Phlebotomy is the mainstay of treatment in hereditary haemochromatosis and is indicated in all

patients with a ferritin level greater than 1,000 microgram / L. Typical initial phlebotomy regimes are
400-500 ml every 1-2 weeks. Once ferritin level falls to the range 50-100 microgram / L, phlebotomy
regime can transition to a maintenance schedule every 2-4 months
After the first episode of SBP, long-term prophylaxis with a quinolone such as ciprofloxacin or
norfloxacin has been shown to reduce the recurrence rate of SBP. This is particularly important in
patients who have a particularly low ascitic fluid protein.

Ctd
Management

first-line therapy is oral metronidazole for 10-14 days

if severe or not responding to metronidazole then oral vancomycin may be used
for life-threatening infections a combination of oral vancomycin and intravenous metronidazole
should be used

PBC) as evidenced by the history of fatigue, elevated liver enzymes, xanthelasma, history of
autoimmune disease in the family, raised ESR, and the elevated cholesterol level. Interlobular
bile ducts become damaged by a chronic inflammatory process causing progressive cholestasis
which may eventually progress to cirrhosis. The classic presentation is itching in a middle-aged
woman.Choleystramine sequestrate bile acid salts in the enteric lumen and to provide relief
for the patient's pruritus. Other drugs such as colestipol or rifampicin can also be used.
Ursodeoxycholic acid is used to slow the progression of the disease and patients on this medication
have shown biochemical and histological improvement.