Optimizing the Nutritional Support of Adult Patients in the Setting of Cirrhosis

Abstract

Aim: The aim of this work is to develop a pragmatic approach in the assessment and management strategies of patients with cirrhosis in order to optimize the outcomes in this patient population. Method: A systematic review of literature was conducted through 8 July 2017 on the PubMed Database looking for key terms, such as malnutrition, nutrition, assessment, treatment, and cirrhosis. Articles and studies looking at associations between nutrition and cirrhosis were reviewed. Results: An assessment of malnutrition should be conducted in two stages: the first, to identify patients at risk for malnutrition based on the severity of liver disease, and the second, to perform a complete multidisciplinary nutritional evaluation of these patients. Optimal management of malnutrition should focus on meeting recommended daily goals for caloric intake and inclusion of various nutrients in the diet. The nutritional goals should be pursued by encouraging and increasing oral intake or using other measures, such as oral supplementation, enteral nutrition, or parenteral nutrition. Conclusions: Although these strategies to improve nutritional support have been well established, current literature on the topic is limited in scope. Further research should be implemented to test if this enhanced approach is effective.

The Molar Ratio of Total Branched-chain Amino Acids to Tyrosine Predicts a Digit Symbol Test Abnormality in Cirrhotic Patients

“…Evaluating the dietary intake helps physicians and dieticians understand poor food habits, dietary choice, and excessive consumption. Suitable management of malnutrition involves establishing daily a diet that includes a restricted calorie intake and diverse nutrient consumption ( 45 ). Using the FFQ, the quantity of daily intakes was calculated based on the portion size and consumption frequency.…”

A Systematic Review of Medical Nutrition Therapy Guidelines for Liver Cirrhosis: Do We Agree?

“…Patient preferences and views should be incorporated in the CPGs development process for facilitating CPGs acceptability and compliance by the target group . With the majority of cirrhotic patients demonstrating decreased food intake as a result of digestive problems and hepatic encephalopathy, and many others adhering to restrictive diets and heavy alcohol intake, pragmatic and feasible CPGs are needed for increased adherence . Additionally, patient engagement has already been identified as an indicator of improved care quality in cirrhosis …”

Hepatotherapeutic Tendency of Citrullus lanatus Rind Methanolic Extract on Liver Markers in Male Wistar Rats

“…Watermelon rind contains significant quantity of antioxidant phytochemicals [22]. Alkaloids, flavonoids and phenols possess antioxidant properties [18]. Several studies have revealed the positive correlation between oxidative stress and cellular damage [15,17].…”

“…Experiment to determine the liver function biomarkers were carried out using the standard laboratory procedures [14]. The biomarkers tested for include; alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), total proteins (TP), bilirubin and albumin [18]. This test was carried out on blood samples collected on day 42 of the experimental period.…”