Nutritional Management on Hepatitis

7/30/2019 Nutritional Management on Hepatitis

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NUTRITIONAL MANAGEMENT

ON HEPATIC DISORDERS


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HEPAR / LIVER

One of the largest vital organ

25 % parenchymal tissues function in normal

condition still sustainable life

Has multicomplex important function, play a rolein maintain and providing to perform

implementing life process

As metabolism centre, formation and enzymatic

arrangement, fashioned clotting factorsAct in detoxification, phagocytics (RES)

The occurrence of Kupffer cell, macrophage

within the liver reveals bodys defense


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Concerred on

1. Energy nutrients metabolism, such asglikogenesis, glikogenolisis, glukoneogenesis ;

deliver numerous enzymes (SGOT, SGPT, -GT,

and bile) and regulate the value of blood glucose

and cholesterol.

2. Plasma protein synthesis (albumin, globulin,

fibrinogen, prothrombine and coagulation/clotting

factors)

Storage place for fat soluble vitamins, vit. B12

and mineral Cu & Fe


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The liver metabolized 40% up to 80% amino acids

depends on its configuration perform degradation

(catabolism) of 7 sort essential amino acids includesAromatic Amino Acid, while Branch Chained Amino

Acid (BCAA : Leucine, Isoleucine & Valine) be

metabolized and yielding energy in the muscle


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H E P A T I T I S


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Acute (Inflammatory)

Hepatitis Viral Hepatitis

VH-A, VH-B, VH-non A non B, VH-C, VH-D, etc

Acute Recurrence Hepatitis

May caused by medications, toxins, alcoholic (drunk)

Incomplete recover / healing of Viral Hepatitis also inaddition with repeated infection and nutritional intakeespecially in extremly in adequacy of protein will leadto become necrotics and fibrotics.

Necrotics resulting from hepatic cellular damage willstimulate to regenerate in effort healing liver functionas well as compensation in liver parenchymeperformance / feature accompany with fibrosis


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Furthermore reveals pseudolobulasi with noduls

as spesifics mark forChirrosis Hepat is.

It will happened obstruction post sinusoid / venaporta and decrease of albumin syntesis, tends to get

ascites.

Lack of protein in long time, it will makes lack of

lipoprotein such as lipotropics factors (choline,methionine) resulting fat accumulation Fatty

Liver.

In case ofch ron ic l iver fai lure, will appear shunt

between portal circulation and systemic circulation

half part of glucose enterred systemic

hyperglycaemia hyperinsulinaemia ; diabetic

c i r rhos is

Catabolism of BCAA (energy sources in the muscle)


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Nutritional Management on

Hepatitis


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Acute (Viral) Hepatitis

The aim to effort the improvement of liver cellparenchyme. Function of the liver have to

recover absolutely. The value of enzymes tends

back to normal, and improve the complaints.

Giving the liver to rest.

Soft-foods meal in a few portion consumed and

frequent, kinds of chopped food, unirritation taste.

Energy needs - 2/3 requirements (65% normal)

Protein - around 0,5 gram/kg BW (animal protein

: plant protein = 1 : 2-3)


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Fat maximally 20% total energy, which is substance

food stuff easy to digest

Refined simple carbohydrate

Adequate vitamin and mineral (B1, Cu, Fe)

If there is ascites - a few or without salt.

Better or improve condition and better or improveappetite protein can be increased 0,75 gram/kg

BW.

Energy and lipid - increase gradually (suitable

tolerance)


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Chronic Hepatitis

Chrirrosis without complication Soft food stuff, can be strained (filtered), chopped meal

uniritation taste

Sufficient energy initially 40 Kkal/kgBW/day,appropriate and tolerance with the appetite can be

gradually increase up 45 Kkal/kgBW/day. Protein also gradually arise depends on it illness.

Beginning 0,3 0,5 gram/kg BW/day, which 60-70% fromanimal source (high biological value) arise 0,75 gram,mind in source of BCAA

Carbohydrate 65% total energy - 20% from refined CHor complex CH

Lipid / Fat 15-20% from total energy

Supplement for vitamin, mineral


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Chirrosis hepatis with cemplication

(encephalo hepatic)

Conform with condition, might be / mostlyparenteral

Amonia yielding from the urolysis process taken

by gut / bowel bacterias can not be enterred the

urea cycle.

The existence of Portal Systemic Shunt - leads

to disturbance of metabolism process ; resulting

ammonia and other toxical substances yielding

pathological central sign and symptom.


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S o s I a l I z e

Intended for suffer post hepatitis virus, thepossibility getting relapse and recurrence or have

got cirrhosis (in early stage), have to give food

sources from BCAA compound in daily food

pattern consumed.

Legumes / beans especially red/kidney bean, soy

bean, and its product (soy bean curd tahu/tofu,

soy bean cake - tempe), green/mung bean and

four sided bean (kecipir) are plant sourceswhich rich contents of BCAA


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Pass through animal experiment (wistar albino rat

240 gam) could be proved by microphotoes in

anatomical pathology that chirrosis hepatis can beobstructed / blocked or can be restrained and

controlled by (pure-powdered) BCAA, kidney bean

and soy bean cake.

Documents

Nutritional Management on Hepatitis