Diet For Cirrhosis And Ascites

What Are Complications Of Ascites

Ascites can lead to:

• Abdominal problems: The fluid buildup may lead to pain, discomfort and difficulty breathing. These symptoms can interfere with your ability to eat, walk and do daily activities.
• Infection: The fluids can become infected, called spontaneous bacterial peritonitis. You may have fever and stomach pain. Call your healthcare provider if you have these symptoms. Youll need IV antibiotics and long-term antibiotic treatment to keep the infection from coming back.
• Hepatic hydrothorax, or fluid in the lungs: Abdominal fluid fills the lung, usually on the right side. You may experience shortness of breath, cough, chest discomfort and hypoxemia . You may need thoracentesis to remove the fluid.
• Ascites-related hernias: The increase in abdominal pressure can lead to hernias, specifically umbilical and inguinal hernias. Your healthcare provider will discuss your treatment options.
• Kidney failure: If cirrhosis worsens, it may lead to kidney failure .

A Healthy Diet A Healthier Liver A Healthier You

So, what should you eat to ensure that your liver can function normally?

If youre a liver patient, your diet is adjusted to meet your individual needs. Talk to your doctor about whats best for you. Still, here are some general food tips for a healthy or healthier liver:

• What to avoid: Dont eat foods high in fat, sugar and salt. Stay away from a lot of fried foods including fast food restaurant meals. Raw or undercooked shellfish such as oysters and clams are a definite no-no.
• Talk to your doctor about alcohol and your liver health: Depending on the state of your liver, you should avoid alcohol. If youre allowed alcohol, limit it to no more than one drink a day if youre a woman and two drinks a day if youre a man.
• Eat a balanced diet: Select foods from all food groups: Grains, fruits, vegetables, meat and beans, milk, and oil.
• Eat food with fiber: Fiber helps your liver work at an optimal level. Fruits, vegetables, whole grain breads, rice and cereals can take care of your bodys fiber needs.
• Drink lots of water: It prevents dehydration and it helps your liver to function better.

Further Advice On Protein For People With Hepatic Encephalopathy

People with hepatic encephalopathy should also follow the above guidance including to eat more protein. In the past, patients were advised to cut down on protein. We now know this is wrong, but you may still see it in some information or hear it said by health professionals.

You might find it helpful to:

• Spread your protein intake out over the day. Avoid having all of your daily protein in one meal.
• Take as much of your protein from vegetable sources as possible. Vegetable protein is better tolerated than dairy or meat. Try lentils, beans, peas, nuts, oatmeal, wild rice, and soybean products such as soy milk, tofu and edamame.

Choose dairy sources of protein such as eggs and cheese over meat sources. Dairy can be better tolerated than protein from meat sources. Fish and poultry are better sources than red meat.

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Cirrhosis And Ascites Treatment And Prevention

Cirrhosis and ascites involve fluid buildup in the abdomen. In fact, this condition can result in 10 liters of fluid being drained from the stomach. Its normal for the abdomen to have some fluid. However, the problem is when fluid buildup results in lots of the stuff clogging up the abdomen. This is one of the possible complications if you have liver cirrhosis. In some situations, it can cause a lot of health issues depending on how much fluid gets stored in the gut. In the case of cirrhosis, its all related to liver function being affected and too much fluid in the abdomen.

The good news is you can take steps to treat and prevent the condition. They include low-salt diet, fluid removal, and shunt tube. If you have late-stage cirrhosis then the only permanent option is a liver transplant. However, this is a complex and pricey option so its better to manage liver cirrhosis as effectively as possible to prevent you from developing late-stage cirrhosis. This can save a lot of time, effort, and money. For example, simply avoiding a high-sodium diet can help to manage ascites since salt causes water retention. That can make your situation worse

Eat Under 1500mg Of Sodium/daily

This is the recommended daily amount for most adults. This figure is much lower than many people think. For example, one TBSP of soy sauce can have 1000mg of sodium, which is two-thirds of what you need for one DAY. When possible avoid table salt and go with low-salt varieties of pre-packaged foods.

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How To Follow The Diet

If you have liver cirrhosis, its important to get enough calories and high quality protein each day. This can help prevent malnutrition and preserve lean body mass the part of your body that isnt fat.

The general recommendation is to eat 1618 calories and 0.450.68 grams of protein per pound of body weight per day .

For reference, this means that a person who weighs 150 pounds should consume 2,4002,700 calories and 68102 grams of protein per day.

People with cirrhosis should prioritize high protein foods and incorporate both plant- and animal-based protein sources into their diet. Adding protein to every meal and snack can increase your overall protein intake and may help prevent muscle loss .

Still, more research is needed.

When following a liver cirrhosis diet, aim to limit any foods and drinks that are difficult for the liver to process.

