Chylothorax occurs when fluid from your lymphatic system builds up in your chest or thoracic cavity. Patients with chylothorax have difficulty breathing because this build-up takes up space, restricting the expansion of their lungs. Treatments typically depend on the reason for the build-up. A diet may not be the best treatment, depending on the cause of the condition. However, when no known cause can be determined, a diet to decrease the amount of fats absorbed by the lymphatic system can help decrease the fluid build-up.
MCT Diet
MCT diets help treat chylthorax. MCT stands for medium chain triglycerides. Typically, dietary fats consist of a mixture of mainly long chain triglycerides or LCTs, with a small amount of short and medium chain triglycerides. During digestion, the lymphatic system absorbs the LCTs. The lymphatic system does not, however, absorb MCTs. MCTs are absorbed by the liver via the hepatic portal vein. The MCT diet limits fat consumption to the MCTs, eliminating or greatly reducing the consumption of LCTs. This results in less fluid absorbed into the lymphatic cells and subsequently, less leakage of lymphatic fluid into the thoracic cavity, relieving the chylothorax.
Components
Available by prescription, medium chain triglycerides or the MCT diet consists of a mixture of fatty acids and safflower oil. The safflower oil serves as a source of polyunsaturated fat. Coconut oil, palm kernel oil and butter contain high levels of MCTs, but patients needing treatment for chylothorax usually do not simply eat MCT-containing foods. Typically, their treatment requires prescription supplementation and Total Parenteral Nutrition or TNP, administered via intravenous solution. MCT does not contain protein or carbohydrates, but does provide a dietary fat source of nutrition that is absorbed faster and more easily than other oils and fats. Because the liver must absorb the MCTs, people with liver problems including cirrhosis, hepatitis, or high blood pressure inside the liver, or liver damage should not follow an MCT diet.
Rutin Supplementation
The addition of rutin to the MCT diet may help decrease fluid build-up as well. Rutin, a flavonol supplement available in vitamin stores, stimulates white blood cells called macrophages to carry away some of the fat in the lymphatic fluid. This helps reduce the amount of fluid build-up, which, in some individuals, can decrease the severity of the chylothorax.
Effectiveness
A 2005 study reported in the Asian Journal of Clinical Nutrition indicated that lymph drainage for patients on an MCT diet took, on average, about 12 days, though the MCT-rich diet continued for about 30 days. About 87 percent of the patients undergoing this treatment resolved the chylothorax, eventually returning to a normal diet.
References
- Journal of Respiratory Diseases: Chylothorax: A Review of Current Management Strategies
- Medscape Today: Chylothorax as a Result of Chronic Lymphocytic Leukemia: Discussion
- Mar Vista Animal Medical Center: Chylothorax
- Pediatrics: Dietary Management of Pediatric Chylothroax
- Bio Info Bank Library: Chylothorax Diet Therapy
- Drugs.com: Medium Chain Triglycerides
