protein breakdown. Protein Protein intake should be adjusted as per the individual requirement. A protein intake of 1g/ kg body weight per day is given to achieve positive nitrogen balance. In case of hepatic coma, protein requirement is reduced to .5g/ kg bodyweight per day.
Fat Steatorrhoea or fatty infiltration of liver may be seen in cirrhosis patient. A low intake of fat in the form of medium chain triglyceride (eg Coconut oil) may prove to be effective in reducing the malabsorption of fat. Carbohydrate High carbohydrate ( -400g/day) may be given for its protein sparing effect. This protects and supports liver function.
Carbohydrate intake also helps in maintaining the weight of the patient. MALNUTRITION IN CIRRHOSIS! Malnutrition is common and predominant in liver diseases. The factors resulting in malnutrition are: • Decreased food intake because of anorexia, nausea and vomiting, unpalatable diet and the drugs • Impaired digestion and absorption of nutrients due to pancreatic insufficiency, bile salt deficiency and mucosal defect • Increased energy requirement • Insufficient protein synthesis • Alcohol consumption UNIT- IN GASTRO INTESTINAL AND LIVER - - DIET IN GASTRO INTESTINAL AND LIVER DISORDERS HEPATIC ENCEPHALOPATHY!
Hepatic encephalopathy is a damage of brain and nervous system that occurs as a complication of liver disorders. Hepatic encephalopathy is characterized by neurological disturbances, elevated ammonia levels (ammonia which is not converted to urea by liver), high blood concentration of aromatic amino acids and low levels of branched chain amino acids. The symptoms of hepatic encephalopathy are mild confusion, euphoria or depression, decreased attention, irritability, disturbance in sleep patterns, lethargy, speech disorientation, and finally coma. Restriction of dietary protein is the first step.
The diet should be rich in calories, low protein (BCAA protein can be given) and restricted fluid. Electrolyte imbalance should be corrected and vitamin supplementation especially vitamin B and C may be given Vitamins and minerals Supplementation of vitamins is needed to replenish liver stores and repair tissue damage. The important vitamins are pyridoxine, cyanocobalamin, folate, niacin and thiamine. Supplementation of minerals such as calcium, magnesium and zinc should be given in adequate