Nutritional assessment and treatment of patients with liver cirrhosis.

Prevalence of chronic liver diseases, including liver cirrhosis, is increasing worldwide. The nutritional state assessment in these patients is complicated, and besides anthropometry is based on several other tools in order to be more accurate. Specific dietary recommendations are needed in patients with chronic liver diseases in order to help prevent and treat liver decompensation because malnutrition is an independent predictor of mortality. This review focuses on essential aspects in the nutritional assessment of cirrhotic patients and some general recommendations for their treatment.

[Dietetic assessment of patients with gastroenterologic diseases at the out-patient service of the Institute National of Sciences Medicine and Nutrition Salvador Zubiran]. / Evaluación dietética en pacientes con padecimientos gastroenterológicos en el área de Consulta Externa del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.

UNLABELLED: Assessment of dietetic management is necessary for detection/correction of faults and best care of patients. AIM: Our aim was to evaluate dietetic management and nutritional status of gastroenterologic patients. METHODS: Anthropometric, clinical-nutritional, biochemical, and dietetic parameters were assessed in 110 patients (150 with liver cirrhosis [LC], 30 with inflammatory bowel disease [IBD], and 30 with chronic and skin. In CP, prescribed energy, g and % carbohydrates and lipids were less than ideal and proteins were greater; in cirrhotics, less proteins and a great % of carbohydrates were prescribed; in IBD fewer lipids and more proteins than ideal were prescribed. Cirrhotics usually consumed less fat (g) and more proteins than prescribed, and patients with CP and IBD a greater amount of carbohydrates than prescribed. Cirrhotics consumed more % carbohydrates and < % lipids than ideal; CP patients lipid intake was less and protein intake above ideal and in IBD, carbohydrate intake was greater and lipid intake lower than ideal. CONCLUSIONS: Anthropometric and biochemical parameters were not useful for assessment of these patients. Prescribed diet was too restricted regarding proteins in LC and was inadequate in energy/nutrients in patients with CP. Fewer lipids and more proteins were prescribed in IBD. The inadequacy of prescripted diet, lack of information regarding the person who prescribed it, and lack of constant supervision may cause non-adherence to diet and thus may affect nutritional status.