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Cirrhosis

In cirrhosis, a chronic progressive disease, normal liver cells are replaced by scar tissue. Prolonged, heavy alcohol use is the most common cause, but cirrhosis may also result from hepatitis, inflammation or blockage of the bile ducts, inherited conditions, or a reaction to a drug or environmental toxin.

In its early stages, cirrhosis does not usually produce symptoms, but as the liver is increasingly infiltrated with fibrous tissue, a person may experience fatigue and nausea, and have a poor appetite. In the later stages, jaundice may develop and fine, spidery blood vessels appear on the skin. The liver damage is irreversible, but the progress of cirrhosis can be arrested and the complications treated with diet and other measures.

 

DIET AND LIVER REPAIR

Stop drinking alcohol. Whether or not alcohol intake is the cause of cirrhosis, it is essential to stop drinking entirely to prevent further liver damage. Although the scar tissue cannot be replaced, the liver does have a remarkable ability to repair itself. To achieve this and regain lost weight, a daily intake of 2,000 to 3,000 calories is necessary. Most people with cirrhosis, however, have little appetite; thus, frequent small meals may be more tempting than three large ones.

Eat plenty of protein. It is important to include sufficient protein in the diet. The recommended daily intake of protein for those with cirrhosis is 0.54 g per pound (1.2 g per kilogram) of body weight. This is more than the amount that is recommended for healthy people. Some evidence supports the use of vegetable protein foods such as those in soy, peas, and legumes, especially for people who develop mental confusion, a condition called hepatic encephalopahty. A good supply of carbohydrates is needed. Moderate amounts of polyunsaturated fats (oily fish, corn oil, safflower oil) also provide needed calories without overburdening the liver. Regular intake of vitamin C in the form of fresh fruits and vegetables will also help, strengthening the immune system.

Replace depleted vitamins and minerals. Nutritional deficiencies are common among cirrhosis patients. Enriched cereals, breads and pasta, and fruits and vegetables will help. Often, a doctor will also prescribe supplements.

 

FLUIDS AND SALT

The orderly flow of body fluids is an early casualty of cirrhotic damage. In a healthy person, the blood supply circulates through vessels in the liver; but in cirrhosis, rigid scar tissue forms on the liver, hindering the blood from passing freely. As the blood backs up, the pressure in the supplying vessels increases, which forces plasma out of the blood vessels and into the tissues that surround the abdominal cavity. People with cirrhosis often have distinctive abdominal swelling, known as ascites. The volume of blood in the vessels throughout the body is therefore decreased, and when the kidneys register the fall in blood flow, they send out a signal for help in the form of the hormone aldosterone. Far from helping, this causes the body to retain sodium (instead of excreting it in the urine in he normal manner), which in turn produces a further damming o fluid and worsens the ascites. The whole body becomes puffy and swollen, and the vicious cycle continues with other complications that arise as the blood seeks a way to bypass the obstruction in the liver. This entails increasing blood flow in vessels in neighboring organs, such as the veins of the esophagus. Some cirrhotic patients suffer from varices (varicose veins) in the esophagus, which can rupture and cause severe bleeding.

People with cirrhosis should eat little salt, especially if ascites is present, and drink about four to six glasses of fluids a day. If varices are present in the esophagus, the food should be soft and thoroughly chewed.

 
 

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