Published in:
01-03-2020 | Sarcopenia | Nutrition in Patients with Chronic Liver Disease (E Tapper, Section Editor)
Nutrition in Cholestatic Liver Disease
Authors:
Daniela Goyes, Christopher J. Danford, Hirsh D. Trivedi, Alan Bonder
Published in:
Current Hepatology Reports
|
Issue 1/2020
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Abstract
Purpose of Review
Cholestatic liver disease, including primary biliary cholangitis and primary sclerosing cholangitis, can be associated with numerous extrahepatic complications. Of these, malnutrition can negatively impact quality of life in these patients. Achieving nutritional optimization in patients with cholestatic liver disease is an essential component in the overall management of the disease.
Recent Findings
Through various mechanisms, including abnormalities in bile acid metabolism, malabsorption, anorexia, and increased metabolic rate, chronic malnutrition in cholestatic liver disease can lead to vitamin, mineral, and protein deficiencies. This in turn can result in complications including osteoporosis and fractures, coagulopathy, skin, and neurologic changes. In addition, protein deficiency can worsen ascites and encephalopathy and promote sarcopenia, which increases morbidity and mortality. Such sequelae, which are often more pronounced in those with cirrhosis, highlight the importance of addressing nutritional status early on in these patients.
Summary
Monitoring and replacing essential vitamins and minerals is crucial in preventing complications associated with nutritional deficiencies. Ensuring adequate caloric and protein intake may reduce the overall morbidity associated with cholestatic liver disease. We herein summarize important concepts and management strategies of optimizing nutrition in cholestatic liver disease.