Liver and Gallbladder Diseases Flashcards
What is the function of the gallbladder?
The gallbladder is an organ that’s found in your abdomen. Its function is to store bile until it’s needed for digestion. When we eat, the gallbladder contracts, or squeezes, to send bile into your digestive tract.
What are the different types of disorders of the Gall Bladder?
- Cholelithiasis: the formation of gallstones.
- Cholecystitis: inflammation of the gallbladder
- Cholestasis: Any condition in which the flow of bile from the liver stops or slows.
Symptoms Include:
– Pain
– Steatorrhoea
– Jaundice
What is Nutrition Management of Gallbladder diseases?
• Low-fat diet IF required – Increased pain with fat – Steatorrhoea • Malnutrition • Prevention
What are the functions of the liver?
Bile production and excretion.
Excretion of bilirubin, cholesterol, hormones, and drugs.
Metabolism of fats, proteins, and carbohydrates.
Enzyme activation.
Storage of glycogen, vitamins, and minerals.
Synthesis of plasma proteins, such as albumin, and clotting factors.
What are the Disorders of the Liver?
- NAFLD/MAFLD → NASH
* Chronic Liver Disease (CLD)
What is the Pathophysiology of
Malnutrition in Liver Disease?
• Poor dietary intake – Early satiety – Taste changes – Low salt diet – Fluid restrictions • Malabsorption • Low protein synthesis • Hypermetabolism • Fatigue • Medications (Lactulose)
What anthro to be recorded
– Mid arm circumference –Triceps skinfold – Hand Grip Strength –Short physical performance battery (SPPB)
• Without ascites:
– Actual body weight
• With ascites:
– Ideal body weight according to height
What are the patient Energy Recommendations?
(125-145 kJ/kg)
• Caloric intake - divided into 4-6 meals per
day, including a late evening snack
• High protein energy supplements/enteral
nutrition provided to those unable to meet
requirements orally
What is the protein management for Liver disease patients?
• Protein restriction no longer advised • No clinical evidence for restriction • 1.2 – 1.5 g/kg BW • Should not be restricted in Encephalopathy
What is fat management for Liver disease patients?
• Usually no restriction
–Good energy source - restrict if steatorrhoea till malabsorption improves
–In severe cases <30g/d, supplementing
with MCT oils
What is Sodium management for Liver disease patients?
• 60 mmol/day (ESPEN)
• No added salt diet 100 mmol/d (2300
mg or ~1 tsp) if no ascites/odema
( 1 mmol = 23 mg of sodium)
What is the recommended treatment for patients with MAFLD?
• Previously NAFLD • Progresses to NASH • Aim for 7-10% weight loss • Exercise • Mediterranean diet – Bodyweight – Insulin sensitivity – Hepatic steatosis/fibrosis
What is a Possible PESS Statement?
(1)Malnutrition related to anorexia and early satiety
as evidenced by weight loss of 10% in 1 month and
significant muscle wasting and fat loss.
(2) Inadequate energy and protein intake related to new
onset of regurgitation as evidenced by likely weight loss
(masked by fluid) and need for alternative nutrition to provide adequate nutrition.
What is an intervention plan?
Soft diet + Low salt while in hospital
Previously tolerated supplement (Resource Plus) x 3 per day
Food charts
Mid meal trolley
