Nutritional problems of patients suffering from cirrhosis of the liver

BACKGROUND Liver plays a critical role in energetic metabolism and in many other biochemical processes; that's why advanced liver disease is frequently associated with protein-calorie malnutrition, that compromises clinical outcome of these patients. Unfortunately, assessing nutritional status in patients with liver disease is difficult because of fluid excess and reduction of the protein synthesis. Multiple factors are involved in the cause of protein-calorie malnutrition; in addition to well-described factors of maldigestion and malabsorption, the importance of poor dietary intake cannot be overemphasized.
CONCLUSIONS Nitrogen economy can be improved in the majority of patients by frequent small meals and by special dietary supplements in those who are intolerant of proteins. Nutrient intake can be increased by supplemental enteral nutrition and can be ensured by tube or parenteral feeding.