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Diagnosis and treatment of nutritional deficiencies in alcoholic liver disease: Overview of available evidence and open issues.
Dig Liver Dis 2015; 47(10):819-25DL

Abstract

Malnutrition is common in alcoholic liver disease and is associated with high rates of complications and mortality. In this article, the current literature was reviewed to highlight the relevance of proper nutritional management providing levels of evidence, when available. A PubMed search was performed for English-language publications from 1980 through 2014 with the keywords: alcoholic liver disease, nutritional deficiencies, nutritional support, enteral nutrition, parenteral nutrition, and protein-energy malnutrition. Manuscripts focused on nutritional approach in patients with alcoholic liver disease were selected. Although nutritional support for malnourished patients improves the outcome of hospitalization, surgery, transplantation and reduces the complications of liver disease and the length of hospital stay, specific guidelines are scanty. Both enteral and parenteral nutrition appear to improve nutritional parameters and liver function; however data on survival is often conflicting. As micronutrient depletion is common in alcoholic liver disease and each deficiency produces specific sequelae, all cirrhotic patients should be screened at baseline for deficiencies of micronutrient and supplemented as needed. In summary, protein-energy malnutrition and micronutrient depletion are clinical concerns in alcoholic liver disease. Nutritional therapy, including enteral nutrition, parenteral nutrition and micronutrient supplementation should be part of the multidisciplinary management of these patients.

Authors+Show Affiliations

Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy. Electronic address: robertaelisa.rossi@gmail.com.Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Italy.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26164399

Citation

Rossi, Roberta Elisa, et al. "Diagnosis and Treatment of Nutritional Deficiencies in Alcoholic Liver Disease: Overview of Available Evidence and Open Issues." Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 47, no. 10, 2015, pp. 819-25.
Rossi RE, Conte D, Massironi S. Diagnosis and treatment of nutritional deficiencies in alcoholic liver disease: Overview of available evidence and open issues. Dig Liver Dis. 2015;47(10):819-25.
Rossi, R. E., Conte, D., & Massironi, S. (2015). Diagnosis and treatment of nutritional deficiencies in alcoholic liver disease: Overview of available evidence and open issues. Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 47(10), pp. 819-25. doi:10.1016/j.dld.2015.05.021.
Rossi RE, Conte D, Massironi S. Diagnosis and Treatment of Nutritional Deficiencies in Alcoholic Liver Disease: Overview of Available Evidence and Open Issues. Dig Liver Dis. 2015;47(10):819-25. PubMed PMID: 26164399.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis and treatment of nutritional deficiencies in alcoholic liver disease: Overview of available evidence and open issues. AU - Rossi,Roberta Elisa, AU - Conte,Dario, AU - Massironi,Sara, Y1 - 2015/06/08/ PY - 2015/01/29/received PY - 2015/04/28/revised PY - 2015/05/30/accepted PY - 2015/7/13/entrez PY - 2015/7/15/pubmed PY - 2016/7/12/medline KW - Alcoholic liver disease KW - Enteral nutrition KW - Nutritional deficiencies KW - Nutritional support KW - Parenteral nutrition KW - Protein–energy malnutrition SP - 819 EP - 25 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 47 IS - 10 N2 - Malnutrition is common in alcoholic liver disease and is associated with high rates of complications and mortality. In this article, the current literature was reviewed to highlight the relevance of proper nutritional management providing levels of evidence, when available. A PubMed search was performed for English-language publications from 1980 through 2014 with the keywords: alcoholic liver disease, nutritional deficiencies, nutritional support, enteral nutrition, parenteral nutrition, and protein-energy malnutrition. Manuscripts focused on nutritional approach in patients with alcoholic liver disease were selected. Although nutritional support for malnourished patients improves the outcome of hospitalization, surgery, transplantation and reduces the complications of liver disease and the length of hospital stay, specific guidelines are scanty. Both enteral and parenteral nutrition appear to improve nutritional parameters and liver function; however data on survival is often conflicting. As micronutrient depletion is common in alcoholic liver disease and each deficiency produces specific sequelae, all cirrhotic patients should be screened at baseline for deficiencies of micronutrient and supplemented as needed. In summary, protein-energy malnutrition and micronutrient depletion are clinical concerns in alcoholic liver disease. Nutritional therapy, including enteral nutrition, parenteral nutrition and micronutrient supplementation should be part of the multidisciplinary management of these patients. SN - 1878-3562 UR - https://www.unboundmedicine.com/medline/citation/26164399/Diagnosis_and_treatment_of_nutritional_deficiencies_in_alcoholic_liver_disease:_Overview_of_available_evidence_and_open_issues_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1590-8658(15)00350-3 DB - PRIME DP - Unbound Medicine ER -