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Alcoholic Liver Disease and Malnutrition
Author(s) -
McClain Craig J.,
Barve Shirish S.,
Barve Ashutosh,
Marsano Luis
Publication year - 2011
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/j.1530-0277.2010.01405.x
Subject(s) - malnutrition , medicine , intensive care medicine , cirrhosis , liver disease , parenteral nutrition , alcoholic liver disease , hepatic encephalopathy , enteral administration , protein–energy malnutrition , encephalopathy , disease , medical nutrition therapy , kwashiorkor , weight loss , pediatrics , obesity
Malnutrition, both protein energy malnutrition (PEM) and deficiencies in individual nutrients, is a frequent complication of alcoholic liver disease (ALD). Severity of malnutrition correlates with severity of ALD. Malnutrition also occurs in patients with cirrhosis due to etiologies other than alcohol. The mechanisms for malnutrition are multifactorial, and malnutrition frequently worsens in the hospital due to fasting for procedures and metabolic complications of liver disease, such as hepatic encephalopathy. Aggressive nutritional support is indicated in inpatients with ALD, and patients often need to be fed through an enteral feeding tube to achieve protein and calorie goals. Enteral nutritional support clearly improves nutrition status and may improve clinical outcome. Moreover, late‐night snacks in outpatient cirrhotics improve nutritional status and lean body mass. Thus, with no FDA‐approved therapy for ALD, careful nutritional intervention should be considered as frontline therapy.