This talk will discuss an often neglected complication of cirrhosis: hepatic osteodystrophy (HO) which
is much more prevalent than you think it is! HO is defined as disordered bone metabolism in chronic
liver disease (CLD), the most common being osteoporosis and osteopaenia.

The scenarios where HO is relevant such as in stable cirrhotic patients, those pre- and post-liver
transplant, morbidity and mortality consequent if HO remains unrecognised and unmanaged, will be
outlined. In patients with CLD, which non-invasive tests to order pre-emptively, frequency, their
interpretation thereof will be discussed.

Management by way of vitamin D, calcium supplementation, diet, up-to-date anti-resorptive therapy
and their side effects are important. The final section of the presentation will cover some practical
tips and what pitfalls to avoid in patients with gastrointestinal and liver disorders.
The ultimate aims of this presentation are to educate our gastroenterology and hepatology
colleagues to anticipate and pro-actively manage HO in order to prevent osteoporosis and fractures
in patients with CLD.