Tuesday, August 9, 2011

Nutrition and Diet for Healthy Liver

Proper nutrition and a balanced diet are critical to liver health and regeneration of liver cells.  Sufficient calories, carbohydrates, fats and proteins even form a vital source of treatment of few liver disorders.
Take the case of Cirrhosis, wherein the patient needs to consume a protein-rich diet and 2Kcal to 3Kcal daily for ensuring regeneration of the liver. High protein intake, however, may cause increase in blood ammonia levels in few cirrhotic patients having protein intolerance which may need drugs like Lactulose and Neomycin to control the ammonia level. In contrast, too little protein delays the regeneration of the liver cells. In such individuals, protein intake levels will have to be carefully monitored by the doctor.

Gall bladder disorders

Prevention of obesity as well as reduced consumption of high fat and cholesterol foods helps keep gall bladder disorders in check. In the process of digestion, the gall bladder releases bile into the small intestine through the common bile duct. Majority of gall bladder problems are due to gallstones and over 90% of all gallstones are a result of excessive cholesterol which crystallizes into stones. A balanced diet with controlled cholesterol intake may help minimize incidence of gallstones.
Hepatic encephalopathy
In the case of Hepatic encephalopathy, the mental function is impaired due to altered liver function. E.g. in Cirrhosis, when entry of impure blood into the liver is obstructed due to scar tissue formation. The blood which is normally detoxified in the liver, is consequently shunted back into the central circulation and upon reaching the brain the toxins in the blood, like amino acids, ammonia etc affect the mental function in some cases.        
Dietary treatment is focused on reducing such toxins, which can be achieved by restriction of protein intake to say 20 grams or less daily, which may be impractical for prolonged therapy. Generally, physicians may suggest upto 40 gms of daily protein intake coupled with lactulose and neomycin for reducing the ammonia production in intestines. Foods and dietary supplements rich in certain amino acids like Hepatic acid, which are less likely to cause Hepatic Encephalopathy, are even prescribed as a protein rich source in certain cirrhotic patients.
Ascites and Edema
The conditions Ascites and Edema refer to fluid accumulation in the abdominal cavity and in tissues, respectively. They may be caused by excessive accumulation of Sodium as a result of portal hypertension and liver disease. Sodium intake is restricted within 2-4 grams for patients with Cirrhosis and diet may exclude packaged foods like soups and vegetables, cold cut meats, dairy products and ice cream as well as ketchup and mayonnaise. Fresh foods, which are mostly low in Sodium, are preferred.
Cholestatis refers to inability of the liver to excrete bile and may result in a condition called Steatorrhea. Steatorrhea is the malabsorption of fat due to insufficient bile which dissolves fat in the intestine. Symptoms may be weight loss due to calorie loss and stools which may smell foul and float. Fat supplements like medium chain triglycerides (MCT oil) and safflower oil which are absorbable with less dependence upon bile may be prescribed by the physician and can also be used as Caloric supplements. Patients suffering from Steatorrhea may have difficulty in absorbing fat soluble vitamins, but not water soluble vitamins. Supplements of fat soluble vitamins may be administered only under strict observation of a physician.
Wilson disease
Wilson disease is a condition wherein Copper metabolism is defective due to inability of the liver to excrete excess Copper. The excess Copper accumulates first in the liver followed by the brain and the cornea of the eye. A de-coppering agent, Penicillamine, is required to remove the excess Copper.  Foods containing copper, like mushrooms, chocolate, nuts and shellfish have to be avoided. 
In Hemochromatosis, there is accumulation of excessive Iron due to malabsorption in the intestine. This gets accumulated in the liver, pancreas and other organs. Avoidance of Iron supplements in diet may be sufficient precaution.
Fatty Liver
Fatty Liver is not caused by eating fat but is related to intake of alcohol or some drugs, obesity, starvation and other reasons.  A well balanced diet and removal of the responsible chemical substance or drug is the suggested treatment.
Fast foods and Food Supplements
Patients with liver disease should be very careful of supplements to the diet, especially fast foods or packaged nutritional supplements as these contain large amounts of salt, potassium or inappropriate blends of proteins. Even those that are deemed safe must be consumed under advice of a physician.

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