Nutritional status in cirrhosis; pathogenesis and management

Mousa, Nasser; Mokhtar, Abdel-Rahman; Abbas, Neven; Awad, M. M.; Adel, Ibrahim

doi:10.21608/mjvh.2019.55726

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…Additionally, anorexia, gastroparesis, nausea, increased leptin levels, encephalopathy and gastritis are found to be contributors of malnutrition. Ascites, frequent paracentesis, some drugs such as diuretics and lactulose, a sodium-restricted diet and alcohol consumption (decreases appetite) can also result in metabolic malfunctioning and thus contribute to a reduction in dietary intake, which leads to malnutrition in liver disease[ 12 , 13 ]. The deficiency of biliary salts due to liver malfunction and decreased assimilation of nutrients, abnormal motility of the digestive tract and an increased bacterial growth may subsequently lead to an impaired uptake and metabolism of nutrients, resulting in malnutrition[ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Malnutrition and liver disease in a developing country

Siddiqui¹,

Parkash²,

Hashmi³

2021

WJG

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Malnutrition is a highly prevalent and under recognized condition in developing countries of South Asia. The presence of malnutrition causes a severe impact on patients with liver cirrhosis. The etiology of cirrhosis differs in the South Asian region compared to the West, with hepatitis B and C still being the leading causes and the prevalence of nonalcoholic fatty liver disease increasing over time. Comorbid malnutrition worsens outcomes for cirrhosis patients. Urgent attention to address malnutrition is needed to improve patient outcomes. The etiology and pathophysiology of malnutrition in liver diseases is multifactorial, as reduction in liver function affects both macronutrients and micronutrients. A need for nutritional status assessment for liver disease patients exists in all parts of the world. There are many widely studied tools in use to perform a thorough nutritional assessment, of which some tools are low cost and do not require extensive training. These tools can be studied and evaluated for use in the resource limited setting of a country like Pakistan. Treatment guidelines for proper nutrition maintenance in chronic liver disease exist for all parts of the world, but the knowledge and practice of nutritional counseling in Pakistan is poor, both amongst patients and physicians. Emphasis on assessment for nutritional status at the initial visit with recording of vital signs is needed. Simultaneously, treating physicians need to be made aware of the misconceptions surrounding nutritional restrictions in cirrhosis so that patient education is done correctly based on proper scientific evidence.

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Section: Introductionmentioning

confidence: 99%

Malnutrition and liver disease in a developing country

Siddiqui¹,

Parkash²,

Hashmi³

2021

WJG

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Sarcopenia and malnutrition in patients with liver diseases

Ostrovskaya,

Maevskaya

2023

Medicinskij sovet

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This review focuses on the most current information on the pathogenesis, diagnosis and treatment of sarcopenia and malnutrition in patients with liver disease. Sarcopenia and malnutrition are common complications of liver diseases. Liver cirrhosis, as a stage of the pathological process, serves as the main predisposing factor for the development of malnutrition and sarcopenia. The frequency of sarcopenia in liver cirrhosis is 30–50% and reaches 100% in decompensated patients. The main pathogenetic links are: impaired proteostasis of skeletal muscles, systemic inflammation and changes in gut microbiota. In recent years, enough data have been accumulated to consider these conditions as a prognostically unfavorable factor in patients with liver cirrhosis of various etiologies, affecting their quality of life and survival, as well as worsening the out-comes of transplantation. This dictates the necessity to define unified approaches to diagnostics and correction of these conditions. Currently, tests are used for diagnosis, which allow to assess muscle strength and function. Muscle mass is assessed using instrumental methods by measuring individual muscles and calculating skeletal muscle indices. In patients with liver cirrhosis and concomitant sarcopenia and malnutrition, nutritional and lifestyle modification strategies are applicable for correction in addition to therapy aimed at elimination of the etiologic factor. The aim of the review is to evaluate the problems of diagnosis and effective treatment of malnutrition and sarcopenia in patients with liver disease based on literature data. The article presents an overview of the main strategies for the approach, diagnosis and correction of these conditions.

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Nutritional status in cirrhosis; pathogenesis and management

Abstract: Table (1) Factors that contribute to malnutrition in chronic liver disease 20,21 .

Cited by 2 publications

References 27 publications

Malnutrition and liver disease in a developing country

Malnutrition and liver disease in a developing country

Sarcopenia and malnutrition in patients with liver diseases

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