients with Cirrhosis and Portal Hypertension?

  • Portal Hypertension (J Gonzalez-Abraldes and E Tsochatzis, Section Editors)
  • Published:
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Abstract

Purpose of Review

In spite of the many health benefits attributed to exercise, reports summarizing the literature in patients with cirrhosis are scarce. We aimed to provide a comprehensive review focusing on potential safety considerations in cirrhosis.

Recent Findings

Diminished exercise capacity in patients with cirrhosis worsens their prognosis before and after liver transplantation. Exercise poses unique challenges in this population, raising questions of safety—worsening portal hypertension and malnutrition—and efficacy. In this review, we show that the balance of evidence supports supervised exercise programs with demonstrable benefits with respect to portal pressure, functional capacity, and muscle mass indexes. There are also benefits regarding their emotional function and perceived general health. Key to interpreting the benefits and risk profile of exercise is the impact of non-selective beta-blockage.

Summary

Patients with cirrhosis, with or without portal hypertension, should receive an exercise prescription as part of their standard of care. However, some standard safety recommendations should be universally followed.

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Funding

This work is supported by the University of Arkansas for Medical Sciences College of Medicine Clinician Scientist Program.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA

    Elliot B. Tapper

  2. Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, 4301 W. Markham #567, Shorey 8 / 68, Little Rock, AR, 72205, USA

    Roberto Martinez-Macias & Andres Duarte-Rojo

Authors
  1. Elliot B. Tapper
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  2. Roberto Martinez-Macias
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  3. Andres Duarte-Rojo
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Corresponding author

Correspondence to Andres Duarte-Rojo.

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Conflict of Interest

Elliot B. Tapper reports grants from Valeant, grants from Gilead, and personal fees from Novartis, outside the submitted work.

Roberto Martinez-Macias and Andres Duarte-Rojo declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Portal Hypertension

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Tapper, E.B., Martinez-Macias, R. & Duarte-Rojo, A. Is Exercise Beneficial and Safe in Patients with Cirrhosis and Portal Hypertension?. Curr Hepatology Rep 17, 175–183 (2018). https://doi.org/10.1007/s11901-018-0404-z

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  • DOI: https://doi.org/10.1007/s11901-018-0404-z

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