C2 Nutrition Therapy for hepatic and pancreatic disorders

Question 1

Describe fatty liver and its treatment method.

Answer 1

• Fatty liver is the buildup of fat in the liver due to an imbalance between fat synthesis from the blood and the amount of fat exported to the blood through VLDL.
• Treatment by weight reduction, blood glucose levels control, and avoidance of alcohol.

Question 2

Describe hepatitis and its nutritional therapy.

Answer 2

• Hepatitis is the inflammation of the liver caused by specific viruses.

Nutritional therapy:
- High calorie, high protein diet.
- Liquid supplements to improve nutrient intake
- Small frequent meals
- Fluid and electrolyte replacement
- Restriction of sodium and fat intake.

Question 3

Describe cirrhosis, its causes and nutritional therapy.

Answer 3

• Cirrhosis is the gradual destruction of liver tissue leading to sever scarring that impairs liver function and cause liver failure.

Nutritional therapy:
- Customized for each patient’s needs
- Avoidance of substances that an cause further liver damage
- Enteral and parenteral nutrition.
- Energy intake should be 20% above resting metabolic rate.
- Small and frequent meals (4-6 times daily)
- 0.8-1.2g/KG protein
- MCT oil if malabsorption occurs.
- Restrict sodium intake to control ascites.

Question 4

What are some complications associated with cirrhosis?

Answer 4

• Portal hypertension: Scarred tissue impairs blood flow and increases pressure in portal vein
• Ascites: Accumulation of fluid in the abdominal cavity.
• Hepatic encephalopathy
• Collaterals & Gastroesophageal varices.

Question 5

What are the types of hepatitis?

Answer 5

• Hepatitis A: Transmitted via fecal-oral route
• Hepatitis B and D: Parenteral or sexual transmission
• Hepatitis C: Transmitted via blood or serum

Question 6

Describe treatment and nutritional therapy for cholelithiasis (gallstones) ?

Answer 6

• Low fat diet
• Cholecystectomy (Surgical removal)
• Shock-wave lithotripsy
• Capsule urso-deoxycholic acid

Question 7

Describe nutritional therapy for pancreatitis.

Answer 7

Acute pancreatitis:
- Pain control and intravenous hydration
- Fat-restricted diet
- Continuous tube feedings
- 1.5g/kg of protein

Chronic pancreatitis
- 35kcal/kg, 1.5g protein/kg
- Abstinence from alcohol
- Pancreatic enzyme replacement for malabsorption
- Dietary supplements