The role of nutrition in hepatic encephalopathy

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The role of nutrition in hepatic encephalopathy.

Pharmaceutical issues and technical problems

Current Opinion in Clinical Nutrition & Metabolic Care. 11(3):275-280, May 2008.

Schulz, Gustavo Justo; Campos, Ligocki; Coelho, Julio Cezar Uili

Abstract:

Purpose of review: Protein-calorie malnutrition may be observed in all clinical

stages of liver disease. Nutritional management in these patients is imperative.

It is crucial that protein intake is not restricted ad hoc. Administration of

vegetable proteins for patients who cannot tolerate standard proteins and, if

necessary, branched-chain amino acid-enriched formulae can be an option to these

patients. This issue, however, remains controversial.

Recent findings: This study is an update on the nutritional management of

hepatic encephalopathy based on several studies of the last decades, involving

dietary protein intake and branched-chain amino acid supplementation.

Summary: Malnutrition is a common complication of liver disease and it adversely

affects patient outcome. Inadequate dietary protein intake has a very

deleterious effect on hepatic encephalopathy, nutritional status, and clinical

outcome in these patients and must be avoided. The administration of

branched-chain amino acids stimulates hepatic protein synthesis, reduces

postinjury catabolism and therefore improves nutritional status. Conflicting

results in various different trials, however, exist, and this issue remains

unclear.

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