Dietary Supportive Therapy for Cirrhotic Liver
patients with cirrhosis, a balanced nutritional diet is very important as
a supportive therapy. Patients with cirrhosis often show signs of
malnutrition, and the main reasons are:
1. Poor appetite causes insufficient food intake
2. In the de-compensated stage, nutrients from food are poorly absorbed
due to edema in the gastrointestinal system and the lack of digestive
3. Due to the deterioration of liver functions, nutrients absorbed from
the intestines are not well metabolized in the liver
4. The damaged liver requires more amounts of certain nutrients for
regeneration and repair
5. The use of diuretic medication and aspiration of the ascites can cause
the loss of protein
Correct dietary therapy can improve the metabolism of the liver and also
meet the nutritional needs of the other organ systems. It can promote the
regeneration and repairing of the liver structure and improve the
detoxification functions of the liver. A good diet can also enhance the
immune functions of the body, raise resistance to infections, and promote
good nutrient storage, transport, and regulation in the liver.
The prevention of malnutrition related damage is very important and
therefore, nutritional therapy is one of the most important treatment
factors in cirrhosis.
What is the correct diet for patients with cirrhosis?
The following are some general guidelines:
1. Carbohydrates: Carbohydrates should make up about 40% of the diet. This
amount can help protect the liver, enhance resistance to infections, and
reduce protein catabolism. However, too much carbohydrate intake can cause
weight gain and cause fatty deposits in the liver.
Protein: For a patient with no disorientation, no elevation of serum
nitrogen, about 60 grams of protein per day should meet the daily
requirement. Proteins absorbed through natural foods such as meat, fish,
soy products, and eggs are the best. For patients that have problems with
eating solid foods, protein can be taken as amino acids, albumin or serum
infusion. When there are symptoms of encephalopathy, protein intake should
be reduced to less than 20 grams per day.
Multiple Vitamins and minerals: Supplements with multiple vitamins and
minerals are important. Fresh vegetables and fruits are good sources rich
in vitamins and minerals. Vitamins B1, B2, C, E, K, and minerals zinc and
selenium are important.
3. Fats and oils: A cirrhotic liver cannot metabolize fats well, so low
fat diet is important. Animal fats and fried foods should be avoided as
much as possible. Olive oil is recommended for cooking.
5. For patients with ascites and edema, it is very important that salt
intake be restricted to less than 2 grams per day. For patients with
persistent ascites, salt should be eliminate from the diet and water
intake should be limited to about 1500 ml per day.
6. For patients who have varices in the esophagus or stomach, hard foods
should be avoided. Soft foods should also be well chewed before ingesting
to prevent bleeding.