It is vitally important that patients with liver disease maintain a balanced diet, one which ensures adequate calories, carbohydrates, fats and proteins. Such a diet will aid the liver in the regeneration of liver cells. Nutrition that supports this regeneration is a means of treatment of some liver disorders.
Patients with cirrhosis, for example, who are malnourished, require a diet rich in protein and providing 2,000 – 3,000 calories per day to help the liver re-build itself. However, some cirrhotic patients have protein intolerance. Too much protein will result in an increased amount of ammonia in the blood, while too little protein can reduce healing of the liver. Doctors must carefully prescribe a specific amount of protein that will not elevate the blood ammonia. Lactulose and neomycin are two drugs that help keep the ammonia down.
It is believed that the risk of gallbladder disorders can be reduced by avoiding high fat and cholesterol foods and preventing obesity. The gallbladder is a storage sac for the bile produced by the liver. During digestion, the gallbladder releases bile into the small intestine through the common bile duct. Most gallbladder problems are caused by gallstones and 80-90% of all gallstones are produced from excessive cholesterol which crystallizes and forms stones. By maintaining a well-balanced diet and avoiding high cholesterol intake, the incidence of gallstone formation may be lowered.
If you have cirrhosis, be careful to limit additional liver damage:
- Don’t drink alcohol. Whether your cirrhosis was caused by chronic alcohol use or another disease, avoid alcohol. Drinking alcohol may cause further liver damage.
- Eat a low-sodium diet. Excess salt can cause your body to retain fluids, worsening swelling in your abdomen and legs. Use herbs for seasoning your food, rather than salt. Choose prepared foods that are low in sodium.
- Eat a healthy diet. People with cirrhosis can experience malnutrition. Combat this with a healthy plant-based diet that includes a variety of fruits and vegetables. Choose lean protein, such as legumes, poultry or fish. Avoid raw seafood.
- Avoid infections. Cirrhosis make sit more difficult for you to fight off infections. Protect yourself by avoiding people who are sick and washing your hands frequently. Get vaccinated for hepatitis A and B, influenza, and pneumonia.
- Use over-the-counter medications carefully. Cirrhosis makes it more difficult for your liver to process drugs. For this reason, ask your doctor before taking any medications, including nonprescription drugs. Avoid drugs such as aspirin and ibuprofen (Advil, Motrin IB). If you have liver damage, your doctor may recommend you avoid acetaminophen (Tylenol, others) or take it in low doses for pain relief.
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.
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.
General recommendations for patients with severe liver disease include:
- Eat large amounts of carbohydrate foods. Carbohydrates should be the major source of calories in this diet.
- Eat a moderate intake of fat, as prescribed by the health care provider. The increased carbohydrates and fat help prevent protein breakdown in the liver.
- Have about 1 gram of protein per kilogram of body weight. This means that a 154-pound (70-kilogram) man should eat 70 grams of protein per day. This does not include the protein from starchy foods and vegetables. A person with a badly damaged liver may need to eat less protein. Talk to your doctor about your protein needs.
- Take vitamin supplements, especially B-complex vitamins.
- Reduce the amount of salt you consume (typically less than 1500 milligrams per day) if you are retaining fluid.