Liver disease Flashcards
two sources of blood to the liver
- oxygenated blood via the hepatic artery
- nutrient rich blood via the portal vein from the GI tract
what macronutrients are the liver involved in metabolizing
-all of them
steatosis
-alcoholic and nonalcoholic fatty liver
steatohepatitis
-fatty liver with inflammation
cirrhosis
-permanent destruction of normal liver tissue
NAFLD
-hepatic manifestation of metabolic syndrome and has been linked to obesity and diabetes
complications of cirrhosis
-portal hypertension which leads to development of varices (large dilated veins which commonly occur in the esophagus, stomach, or rectum) and ascites (accumulation of fluid in the peritoneal space)
end stage liver disease can lead to
-the development of hepatic encephalopathy or decreased mental status that can run the gamut from confusion to coma
patients with end stage liver disease typically end up with
the major causes of malnutrtion due to liver disease are
- poor dietary intake
- maldigestion
- malabsorption
- abnormalities in metabolism and storage
the goals of nutritional support of people with end stage liver disease
-prevent or correct malnutrtion or supply adequate calories withou precipetating hepatic encephalopathy
nutritional support in end stage liver failure typically involves…
- sodium or fluid restriction to manage presence of ascites or edema
- small and frequent meals are prescribed to address early satiety commonly caused by ascites as well as to minimize the risk of hypoglycemia
- vitamins and minerals due to decreased intake and malabsorption
what is controversial in the management of hepatic encephalopathy?
- protein restriction
- may be restricted in an attempt to lower plasma ammonium levels
- however long term protein restriction is not advised since the patient will most likely be protein depleted
- BCAA supps may be considered
what is a common treatment for end stage liver disease
-transplant
