Nutritional Challenges in Patients with Advanced Liver Cirrhosis.

Stirnimann, Jessica; Stirnimann, Guido (2019). Nutritional Challenges in Patients with Advanced Liver Cirrhosis. Journal of clinical medicine, 8(11) MDPI 10.3390/jcm8111926

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Patients with advanced liver cirrhosis are at risk of malnutrition and nutrition-associated complications. Significant ascites, a frequent finding in these patients, has an especially negative impact on oral nutrition. A negative caloric and protein balance can further deteriorate the already impaired synthetic function of the cirrhotic liver. An important factor in this situation is the diminished capacity of glycogen production and storage in the cirrhotic liver and, consequently, a reduced tolerability for fasting episodes. These episodes are frequently observed in hospitalized patients, e.g., while waiting for investigations, interventions or surgery. A comprehensive work-up of patients with advanced liver cirrhosis should include not only a thorough assessment regarding nutritional deficits, but also a muscularity analysis to identify patients with sarcopenia. The overall nutritional treatment goal is to cover caloric deficits and assure a sufficiently high protein intake. Furthermore, vitamin and micronutrient deficiencies should be identified and corrective measures implemented where required. Ideally, optimal nutrition management can not only prevent the progression of malnutrition and sarcopenia in patients with advanced liver cirrhosis, but positively influence the evolution of the liver disease.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Stirnimann, Jessica and Stirnimann, Guido

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2077-0383

Publisher:

MDPI

Language:

English

Submitter:

Thi Thao Anh Pham

Date Deposited:

17 Jan 2020 14:41

Last Modified:

17 Jan 2020 14:41

Publisher DOI:

10.3390/jcm8111926

PubMed ID:

31717529

Uncontrolled Keywords:

ascites cirrhosis micronutrients nutrition sarcopenia sarcopenic obesity vitamins

BORIS DOI:

10.7892/boris.137302

URI:

https://boris.unibe.ch/id/eprint/137302

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