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[Nutritional Assessment and Management for Patients with Chronic Liver Disease].
Korean J Gastroenterol 2018; 71(4):185-191KJ

Abstract

When liver disease is severe, the prognosis can be worse if the patient is malnourished. Adequate nutritional support for patients with liver diseases can improve the patient's condition and prognosis. In the case of liver cirrhosis, malnutrition can occur due to a variety of causes, including poor oral intake, maldigestion, malabsorption, associated renal disease, and metabolic abnormalities. For a nutritional assessment, it is important to check the dietary intake, change in body composition, including anthropometry, and a functional assessment of muscle. Counselling and oral or enteral nutrition is preferred over parenteral nutrition as in other diseases. If esophageal varices are present, care should be taken when installing a feeding tube, but if there are ascites, percutaneous endoscopic gastrostomy is contraindicated because of the risk of complications. Calories of 30-35 kcal/kg/day and protein from 1.2 to 1.5 g/kg/day are appropriate. Protein restriction is unnecessary unless the hepatic encephalopathy is severe. A late evening snack and branched chain amino acids can be helpful. In the case of cholestasis, the supply of manganese and copper should be restricted. Sarcopenia in patients with liver cirrhosis is also prevalent and associated with the prognosis.

Authors+Show Affiliations

Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.

Pub Type(s)

Journal Article
Review

Language

kor

PubMed ID

29684966

Citation

Lee, Tae Hee. "[Nutritional Assessment and Management for Patients With Chronic Liver Disease]." The Korean Journal of Gastroenterology = Taehan Sohwagi Hakhoe Chi, vol. 71, no. 4, 2018, pp. 185-191.
Lee TH. [Nutritional Assessment and Management for Patients with Chronic Liver Disease]. Korean J Gastroenterol. 2018;71(4):185-191.
Lee, T. H. (2018). [Nutritional Assessment and Management for Patients with Chronic Liver Disease]. The Korean Journal of Gastroenterology = Taehan Sohwagi Hakhoe Chi, 71(4), pp. 185-191. doi:10.4166/kjg.2018.71.4.185.
Lee TH. [Nutritional Assessment and Management for Patients With Chronic Liver Disease]. Korean J Gastroenterol. 2018 04 25;71(4):185-191. PubMed PMID: 29684966.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Nutritional Assessment and Management for Patients with Chronic Liver Disease]. A1 - Lee,Tae Hee, PY - 2018/4/25/entrez PY - 2018/4/25/pubmed PY - 2018/12/14/medline KW - Assessment KW - Calorie KW - Cirrhosis KW - Malnutrition KW - Sarcopenia SP - 185 EP - 191 JF - The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi JO - Korean J Gastroenterol VL - 71 IS - 4 N2 - When liver disease is severe, the prognosis can be worse if the patient is malnourished. Adequate nutritional support for patients with liver diseases can improve the patient's condition and prognosis. In the case of liver cirrhosis, malnutrition can occur due to a variety of causes, including poor oral intake, maldigestion, malabsorption, associated renal disease, and metabolic abnormalities. For a nutritional assessment, it is important to check the dietary intake, change in body composition, including anthropometry, and a functional assessment of muscle. Counselling and oral or enteral nutrition is preferred over parenteral nutrition as in other diseases. If esophageal varices are present, care should be taken when installing a feeding tube, but if there are ascites, percutaneous endoscopic gastrostomy is contraindicated because of the risk of complications. Calories of 30-35 kcal/kg/day and protein from 1.2 to 1.5 g/kg/day are appropriate. Protein restriction is unnecessary unless the hepatic encephalopathy is severe. A late evening snack and branched chain amino acids can be helpful. In the case of cholestasis, the supply of manganese and copper should be restricted. Sarcopenia in patients with liver cirrhosis is also prevalent and associated with the prognosis. SN - 2233-6869 UR - https://www.unboundmedicine.com/medline/citation/29684966/[Nutritional_Assessment_and_Management_for_Patients_with_Chronic_Liver_Disease]_ L2 - http://www.kjg.or.kr/journal/view.html?doi=10.4166/kjg.2018.71.4.185 DB - PRIME DP - Unbound Medicine ER -