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Shergill R, Syed W, Rizvi SA, et al. Nutritional support in chronic liver disease and cirrhotics. World J Hepatol. 2018;10(10):685-694doi: 10.4254/wjh.v10.i10.685.
Shergill, R., Syed, W., Rizvi, S. A., & Singh, I. (2018). Nutritional support in chronic liver disease and cirrhotics. World journal of hepatology, 10(10), 685-694. https://doi.org/10.4254/wjh.v10.i10.685
Shergill, Ravi, et al. "Nutritional support in chronic liver disease and cirrhotics." World journal of hepatology vol. 10,10 (2018): 685-694. doi: https://doi.org/10.4254/wjh.v10.i10.685
Shergill R, Syed W, Rizvi SA, Singh I. Nutritional support in chronic liver disease and cirrhotics. World J Hepatol. 2018 Oct 27;10(10):685-694. doi: 10.4254/wjh.v10.i10.685. PMID: 30386461; PMCID: PMC6206154.
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World J Hepatol. 2018 Oct 27;10(10):685-694. doi: 10.4254/wjh.v10.i10.685.

Nutritional support in chronic liver disease and cirrhotics.

World journal of hepatology

Ravi Shergill, Wajahat Syed, Syed Ali Rizvi, Ikjot Singh

Affiliations

  1. Radiology Department, McMaster University, Hamilton, ON L8S4L8, Canada. [email protected].
  2. Undergraduate Medicine, McMaster University, Hamilton, ON L8S4L8, Canada.

PMID: 30386461 PMCID: PMC6206154 DOI: 10.4254/wjh.v10.i10.685

Abstract

The liver is a major organ and an essential component in maintaining an appropriate nutritional status in healthy individuals through metabolism of protein, carbohydrates, and fat. In individuals with chronic liver disease (CLD), along with a number of other essential functions that the liver serves, its role in nutrition maintenance is severely impaired. Common causes of CLD include hepatitis C, alcoholic liver disease, and non-alcoholic liver disease. Amongst this population, the most common manifestation of impaired nutritional maintenance is protein-calorie malnutrition. Aside from inherent abnormalities in metabolism, such as malabsorption and maldigestion, CLD can be associated with anorexia as well as increased metabolic requirements, all of which contribute to a state of malnutrition. Given the systemic implications and impact on prognosis of malnutrition, proper nutritional assessment is essential and can be achieved through a thorough history and physical, as well as biochemical investigations and anthropometry as needed. Following an appropriate assessment of a patient's nutritional status, an approach to management can be decided upon and is based on the extent of malnutrition which directly reflects the severity of disease. Management options can be grossly separated into enteral and parenteral nutrition. The former is usually sufficient in the form of oral supplements in less severe cases of malnutrition, but as the CLD worsens, parenteral nutrition becomes necessary. With appropriate assessment and early intervention, many of the complications of CLD can be avoided, and ultimately better outcomes can be achieved.

Keywords: Anthropometry; Chronic liver disease; Cirrhosis; Energy requirements; Liver; Malnutrition; Nutrition

Conflict of interest statement

Conflict-of-interest statement: No conflict of interest.

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