The clinical learning environment (CLE) encompasses the learner's personal characteristics and experiences, social relationships, organizational culture, and the institution's physical and virtual infrastructure. During the COVID-19 pandemic, all 4 of these parts of the CLE have undergone a massive and rapid disruption. Personal and social communications have been limited to virtual interactions or shifted to unfamiliar clinical spaces because of redeployment. Rapid changes to the organizational culture required prompt adaptations from learners and educators in their complex organizational systems yet caused increased confusion and anxiety among them. A traditional reliance on a physical
Summary
Background
Malnutrition is a commonly encountered issue in patients with alcohol‐associated liver disease. The role of nutritional supplementation in the management of alcohol‐associated liver disease is integral to patient outcomes—it has been shown to decrease rates of hepatic encephalopathy, improve outcomes post‐liver transplant, reduce 90‐day hospital readmissions and lower mortality. Despite these benefits, many studies have shown nutritional support to be an underutilised tool in the care of patients with alcohol‐associated liver disease.
Aims
To review the epidemiology, pathophysiology, recommendations for nutritional assessment and supplementation, as well as future directions for research of the relationship between nutrition and alcohol‐associated liver disease.
Methods
A literature search was conducted via PubMed using MeSH terms to inform this narrative review.
Results
Decreased dietary intake, socioeconomic status, impaired absorption of nutrients and increased free radical species are implicated in the pathophysiology of malnutrition in alcohol‐associated liver disease.
Conclusions
Malnutrition is common in alcohol‐associated liver disease, and physicians should be aware of its association with poor clinical outcomes. Routine nutritional assessment, involvement of a dietician and nutritional supplementation are recommended to improve clinical outcomes in patients with alcohol‐associated liver disease.
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