What Do We Know About the Symptoms and Palliative Care Needs of People Affected by Liver Disease?

Chronic liver disease (CLD) is a group of conditions that affect the liver and include cirrhosis, or replacement of functional liver with scarring, and hepatocellular carcinoma (HCC), the most common primary liver cancer. CLD is a major cause of morbidity and mortality worldwide and arises from a variety of conditions including viral hepatitis, chronic alcohol consumption, metabolic syndrome, autoimmune diseases, congenital metabolic diseases, and injury from ingestion of drugs or toxins. Symptoms of CLD include pain, itching, cramping, fatigue, swelling, confusion, sleep disturbance, anxiety, and depression. CLD results in significant burden and distress among patients and their informal caregivers, as well as financial toxicity and stigmatization. The roles of palliative care in this population may include addressing symptoms, informal caregiver burden, uncertainty and lack of information, care coordination, and existential and spiritual distress.