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Nutrition and liver diseases
Presented by
Dr.P.Nazni
Reader & Head i/c
Department of Food Science
Periyar University
Salem 636 011, Tamilnadu, India
Liver
The liver is located in the
upper right-hand portion of
the abdominal cavity,
beneath the diaphragm, and
on top of the stomach, right
kidney, and intestines.
Shaped like a cone, the liver
is a dark reddish-brown
organ that weighs about 3
pounds.
Why it’s called a “Liver”
Synthesizes Clotting factor
Albumin
Glycogen
Stores Glycogen
Albumin
Fat soluble Vitamins
Metabolizes Medications
Toxins
Amino acids
Functions of the Liver:
A Brief Overview Largest organ in body, integral to most
metabolic functions of body, performing over 500 tasks
Only 10-20% of functioning liver is required to sustain life
Removal of liver will result in death within 24 hours
Functions of the Liver Main functions include:
Metabolism of CHO, protein, fat
Storage/activation vitamins and minerals
Formation/excretion of bile
Steroid metabolism, detoxifier of drugs/alcohol
Action as (bacteria) filter and fluid chamber
Conversion of ammonia to urea
Gastrointestinal tract significant source of ammonia
Generated from ingested protein substances that are
deaminated by colonic bacteria
Ammonia enters circulation via portal vein
Converted to urea by liver for excretion
Liver Diseases
Duration
Acute vs Chronic
Pathophysiology
Hepatocellular vs Cholestasic
Etiology
Viral
Alcohol
Toxin
Autoimmune
Stage/Severity
ESLD
Cirrhosis
Viral hepatitis A, B, C, D, E (and G)
Alcoholic liver disease
Non-alcoholic liver disease
Cholestatic liver disease
Hepatocellular carcinoma
Inherited disorders
Classifications
Cirrhosis is common
end result of many
chronic liver disorders
Severe damage to structure &
function of normal cells
Inhibits normal blood flow
Decrease in # functional hepatocytes
Results in portal hypertension &
ascites
Portal systemic shunting
Blood bypasses the liver via shunt,
thus bypassing detoxification
Toxins remain in circulating blood
Neurtoxic substances can precipitate
hepatic encephalopathy
www.gutfeelings.com/ CRLIVER.JPG
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Fatty liver
Normal healthy liver, surface is smooth
and uniformSever cirrhosis, surface is very nodular
www.gihealth.com/ newsletter/34/two_livers.jpg
Complications of liver cirrhosis
Portal hypertension
Esophageal varices (EV)
Ascites
Hyperammonaemia
Hepatic encephalopathy (HE)
Hepatorenal syndrome
Malnutrition is an early and typical aspect
of hepatic cirrhosis.
70% of p’t with cirrhosis have signs of
PT/Cal malnutrition.
Way to lead malnutrition
food intake (anorexia, nausea, drugs)
malabsorption
energy and PT requirement
paracenthesis induced PT loss
complications
Nutrition in the complications of liver
cirrhosis
Calories (Cal)
Fat
Protein (PT)
Carbohydrate (CHO)
Sodium (Na)
Fluid
Vitamins
Total Cal=30 kcal/kg
Fat=30-35% of total Cal
PT=1g/kg/d
CHO=remainder of the Cal requirement
Na : not exceed 2g(88mmol)/d
Daily sodium intake :
130 (mmol/kg) * wt change (kg/d) + 24h urinary
Na (mmol/d) – 10 (mmol/d)
Na free diet : energy, PT, lean body mass
Na intake should be restricted before fluid
Fluid : no need to restrict at the beginning
Vitamins : supplement water and fat solutable vit.(B1,
B12, folate, A, D, E, K)
Jaundice Jaundice is not a disease but rather a sign that can occur in many
different diseases. Jaundice is the yellowish staining of the skin
and sclerae
Yellow coloration of the eyes, skin,
tongue and urine.
Loss of appetite.
Dull pain in the liver region.
Nausea,
severe constipation,
extreme weakness.
Fever,
headache and undue fatigue.
Symptoms of Jaundice
Causes of jaundice
Blockage in the bile ducts
Gallstones.
Hepatitis virus,
Typhoid, cancer, malaria, and anemia.
Improper or short flow of the blood in the liver
Tuberculosis, and yellow fever.
It can be inborn.
Red blood corpuscles in able to function properly.
There is problem in the functioning of liver.
Jaundice Diet Barley water, fruit juices are
effective.
Do not give fatty foods and also avoid foods which agitate stomach.
Do not give cereals and pulses.
In case of fever give fruit diet and fresh fruit juices to drink and to take good rest.
Grapes, black soya beans, nuts, sweet potatoes are effective fruits for jaundice patients.
Barley water
fruit juices
Natural treatment for Jaundice
Take half to one teaspoon of papaya leaves paste and addhalf to one tablespoon of honey and mix it well. Eat thisregularly for one-two week.
Take 10-15 basil leaves (tulsi leaves) and make its paste;add this in a half glass of freshly made radish juice.
Amla
Drink lemon juice
Take 7-10 leaves (dry) of snake gourd and boil in a cup ofwater. Boil 10-15 coriander seeds in half liter water.mixture of snake gourd along with coriander solution threetimes a day.
Orange juice
Hepatitis Hepatitis (plural hepatitides) implies inflammation of the liver
characterized by the presence of inflammatory cells in the tissue ofthe organ.
Types of hepatitis
Hepatitis A - This is caused by eating infected food or water
Hepatitis B - This is an STD (sexually transmitted disease). It is caused by
the virus HBV (Hepatitis B Virus)
-Unprotected sexual intercourse
-Using a syringe that was used by an infected person
-A baby can become infected through his mother's milk if
she is infected.
- Being bitten by someone who is infected.
Hepatitis C - Hepatitis C is usually spread through direct contact with
the blood of a person who has the disease.
Hepatitis D - Only a person who is already infected with Hepatitis B.
Hepatitis E - A person can become infected by drinking water that
contains HEV (Hepatitis E Virus).
Hepatitis X - Hepatitis of an unknown virus.
Hepatitis G - This is a type of hepatitis caused by the Hepatitis G virus
(HGV).
Signs and Symptoms of Hepatitis? The acute phase of hepatitis
Diarrhea
Fatigue
Loss of appetite
Mild fever
Muscle or joint aches
Nausea
Slight abdominal pain
Vomiting
Weight loss
The acute phase is not usually dangerous,
Diet therapy
Hydration
No alcohol
Low fat, moderate protein, high CHO diet,
high calorie
Small frequent meals
Vit B, C, K
Thank You!
