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Nutritional Challenges in Patients with Advanced Liver Cirrhosis

1
Division of Diabetology, Endocrinology, Nutritional Medicine and Metabolism, University Hospital Inselspital and University of Bern, 3010 Bern, Switzerland
2
University Clinic for Visceral Surgery and Medicine, University Hospital Inselspital and University of Bern, 3010 Bern, Switzerland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(11), 1926; https://doi.org/10.3390/jcm8111926
Received: 24 September 2019 / Revised: 5 November 2019 / Accepted: 5 November 2019 / Published: 9 November 2019
Patients with advanced liver cirrhosis are at risk of malnutrition and nutrition-associated complications. Significant ascites, a frequent finding in these patients, has an especially negative impact on oral nutrition. A negative caloric and protein balance can further deteriorate the already impaired synthetic function of the cirrhotic liver. An important factor in this situation is the diminished capacity of glycogen production and storage in the cirrhotic liver and, consequently, a reduced tolerability for fasting episodes. These episodes are frequently observed in hospitalized patients, e.g., while waiting for investigations, interventions or surgery. A comprehensive work-up of patients with advanced liver cirrhosis should include not only a thorough assessment regarding nutritional deficits, but also a muscularity analysis to identify patients with sarcopenia. The overall nutritional treatment goal is to cover caloric deficits and assure a sufficiently high protein intake. Furthermore, vitamin and micronutrient deficiencies should be identified and corrective measures implemented where required. Ideally, optimal nutrition management can not only prevent the progression of malnutrition and sarcopenia in patients with advanced liver cirrhosis, but positively influence the evolution of the liver disease. View Full-Text
Keywords: cirrhosis; ascites; sarcopenia; sarcopenic obesity; nutrition; vitamins; micronutrients cirrhosis; ascites; sarcopenia; sarcopenic obesity; nutrition; vitamins; micronutrients
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Stirnimann, J.; Stirnimann, G. Nutritional Challenges in Patients with Advanced Liver Cirrhosis. J. Clin. Med. 2019, 8, 1926.

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