Brief Answer: Pain killers have to be avoided. Tramadol a better Detailed Answer: Dear Friend. Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern. Since you have decompensated liver cirrhosis with bleeding varices , taking pain killers can be harmful to you due to following reasons : 1. Most of the pain killers excretes through liver and kidneys , so can further damage them. 2. Pain killers can cause gastric / duodenal ulcer which can bleed so can worsen your variceal bleeding problem. 3. May also damage your kidneys causing a disaster for you. I understand that you need pain killers for osteoarthritis. I prefer to use Tablet Tramadol in my patients with such problems as it is relatively safe. So , you may discuss with your doctor regarding prescribing you Tab Tramadol on as required basis for pain relief. It causes sedation , so should be taken at night. At most , you may sometimes use local pain killer gels , but ideally should be avoided. This is my personal opinion based on details available here. If you still have any query you may please ask me. Stay Healthy. Dr Anshul Varshney , MD

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