In particular, limit your intake of foods high in unhealthy fats such as trans fats, including fried foods and processed snacks.

Cirrhosis can impact your livers ability to produce bile, which is needed for the digestion of fats. Still, unprocessed fat sources like nuts, salmon, and avocados are fine to enjoy in moderation .

You should also avoid alcohol, which can worsen liver damage and scarring. If you have trouble moderating your alcohol intake or struggle with alcohol dependence, dont hesitate to talk with your doctor and ask for help .

Criteria For Considering Studies For This Review

Types of studies

• #21 #11 AND #18 AND #21

Additionally, we will do the following:

• Review clinical practice guidelines and relevant reviews for potentially eligible studies
• Screen the list of references of relevant reviews and included studies identified
• Manually review proceedings of major conferences in the area
• Search for ongoing studies in the World Health Organization International Clinical Trials Registry Platform

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If I Have Ascites How Can I Best Take Care Of Myself

People with ascites should work with a dietitian to plan a sodium-restricted diet. Check food labels, and avoid high-sodium foods.

You can use several salt substitutes. However, avoid substitutes with potassium, since the medicine you may be taking for ascites can also increase potassium. A dietitian can help you plan a healthy diet and provide recommendations for salt alternatives.

In addition, you should:

• Take your diuretics as prescribed.
• Record your weight every day.
• Stop drinking alcohol, which can cause further liver damage.
• Treat hepatitis B or C if necessary.

How To Follow A Liver Cirrhosis Diet: All You Need To Know

1 ).

If you, too, have received a diagnosis of liver cirrhosis, youve likely been told that the condition cant be cured or reversed.

Still, it may be comforting to know that following a cirrhosis diet may prevent further damage to your liver, protect against complications, and improve your quality of life both now and in the long term.

This article covers the basics of a liver cirrhosis diet, including what it is, how it works, and whether its right for you.

2 ).

Cirrhosis has several causes, including liver disease, hepatitis, heart failure, certain autoimmune disorders, and excessive alcohol consumption. It can also be caused by nonalcoholic fatty liver disease, a condition linked to obesity and type 2 diabetes .

Thankfully, if youve received this diagnosis, following a liver cirrhosis diet can help you get the nutrients you need, protect against further liver damage, and prevent long-term complications .

Keep in mind that nutritional recommendations vary depending on several factors. While this article covers some basic guidelines for a liver cirrhosis diet, its best to work with your doctor or dietitian to find a treatment plan tailored to your specific needs.

summary

Liver cirrhosis is a condition characterized by scarring of the liver. Following a liver cirrhosis diet can help supply your body with the important nutrients it needs and prevent further damage to your liver.

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Treatments For Autoimmune Hepatitis And Primary Biliary Cirrhosis

In both of these diseases, your bodyâs natural defense system attacks and damages your liver. Primary biliary cirrhosis destroys the bile duct — the tube that carries the digestive fluid from the liver to the gallbladder and intestine.

Doctors treat autoimmune hepatitis with steroid drugs and other medicines that stop the immune system from attacking the liver. Side effects may include weight gain, diabetes, weak bones, and high blood pressure.

The main treatment for primary biliary cirrhosis is to slow liver damage with the drug ursodiol . Ursodiol can cause side effects like diarrhea, constipation, dizziness, and back pain. Know more about the treatment options for primary biliary cirrhosis.

Diet In Ascites With Cirrhosis Of The Liver

The diet prescribed by doctors for ascites with cirrhosis of the liver – diet 10 for Pevzner. Its daily calorific value is 2300-2600 kcal. Because of the accumulation of fluid in the abdominal region, salt intake is reduced to 7 g per day, and fluids to 1.2 liters. Just as with diet 5, the amount of fats , proteins and carbohydrates are reduced.

And similarly, the diet in ascites with liver cirrhosis does not allow eating foods that can irritate the liver, all the biliary system and the kidneys. These products have been listed above.

Of the foods allowed by this diet, you should mention eggs that can be eaten in any form .

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Diet Recommendations In Cirrhosis

Malnutrition can be common in patients with liver cirrhosis and may be associated with poorer outcomes. Approximately 20% of people with early cirrhosis and close to 100% of people with severe cirrhosis have malnutrition. Due to liver dysfunction that can be associated with cirrhosis, the liver is not able to produce some nutritional proteins, store energy appropriately, or produce types of fat that are used for energy stores. As a result, metabolic compensatory changes can occur that mimic what occurs in non-cirrhotic people who are suffering from starvation. Therefore, people who have cirrhosis may need extra calories and protein. Other side effects of cirrhosis may include loss of appetite, nausea, vomiting, and unintentional weight loss. Due to all these changes it can help to eat small, frequent meals , including an evening snack.

