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If you have cirrhosis, ask your health care provider for a referral
to a registered dietitian, who can create a diet specific to your
needs. Cirrhosis can lead to other problems:
- Ascites (fluid buildup in the abdomen)
- Hepatic encephalopathy (mental confusion)
Cirrhosis refers to the replacement of damaged liver cells by scar
tissue. Too much scarring prevents blood flow through the liver. This
causes even more damage and loss of liver function. Cirrhosis can
hinder the body's use of nutrients and can lead to malnutrition.
Many patients with cirrhosis tend to hold onto (or retain) water. This
often is shown first by swelling in the ankles, particularly after
walking. The swelling may move up the legs to the abdomen. Water
buildup in the abdomen is called "ascites" (pronounced "ah-si-teez").
Sodium (salt)
Too much sodium (or salt) in the diet can make the situation worse,
because sodium encourages the body to retain water. Your doctor will
tell you if you need to limit sodium in your diet. Usually this means
restricting sodium intake to about 2,000 mg a day or less.
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Tips:
If you need to restrict sodium, here are some tips that can help:
- Avoid
salty foods, salt in cooking, and salt at the table. Anything that
tastes salty (such as tomato sauce, salsa, soy sauce, canned soups)
probably has too much salt. Spice things up with lemon juice or herbs,
instead of salt. Fresh foods usually are a better bet than processed
foods.
- Read food labels when shopping. Check the amount of sodium in the foods you are buying.
- Avoid fast-food restaurants. Most fast foods are very high in sodium.
- Go easy on meats, especially red meats, which are high in sodium. When possible, consider vegetarian (meat-free) alternatives.
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A dietitian can inform you about other products, such as antacids, that also contain lots of sodium.
The more fluid you retain, the greater your need to avoid salt. Your
doctor may prescribe diuretics ("water pills") to help you urinate
more. But all the water pills in the world won't help if you eat salty
foods, such as anchovy pizzas.
Calories and protein
People with cirrhosis may need more extra calories and protein. They
may lose their appetite and experience nausea, vomiting, and severe
weight loss. This can lead to shortage of the minerals calcium and
magnesium (signs include muscle cramps, fatigue, weakness, nausea, and
vomiting), or a shortage of zinc (signs include reduced ability to
taste, changes in taste).
It can help to eat small, frequent
meals (4 to 7 times a day), including an evening snack. Your doctor
even may recommend high-nutritional supplement drinks, such as Ensure
or Boost.
When the scarring from cirrhosis prevents blood from
passing through the liver, pressure increases in the veins entering the
liver. This is called portal hypertension. The body is forced to
reroute the blood away from the liver and into the general blood
circulation. This causes large blood vessels, called "varices," to form.
Because the rerouted blood bypasses the liver, it contains high levels
of amino acids, ammonia, and toxins that normally would have been
handled by the liver. When these substances reach the brain, they can
cause confusion and temporary loss of memory (a condition called
"hepatic encephalopathy").
Amino acids and ammonia come from
protein in the diet. Some evidence shows that patients with cirrhosis
do better when they get their protein from vegetables (such as beans,
lentils, and tofu) and from dairy products (eggs, milk, yogurt) instead
of from meats.
Doctors can prescribe a syrup called Lactulose to
push food through the bowels more quickly. This way, less food is
absorbed, the liver has less work to do, and fewer toxins make their
way to the brain.
http://www.hepatitis.va.gov/vahep?page=diet-03-00
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