Health diet

The diet plan for cirrhosis should be done as per recommended dietary modification for cirrhosis. The diet of cirrhosis patient should be according to the different modifications like increased energy requirements, provision of quality proteins, addition of easily digestible fats (although total fat consumption should be reduced), simple forms of carbohydrates like glucose, sugar, fruits and fruit juices and starches like cereals (avoidance of irritating carbohydrates) etc. The diet plan for cirrhosis should be made such a way that it promotes speedy healing of liver (reversal of architectural distortions) by providing all the essential nutrients (proteins, fats, carbohydrates, vitamins and minerals) in adequate amounts. The diet should be planed in such a way that it is also palatable and acceptable to the local customs, traditions and to the liking of the cirrhosis patient. There is no universal diet plan for any medical problem; it should be based on local food habits and one which is acceptable to the patient.

The following diet plan can be followed for cirrhosis:

Early morning: The early morning should start with tea and biscuits with less fat and more carbohydrates.

Breakfast: The breakfast should consist of porridge, easily digestible fruits like papaya.

Mid morning: The midmorning snack can be with sweet potato, potato mix etc.

Lunch: The patient of cirrhosis can have lunch with whole grain like well cooked rice, vegetables and well cooked fish.

Mid afternoon: Custard can be taken in the mid afternoon.

Evening tea: It can be with noodles and fruit juice along with tea or coffee.

Dinner: It should start with soup (vegetable soup or chicken soup). Dinner should be with blend soft rice mixed with vegetables, noodles etc.

Bed time: It should be with a sweet dish.

N.B: The most important point should be remembered in preparing a diet plan for patient with cirrhosis is that the meals should be small and frequent instead of large infrequent meals.

Dietary modification in cirrhosis is very important for speedy reversal of architectural distortions of cirrhosis.
Along with dietary modification, the removal of the causative or aggressive factors of cirrhosis is also important for architectural distortions of cirrhosis.

The following dietary modifications are essential for speedy reversal of architectural distortions of cirrhosis:

Energy requirement:

The energy requirements are increased to correct nutrition deficiencies and to promote reversal of architectural distortions liver, but due to the bedridden condition of the patient the energy requirement of cirrhosis patient is actually less than normal person.

Proteins:

The protein intake should be normal to overcome malnutrition, regenerate liver cells and to replenish plasma proteins. However, if there is hepatic coma, the protein intake should be less than normal depending on the individual tolerance.

Carbohydrates:

A high carbohydrate diet is essential and recommended for increased energy demand and to protect the liver from further damage. Carbohydrates should be in the simple forms like glucose, sugar, fruits and fruit juices and starches like cereals and root vegetables etc. Irritating fibers should not be taken and refined cereals and low fiber vegetables and fruits should be consumed.

Fats:

Many cirrhotic patients suffer from mal-absorption of fat and fat should be restricted to help such patients (although inclusion of adequate amount of fat to improve the palatability of the diet and to promote recovery is recommended). The amount of fat to be included in the diet varies depending on individual. Emulsified fats, which are easily digested like fat from milk, butter, cream, eggs should be given.

Vitamins:

The absorption of fat-soluble vitamins like vitamin A, D, E & K may be affected due to the decreased intake and impaired absorption of fat. Therefore, diet should include fat-soluble vitamins like vitamin A, D, E & K rich foods and vitamin B complex supplements may be required to replenish liver store and repair tissue damage.

Minerals:

Adequate amounts of calcium, magnesium and other minerals should be provided in the diet for cirrhosis patient. The intake of sodium needs to be restricted because of water retention in the body.

Cirrhosis is a condition that consists of the development of fibrosis to the point that there is architectural distortion with the formation of regenerative nodules in the liver. This results in a decrease in liver mass (due to decrease of liver cells), and thus function, and an alteration of blood flow.

The common causes of cirrhosis are alcohol abuse that cause alcoholic liver disease, chronic hepatitis C etc. Cirrhosis has a variety of clinical manifestations and complications, some of which can be life-threatening. In the past it was thought that the architectural distortions of cirrhosis are never reversible, but fortunately it has become apparent that when the underlying insult that has caused the cirrhosis has been removed (like successful treatment of chronic hepatitis C and stopping of alcohol consumption completely), there can be reversal of architectural distortions (mainly fibrosis).

The main objectives of a diet for cirrhosis are as follows:

1. To promote regeneration of liver cells by supplying adequate amount of nutrition through planning an appropriate diet for cirrhosis. Liver cells have tremendous capacity to regenerate, unlike many other organs, but for proper regeneration of liver cells, a suitable diet is basic need. Supply of adequate good quality protein is essential for regeneration of any cell, including liver cells (without protein the DNA and other important biomolecules can not be synthesized and without these biomolecules regeneration is not possible).
2. Due to architectural distortions of liver cells, generally there is nutritional deficiency in cirrhosis, which can hamper the proper regeneration of liver cells. By supplying adequate nutrition with planned diet the regeneration can be sped up. Nutritional deficiencies are also common among alcoholics (chronic alcohol use or abuse is the commonest cause of cirrhosis).
3. In a patient of cirrhosis fluid and electrolyte imbalance may be a problem, especially during the initial stage of management of cirrhosis. This electrolyte imbalance should be corrected through intake of fluids and by adequate diet.