There are two articles in NEJM this year that say naltrexone is 'contraindicated for cirrhosis'. This saddens me. It is not supported by an evidence. Alcohol is 'contraindicated for cirrhosis'. That is supported by evidence

An important message on naltrexone in patients with liver disease: ✅Naltrexone can help reduce alcohol use without harming the liver. 🚫Alcohol DOES harm the liver. We do not need any more barriers to treat patients with AUD➕ALD! @nejm.org @ebtapper.bsky.social www.nejm.org/doi/full/10....

Do you want to support the future of the best speciality? As an Emerging Liver Scholar and Advanced Transplant Hepatology awardee, @aasldfoundation.bsky.social has shaped my career. 🙏 to all who support our pathways into hepatology @aasldnews.bsky.social 🙏Donate👇 www.aasldfoundation.org/donate

📢 PSA: 👩‍⚕️👨‍⚕️Primary care doctors and internists: ‼️Please 🛑 telling patients “it’s just fatty liver” Common, yes. But not benign! ✅ Take 🍺🍸history, perform brief intervention ✅ Manage metabolic risk factors 🧐Fibrosis (FIB-4) ☎️ Your friendly hepatologist if you need help! #liversky #medsky

In an epidemic of alcohol-use disorder, alcohol-associated liver disease, and cancers driven partially by 🥂🍸🍺, click-bait headlines like these are extremely harmful for population health. Let’s do better for our patients and public health. @theguardian.com @nytimes.com @cnn.com @washingtonpost.com

So fun to meet online friends IRL!

When did the hotel mini-bar get not-so-mini?! As an alcohol-associated liver disease focused hepatologist, this trend is very concerning!

Alcohol use is pervasive. I’ve had conversations about how to prevent harmful drinking in teenagers and children (one study I did on an AUD population the average age of first drink was 11). Here is one idea (that can be applied to other habits)! What else can we do help reduce underage drinking?

Most of what we see on the liver transplant wards are sick, young patients with alcohol-associated liver disease. We frequently see patients in their 20s and 30s, many who drank at “socially acceptable levels,” with severe liver disease resulting in either transplant or ☠️. #liversky

As a clinician scientist who has devoted my life to improving health + advancing science, the last few months have been terrifying. I don't understand why the US doesn't want to continue leading in health + science Supporting medical science in the USA - The Lancet www.thelancet.com/journals/lan...

Not surprising, but these pronatalists are white supremacists, backed by tech money and now with a large voice. Who would want to bring children into their sick world? www.npr.org/2025/04/25/n...

It’s #WorldImmunizationWeek Vaccines have saved 154 million lives in the last 50 years. That’s 6 lives every minute. A reminder of what is #HumanlyPossible. Science saves lives. #VaccinesWork bit.ly/wiw2025

Unsurprisingly, this administration misses the 🎯 on why many people don’t have more children: 💰(a one time $5k bonus isn’t enough) My PGY4, I spent more than my salary on childcare (and we had a very reasonably priced day care at the time for the area, ~$1300/m) www.nytimes.com/2025/04/21/u...

Science is nonpartisan. www.nytimes.com/2025/04/18/h...

Home *slightly* early on this gorgeous Friday afternoon for some light reading with my 12.3 lb besties on enteral feeding in hospitalized patients. @nejm.org This is the life! @GISky @liversky @medsky

This trend is *very* concerning given that alcohol damages the liver of females at 2x the rate of males. We are seeing so many young females (20s and 30s) who get very sick and often die from🍸🍷🍻-associated liver disease! We need to work on strategies to 📉 alcohol use in this population! #liversky

An estimated 3.3 million Americans are living with viral hepatitis. I see many of them daily with complications including liver cancer and cirrhosis. We see periodic outbreaks of hepatitis across our country, on top of a growing IVDU-related HCV epidemic. This is pure bananas 🍌.

PSA: You can have iron deficiency without anemia and it still matters and can cause serious symptoms and absolutely warrants treatment.

“DEI and proud” “Donald Trump’s worst nightmare” Happy to be in NYC and supporting ReelAbilities Comedy Night

Wise words from Dr Scott Winder: Congratulate your AUD/ALD on their progress for reducing alcohol use, even if they haven’t achieved abstinence. Addiction is hard. Recognize success. #liversky #ALD-ALLY #medsky

Naltrexone in 🍷🍸🍺-associated liver disease ✅ Overall, safe for treatment of alcohol use disorder in this population Black box warning for chronic liver disease was REMOVED in 2013: 🚫 evidence of harm 🔑 Alcohol causes harm to the liver, naltrexone does NOT Slides: #ALD-ALLY Lamia Haque #liversky

As a constituent who formally worked at NIH: yes and yes.

Heading to @amergastroassn.bsky.social DDW? Apply for 🌈@rainbowingastro.bsky.social inaugural Health Equity Travel Awards! Would love to see a 🌱 hepatologist awarded! 📆Deadline to apply is April 18th! urldefense.com/v3/__https:/...

I frequently see patients with “new” cirrhosis only to find that on chart review they had low platelets/some other finding concerning for cirrhosis or liver disease often YEARS before. Thrombocytopenia should prompt a search for cirrhosis and may save lives/livers! #liversky

Encouraging #GISky and #liversky Fellows to apply! 📆 Apply by April 1st!

