Assessment and Management of Nutrition Status in the Hospitalized Patient With Cirrhosis

Moore, Christopher; Stein, Adam C.

doi:10.1002/cld.758

Cited by 5 publications

(5 citation statements)

References 20 publications

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“…Given that intravenous nutrition is likely to have a short duration, the risk of adverse events from long-term vitamin and micronutrient supplementation is low, even without measuring serum concentrations. Certain vitamins, including vitamins A, D, and K, should be administered with thiamine, folic acid, and pyridoxine to correct deficiencies [ 64 , 89 ].…”

Section: Nutritional Therapy For Aldmentioning

confidence: 99%

Nutritional Support for Alcoholic Liver Disease

et al. 2023

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Malnutrition is a common finding in alcohol use disorders and is associated with the prognosis of patients with alcoholic liver disease (ALD). These patients also frequently show deficiencies in vitamins and trace elements, increasing the likelihood of anemia and altered cognitive status. The etiology of malnutrition in ALD patients is multifactorial and complex and includes inadequate dietary intake, abnormal absorption and digestion, increased skeletal and visceral protein catabolism, and abnormal interactions between ethanol and lipid metabolism. Most nutritional measures derive from general chronic liver disease recommendations. Recently, many patients with ALD have been diagnosed with metabolic syndrome, which requires individualized treatment via nutritional therapy to avoid overnutrition. As ALD progresses to cirrhosis, it is frequently complicated by protein–energy malnutrition and sarcopenia. Nutritional therapy is also important in the management of ascites and hepatic encephalopathy as liver failure progresses. The purpose of the review is to summarize important nutritional therapies for the treatment of ALD.

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Section: Nutritional Therapy For Aldmentioning

confidence: 99%

Nutritional Support for Alcoholic Liver Disease

et al. 2023

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“…The reported prevalence rate of malnutrition in cirrhosis is 40% to 90% 15 . Malnutrition may occur in these patients as a result of decreased nutrient intake, decreased intestinal absorption, and alterations in metabolism 16 …”

Section: Malnutritionmentioning

confidence: 99%

“…15 Malnutrition may occur in these patients as a result of decreased nutrient intake, decreased intestinal absorption, and alterations in metabolism. 16 Current assessment methods include triceps skin fold thickness, mid-arm muscle circumference (MAMC), total body electric conductivity, bioelectrical impedance, and bone density scans. Composite scales, such as the Royal Free Hospital Global Assessment (RFH-GA) and Subjective Global Assessment (SGA), also exist.…”

Section: Malnutritionmentioning

confidence: 99%

The Impact of Frailty, Sarcopenia, and Malnutrition on Liver Transplant Outcomes

Duong

Sadowski

Rangnekar

2021

Clinical Liver Disease

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“…Generally, patients suffering from liver disease present vitamin deficiencies due to altered hepatic function, reduction of reserves, as well as inadequate dietary intake or malabsorption[187]. Deficiencies of vitamins and electrolytes can potentially cause a variety of neuropsychiatric symptoms, hence mimicking or worsening HE.…”

Section: Dietary Approachmentioning

confidence: 99%

Dietary approach and gut microbiota modulation for chronic hepatic encephalopathy in cirrhosis

Campion¹,

Giovo²,

Ponzo³

et al. 2019

WJH

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Hepatic encephalopathy (HE) is a common and serious neuropsychiatric complication of cirrhosis, acute liver failure, and porto-systemic shunting. HE largely contributes to the morbidity of patients with liver disease, severely affecting the quality of life of both patients and their relatives and being associated with poor prognosis. Its presentation is largely variable, manifesting with a broad spectrum of cognitive abnormalities ranging from subtle cognitive impairment to coma. The pathogenesis of HE is complex and has historically been linked with hyperammonemia. However, in the last years, it has become evident that the interplay of multiple actors, such as intestinal dysbiosis, gut hyperpermeability, and neuroinflammation, is of crucial importance in its genesis. Therefore, HE can be considered a result of a dysregulated gut-liver-brain axis function, where cognitive impairment can be reversed or prevented by the beneficial effects induced by “gut-centric” therapies, such as non-absorbable disaccharides, non-absorbable antibiotics, probiotics, prebiotics, and fecal microbiota transplantation. In this context dietary modifications, by modulating the intestinal milieu, can also provide significant benefit to cirrhotic patients with HE. This review will provide a comprehensive insight into the mechanisms responsible for gut-liver-brain axis dysregulation leading to HE in cirrhosis. Furthermore, it will explore the currently available therapies and the most promising future treatments for the management of patients with HE, with a special focus on the dietary approach.

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Assessment and Management of Nutrition Status in the Hospitalized Patient With Cirrhosis

Abstract: http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/12-4-reading-moore a video presentation of this article

Cited by 5 publications

References 20 publications

Nutritional Support for Alcoholic Liver Disease

Nutritional Support for Alcoholic Liver Disease

The Impact of Frailty, Sarcopenia, and Malnutrition on Liver Transplant Outcomes

Dietary approach and gut microbiota modulation for chronic hepatic encephalopathy in cirrhosis

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