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Dietary management of hepatic encephalopathy revisited.
Curr Opin Clin Nutr Metab Care 2014; 17(5):448-52CO

Abstract

PURPOSE OF REVIEW

The burden of hepatic encephalopathy on health services is increasing, and some degree of consensus in relation to drug therapy and prophylaxis has been reached. This review focuses on the role of nutritional interventions in the management of hepatic encephalopathy.

RECENT FINDINGS

A number of relatively new pieces of evidence are emerging in relation to nutrition and hepatic encephalopathy as follows: first, reduction of protein intake is not useful for hepatic encephalopathy, but protein selection should be considered; second, oral supplementation with branched chain amino acids has a role not only for its nutritional effect in cirrhosis per se, but also for its effect in reducing the risk of recurrence of hepatic encephalopathy; third, alterations in gut microbiota develop in parallel with decompensation of cirrhosis, and modulation of gut microbiota may be effective for treating and preventing hepatic encephalopathy; fourth, prebiotics and probiotics are potentially useful in this aim, thus further research or trials on prebiotics and probiotics are required; fifth, micronutrient deficiency, which is common in end-stage liver disease, has adverse effects on the brain and may either directly cause encephalopathy per se, or interact with the mechanisms leading to hepatic encephalopathy.

SUMMARY

Properly performed nutritional interventions are likely to be useful for patients with hepatic encephalopathy, but well conducted clinical trials are required.

VIDEO ABSTRACT

http://links.lww.com/COCN/A7.

Authors+Show Affiliations

Department of Medicine - DIMED, University of Padova, Padova, Italy.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

25025262

Citation

Amodio, Piero, et al. "Dietary Management of Hepatic Encephalopathy Revisited." Current Opinion in Clinical Nutrition and Metabolic Care, vol. 17, no. 5, 2014, pp. 448-52.
Amodio P, Canesso F, Montagnese S. Dietary management of hepatic encephalopathy revisited. Curr Opin Clin Nutr Metab Care. 2014;17(5):448-52.
Amodio, P., Canesso, F., & Montagnese, S. (2014). Dietary management of hepatic encephalopathy revisited. Current Opinion in Clinical Nutrition and Metabolic Care, 17(5), pp. 448-52. doi:10.1097/MCO.0000000000000084.
Amodio P, Canesso F, Montagnese S. Dietary Management of Hepatic Encephalopathy Revisited. Curr Opin Clin Nutr Metab Care. 2014;17(5):448-52. PubMed PMID: 25025262.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary management of hepatic encephalopathy revisited. AU - Amodio,Piero, AU - Canesso,Fabio, AU - Montagnese,Sara, PY - 2014/7/16/entrez PY - 2014/7/16/pubmed PY - 2015/4/8/medline SP - 448 EP - 52 JF - Current opinion in clinical nutrition and metabolic care JO - Curr Opin Clin Nutr Metab Care VL - 17 IS - 5 N2 - PURPOSE OF REVIEW: The burden of hepatic encephalopathy on health services is increasing, and some degree of consensus in relation to drug therapy and prophylaxis has been reached. This review focuses on the role of nutritional interventions in the management of hepatic encephalopathy. RECENT FINDINGS: A number of relatively new pieces of evidence are emerging in relation to nutrition and hepatic encephalopathy as follows: first, reduction of protein intake is not useful for hepatic encephalopathy, but protein selection should be considered; second, oral supplementation with branched chain amino acids has a role not only for its nutritional effect in cirrhosis per se, but also for its effect in reducing the risk of recurrence of hepatic encephalopathy; third, alterations in gut microbiota develop in parallel with decompensation of cirrhosis, and modulation of gut microbiota may be effective for treating and preventing hepatic encephalopathy; fourth, prebiotics and probiotics are potentially useful in this aim, thus further research or trials on prebiotics and probiotics are required; fifth, micronutrient deficiency, which is common in end-stage liver disease, has adverse effects on the brain and may either directly cause encephalopathy per se, or interact with the mechanisms leading to hepatic encephalopathy. SUMMARY: Properly performed nutritional interventions are likely to be useful for patients with hepatic encephalopathy, but well conducted clinical trials are required. VIDEO ABSTRACT: http://links.lww.com/COCN/A7. SN - 1473-6519 UR - https://www.unboundmedicine.com/medline/citation/25025262/Dietary_management_of_hepatic_encephalopathy_revisited_ L2 - http://Insights.ovid.com/pubmed?pmid=25025262 DB - PRIME DP - Unbound Medicine ER -