The document discusses various liver diseases and their relationship to nutrition. It covers fatty liver disease, hepatitis, cirrhosis, and liver transplantation. Key points include:
1) Fatty liver disease is caused by an accumulation of fat in the liver from excess alcohol, drugs, or metabolic issues like insulin resistance. It can progress to inflammation and more serious conditions if not addressed.
2) Hepatitis is liver inflammation that can result from viral infections or other causes like excess alcohol. Symptoms include fatigue and jaundice. Treatment focuses on supportive care and antiviral drugs.
3) Cirrhosis is scarring of the liver that impairs its function. Major causes in the US are alcohol and hepatitis C
Answer: Liver disease progresses slowly. Its primary symptom, fatigue, often goes unnoticed. Other symptoms may be so mild that complications develop before liver disease is diagnosed.
Answer: Substances that irritate the liver, such as alcohol, drugs, and dietary supplements that cause liver damage.
Answer: Alcoholic liver disease and chronic hepatitis C infection, followed by nonalcoholic fatty liver disease and chronic hepatitis B infection.
Table 19-2 Laboratory Tests for Evaluation of Liver Disease
aThe test for prothrombin time evaluates the clotting ability of blood.
Note: U/L = units per liter; dL = deciliter; μg = micrograms; N = nitrogen
Answer: Elevated blood ammonia levels are thought to play a key role in its development due to ammonia’s neurotoxicity. Other substances that may accumulate in brain tissue and disturb brain function include sulfur compounds, naturally occurring benzodiazepines, short-chain fatty acids, and manganese. Some research shows that severe liver damage may lead to reduced serum levels of the branched-chain amino acids and increased levels of the aromatic amino acids, which may alter the types of neurotransmitters produced in the brain. Most likely, a combination of abnormalities contributes to the disruption in neurological functioning.
Table 19-3 Clinical Features of Hepatic Encephalopathy
Answer: Patients with ascites are generally advised to restrict sodium. Because ascites is partly caused by sodium and water retention in the kidneys, treatment usually includes both sodium restriction (to no more than 2000 milligrams of sodium per day) and diuretic therapy to promote fluid loss. Potassium intake should be monitored if a potassium-wasting diuretic (such as furosemide) is used.
Answer: Liver dysfunction and malnutrition often have similar metabolic effects. If fluid retention is present, it can mask weight loss and alter anthropometric and laboratory values.
Answer: Gastrointestinal side effects include nausea, vomiting, diarrhea, abdominal pain, and mouth sores. Some medications may alter appetite and taste perception. Some of the drugs may cause hyperglycemia or outright diabetes, which may need to be controlled with insulin. Electrolyte and fluid imbalances are common. Other possible effects include hypertension, hyperlipidemias, kidney toxicity, protein catabolism, and increased osteoporosis risk.