A good place to start is with a healthful diet. Foods like fruits, vegetables, whole grains, and lean proteins are good choices. Try to eat plant based proteins or very lean cuts of meat such as chicken breast or turkey breast. Some studies show that patients with cirrhosis do better when they obtain protein from vegetables and dairy products instead of meats. It is better to eat a low fat diet versus high fat, as high fat diets have been implicated in worsening cirrhosis. Some people may benefit from high-nutritional supplement drinks, such as Ensure or Boost.

In summary, if you have cirrhosis be careful to limit additional liver damage:

Summary Of Recommendations: Management Of Ascites In Cirrhosis

Diagnosis

• It is recommended that patients give informed consent for a therapeutic or diagnostic paracentesis.
• The initial ascitic fluid analysis should include serum ascitesalbumin gradient in preference to ascitic protein.
• Ascitic amylase should be measured when there is clinical suspicion of pancreatic disease.
• Ascitic fluid should be inoculated into blood culture bottles at the bedside and examined by microscopy for a neutrophil count.

Treatment

• Bed rest is not recommended for the treatment of ascites.
• Dietary salt should be restricted to a no added salt diet of 90mmol salt/day .

Hyponatraemia

• Serum sodium 126135mmol/l, normal serum creatinine. Continue diuretic therapy, but observe serum electrolytes. Do not water restrict.
• Serum sodium 121125mmol/l, normal serum creatinine. International opinion is to continue diuretic therapy, our opinion is to stop diuretic therapy or adopt a more cautious approach.
• Serum sodium 121125mmol/l, serum creatinine elevated . Stop diuretics and give volume expansion.
• Serum sodium 120mmol/l, stop diuretics. The management of these patients is difficult and controversial. We believe that most patients should undergo volume expansion with colloid or saline. However, avoid increasing serum sodium by > 12mmol/l per 24hours.

Diuretics

Therapeutic paracentesis

TIPS procedure

Liver transplantation

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Foods Too High In Sodium

While added salt is a source of sodium in the diet, most of the sodium you eat comes from processed food. In addition to not adding salt to your food, you should also avoid canned foods, frozen meals, snack foods, baked goods and seasoned side dishes to limit sodium intake. Deli meats and cheese are also high in sodium, as well as bacon and sausage. In addition, you want to avoid high-sodium condiments such as ketchup, salad dressing, soy sauce, barbecue sauce and any seasoning with salt in its name, such as celery or garlic salt. Pickles and olives are also high in sodium. Use food labels to help you track sodium in food. Foods with less than 140 milligrams of sodium per serving are considered low-sodium foods.

Reduce The Consumption Of Animal Proteins And Opt For Lean Ones

The liver with cirrhosis does not process protein well, so it is best to reduce your intake to a maximum of 1.5 g of protein per kilogram of body weight daily.

It is important that these sources be as lean as possible to prevent the liver from retaining other components such as fats, which are also present in this type of meat.

Among the most common lean protein sources are beans, tofu and dairy products such as yogurt or cheese, as long as they are low in sodium and fat. Fish such as tuna and salmon, and meats such as turkey or skinless chicken can also be included.

Among the proteins to avoid, in addition to those mentioned above, are viscera, intestines, heart, etc.

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Nutrition In Patients With Cirrhosis

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Fluid And Electrolyte Management In Chronic Liver Disease

Most patients with ascites caused by cirrhosis have an impaired renal handling of water that results in dilutional hyponatremia, the severity of which correlates directly with the severity of liver disease. Several factors contribute to hyponatremia in this setting, but systemic vasodilation, which leads to the inappropriate activation of antidiuretic hormone, promotes water retention. Both ascites and hyponatremia are poor prognostic factors for the patient with cirrhosis.

How Can I Control Ascites

If you have ascites, these steps can help you control the condition:

• Weight checks: Weigh yourself daily. Call your healthcare provider if you gain more than 10 pounds, or more than two pounds per day for three consecutive days.
• Limit alcohol: Its best to avoid alcoholic beverages entirely to reduce your ascites risk.
• Limit NSAID use:Nonsteroidal anti-inflammatory drugs, such as ibuprofen and aspirin, affect your kidneys. They can cause your body to retain excess water and salt.
• Low-salt diet: Stick to a low-sodium diet, consuming no more than 2,000 to 4,000 milligrams per day.

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Assessment Of Reporting Bias

We will investigate the publication bias visually with the use of funnel plots. We will base evidence of asymmetry on P< 0.10 and present intercepts with 90 % CIs. Outcome reporting bias will be evaluated through discrepancies between the registered protocol and the final publication. We will contact authors for more information if we are not able to find the record of a study in the trials registries.