Who has completely deleted their Twitter/X account? I’ve struggled to given what #MedTwitter was and the connections made. Just logged into check and was overwhelmed with xenophobia/islamaphobia/white supremacy and I cannot 🤯. Haven’t pulled the plug just yet but wow…things have gotten very 💩

“Moderate” alcohol-associated hepatitis MELD < 20 journals.lww.com/hepcomm/full... #liversky

This picture reminds me how I have always been extremely goal oriented (Also: So much fun to share this with my mini-me. Bonus: my dad teaching my son how to aim as well as fly fish in high desert streams!)

Ascites is like carrying around a hot tub: Huge energy bill! 1⃣Kilocalorie= energy to 🔥1L by 1°C 2⃣Ascites=Heating ~5-10L to 36°C 24hrs/day 3⃣Energy comes from body breakdown (sarcopenia) If you⬇️ascites➡️the energy bill falls Help patients. ⬇️the ascites!!! #liversky

After five decades, steroid dosing in AAH is revisited: Tapered prednisolone proves superior in reducing infections. #STASH trial @jasmohanbajaj.bsky.social @juanpabloarab.bsky.social @ebtapper.bsky.social @tonybreu.bsky.social @blaneymd.medsky.social journals.lww.com/ajg/abstract... #liversky

Having trained at a center that did a high volume of stem cell transplants, we frequently encountered NRH post-chemo and transplant. These patients do not behave like our patients w/ cirrhosis, with different plt thresholds associated with portal HTN. Carvedilol still works!

👋 #liversky! Do you love the Liver Fellow Network and want to be a part of the amazing work we do? Our application for content writers is out! 📆Apply by April 1st! docs.google.com/forms/d/e/1F... @amcollegegastro.bsky.social @amergastroassn.bsky.social @ebtapper.bsky.social

We are so lucky to have you, Bernie! Hopefully the US can continue to work on global public health initiatives.

As a hepatologist focused on alcohol-associated liver disease, I often remind my patients that the liver isn’t the only organ alcohol impacts. Alcohol use is also associated with cancer as well as brain 🧠 health As a🗺️ community, we need to do more to educate on the health consequences of alcohol!

I personally lean 🌱/🐟-based. My favorites are lentils and other legumes (cheap and delicious!😋 ), Greek yogurt, fish, and eggs (if available). Also: ❤️ healthy! Also, remember that many products/snacks have ⬆️ sodium including another personal favorite: 🧀 (though mozzarella and Swiss have ⬇️)

I saw a picture of a pregnant person getting an ultrasound and immediately thought—“I hope they give albumin.” 🤣🤦‍♀️ Note to self: conditions other than ascites and massive hepatosplenomegaly can cause abdominal distention #medsky #liversky

Really liking this trend of puppies, especially given everything else going on with the world and science. Her is mine when she was a pup! Now is a ~13lbs.

It’s fun being on a teaching team in a teaching hospital where you learn so much from your trainees and from the consulting services!

Please delve deeper into “social” drinking with your patients, especially in those with evidence of liver disease. More often than not, drinking that is considered socially acceptable is harmful to the liver. Sometimes a brief intervention/educational moment is enough to save a liver! #liversky

One need not worry about bleeding when banding varices in patients with low platelets I am not sure why this study excluded people with platelets less than 30 Nevertheless … doi.org/10.3390/dise... #liversky

Amazing #liversky conference by @aasldnews.bsky.social @juanpabloarab.bsky.social + Mazen Noureddin on alcohol-associated liver disease and MetALD. So many great minds working in this area to improve our patients’ lives. Always 👌 time to be a Hepatologist! @vinayjaha.bsky.social #medsky #academicsky

Ramadan Mubarak! 🌙

FANTASTIC presentation by phenomenal patient advocate Jennifer Jones. Hearing from patients about their experience moving through our system is 👀. 👏 We need to take every opportunity to diagnose liver disease AND we need to continue to work on stigma: language matters! @juanpabloarab.bsky.social

Invasive fungal infections in patients with liver disease: immunological and clinical considerations for the intensive care unit Epelbaum, Gallo de Moraes, Olson, & Lionakis link.springer.com/article/10.1... #IDSky #HepSky #MedMycoSky

Apparently, all the residents/med students at our connected hospitals interested in GI/liver know I like research! It’s been so fun to mentor residents/students through projects—especially when they bring their own ideas! Can’t wait to continue this as an attending. #liversky #GISky #academicsky

Yes! 💯 Would also love to see alcohol taxed with proceeds going to fund addiction and ALD research, projects helping those hurt by addiction, treatment…

Us moms in medical training always feel guilty about not being good enough in either part of life—not good enough residents/fellows & not good enough as a parent. But we are. To moms in training—my 👶 is now 7 and it’s all he knows. It gets easier, the guilt is still there. I see you!

Fantastic 📰 @liverthedream.bsky.social ✨ALD is📈prevalent! ✨Abstinence from🍸🍺 is the ONLY available tx to 🛑 progression of 🍸-related injury ✨#liversky MUST🪜up to treat AUD, 💊 are safe➕ effective @rbataller.bsky.social @juanpabloarab.bsky.social @ebtapper.bsky.social www.aasld.org/liver-fellow...

Read our latest issue in full ➡️ tinyurl.com/2rz7b357 bsky.app/profile/thel...

This is just one of MANY reasons why DEI is so important in science and medicine. Lives depend on it!