Cirrhosis

Cirrhotic patients are at risk for multiple nutrient deficiencies because of poor appetite and malabsorption of fats, fat-soluble vitamins, proteins, and some minerals. They exhibit disturbed metabolism of all major nutrients, and the resulting malnutrition correlates with poor outcomes. Unfortunately, aggressive attempts to improve nutritional status have generally not improved the outcomes, with the exception of some studies of branched-chain amino acids for chronic hepatic encephalopathy and increased survival in select patients receiving parenteral nutrition. A cost-effective, practical approach is warranted to meet the nutritional requirements of the cirrhotic patient in the most acceptable and least invasive means possible.