Publication Name	World Journal of Hepatology
Manuscript ID	117010
Country	United States

Category	Gastroenterology & Hepatology
Manuscript Type	Minireviews
Article Title	Muscle cramps in liver cirrhosis: Pathophysiology, burden, and emerging therapeutic approaches
Manuscript Source	Invited Manuscript
All Author List	Hajira Z Malik, Caitlin Marshall, Ahmed Al-Khazraji and Rajab Idriss
Funding Agency and Grant Number
Corresponding Author	Ahmed Al-Khazraji, Assistant Professor, MD, Division of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07103, United States. aa2758@njms.rutgers.edu
Key Words	Cirrhosis; Muscle cramps; Peripheral nerve hyperexcitability; Mitochondrial dysfunction; Involuntary contractions; Nerve stimulation; L-carnitine
Core Tip	Muscle cramps are an overlooked but highly debilitating complication of liver cirrhosis, affecting up to 88% of patients and severely impairing quality of life. Despite their prevalence, cramps remain undertreated due to limited clinician awareness and the absence of guideline directed therapy. This review synthesizes current evidence on the pathophysiology; including nerve hyperexcitability, altered amino acid metabolism, and energy depletion and highlights emerging therapeutic options such as taurine, L-carnitine, branched-chain amino acids, muscle relaxants, and albumin infusion. By summarizing available data and identifying gaps requiring larger randomized trials, this review provides clinicians with a practical framework to better recognize, evaluate, and manage muscle cramps in cirrhosis.
Citation	Malik HZ, Marshall C, Al-Khazraji A, Idriss R. Muscle cramps in liver cirrhosis: Pathophysiology, burden, and emerging therapeutic approaches. World J Hepatol 2026; In press

Received	2025-11-26 02:38
Peer-Review Started	2025-11-26 02:38
First Decision by Editorial Office Director	2025-12-12 08:41
Return for Revision	2025-12-12 08:41
Revised	2026-01-05 16:45
Publication Fee Transferred
Second Decision by Editor	2026-02-09 02:44
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-02-09 11:11
Articles in Press	2026-02-09 11:11
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5182 (online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Copyright	© The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
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