Cirrhosis of the liver is the structural and functional end result of nutritional, infective and toxic changes in the liver. The causes of cirrhosis may be viral infection like hepatitis, excessive alcohol intake with the diet being low in the number of nutrients and malnutrition aggravates any injury to the liver.

The right nutrition along with medication can help. The main objectives of dietary modification are:

To correct fluid and electrolyte balance.

To promote regeneration of liver cells.

To correct nutritional deficiencies.

Principles of diet therapy for cirrhosis:

Energy: The energy requirements are increased to correct prolonged nutrition deficiencies and to promote liver regeneration. The calorie requirement is between 2000-2500 calories per day.  Since the patient is bed ridden his actual energy expenditure is reduced.

Proteins: A high protein diet is helpful for the regeneration of the liver and replenishes plasma protein. In the absence of hepatic coma a high protein intake of about 1.2gm/kg body weight is advised. If the patient is in precoma or coma protein in the diet should be withheld till the patient tides over the crisis.

Carbohydrates: carbohydrate should be supplied liberally so that the liver may store glycogen. The liver function improves with the adequate store of glycogen in the liver. At least about 60% of the calories should come from carbohydrate. They provide energy and protect the liver against further damage.

Fiber: Irritating fibers should be eliminated. Thus, dehusked pulses, refined cereals and low fiber vegetables and fruits should be selected.

Fats: Many cirrhotic patients suffer from malabsorption of fat and, therefore, fat restriction helps to such patients. The amount of fat to be included in the diet, vary depending on individual’s tolerance. Inclusion of adequate amount of fat improves the palatability of the diet and promotes recovery.

Emulsified fats such as fat from milk, butter, cream, eggs should be given as they are easily digested. Medium chain triglycerides present in coconut oil are better tolerated since they are directly absorbed without undergoing digestion.

Vitamins: the fat soluble vitamins like vitamin A, B are not better absorbed by the body due to reduced intake and impaired absorption of fat. Thus supplementation of fat soluble vitamins is required.

Minerals: adequate amounts of calcium and magnesium should be provided in the diet. Sodium intake needs to be restricted if there is water retention in the body.

Note:

• Serve soft foods that are smooth in texture.
• Acutely ill patients may require a fluid diet with 6-8 meals in a day.
• Restrict salt in cooking and for table use.
• Patient should be encouraged to eat.
• Food 800ved should be well cooked, attractive and appetizing.
• Likes and dislikes of the patient should be kept in mind.
• Avoid large meals.
• Foods to be included: sugar, honey, glucose, cereals, pulses, milk and milk products, eggs, fruits, and vegetables.
• Foods to avoid: fried and fatty foods, fats, oils, nuts and oilseeds, strongly flavored vegetables and foods.
• Avoid alcohol and restrict at least for a year after the attack.