Description

This article reviews nutritional assessment and therapy of patients with chronic liver diseases. Protein energy malnutrition is often present in liver disease of alcoholic and nonalcoholic aetiologies. Malnutrition is often multifactorial and causes include decreased oral intake, malabsorption and metabolic changes typical of a stress response superimposed on starvation. Malnutrition is an important prognostic factor in all patients with liver disease. With the methods commonly used the results of nutritional assessment have to be interpreted carefully in the light of liver disease and its complications. Regular assessment is useful, especially when a combination of energy balance, body composition and function is used. Nutritional therapy is effective in hepatological patients. Food should not be withheld from liver patients for a prolonged time, and should be both energy and carbohydrate rich. Prophylactic protein or fat restriction should be avoided. The presence of ascites requires sodium restriction, and in cholestasis supplementation with fatsoluble
vitamins is required.