Liver DiseaseLiver Disease

Effect of chronic liver disease on metabolism and nutritional status

Malnutrition in chronic liver disease is better defined as protein-energy malnutrition (PEM). When diagnosed by anthropometric criteria, PEM may be present in 20% of patients with well compensated liver cirrhosis and in more than 60% of patients with severe liver insufficiency.*
Malnutrition in Liver Cirrhosis

A: Nutrient Intake

Poor intake is prevalent (27%-87%) in patients with alcoholic and non-alcoholic liver disease.

Poor intake is attributed to:

  • Anorexia
  • Nausea
  • Early satiety (due to ascites)
  • Unpalatable diets (salt/protein restricted diets)

B: Malabsorption

Moderate Steatorrhea (<12g/day) occurs in both cholestatic and non-cholestatic liver disease. Steatorrhea may exceed 30g/day in some patients. Malabsorption is mainly due to 

  • Decreased intestinal bile acids
  • Pancreatic insufficiency

C: Major Protein Loss

  • Cirrhosis patients have increased rate of protein breakdown. Due to alterations in energy metabolism, amino acids gets oxidized for energy. Other reasons of protein loss could be:
  • Irreversible loss of nitrogen
  • Increased rate of gluconeogenesis
  • GI bleeding contributes to protein loss
  • Large-volume paracentesis may also cause loss of proteins
THE NESTLÉ HEALTH SCIENCE RANGE OF TAILOR-MADE NUTRITIONAL SOLUTIONS