End stage liver disease is failure of the liver to perform its functions. The liver helps to filter the blood, stores carbohydrates and other nutrients and makes proteins responsible for fluid balance, health of the immune system and blood clotting. It also makes bile that aids in digestion, and helps clear the body of various waste products. In end stage liver disease, waste products such as ammonia can build up and cause encephalopathy, which is brain dysfunction. The diagnosis and treatment of liver disease and other health conditions should be made with the consultation of a health-care professional.
Causes of End Stage Liver Disease and Encephalopathy
The most common causes of end stage liver disease are alcoholic liver disease and viral hepatitis. According to "Robbins and Cotran Pathologic Basis of Disease" by Vinay Kumar M.D. There are many other causes, such as genetic disorders, cancer, immune system dysfunction and toxin ingestion. Encephalopathy, or brain dysfunction, occurs because the liver is not able to filter ammonia and other waste products from the blood.
Protein
According to "Harrison's Principles of Internal Medicine" by Anthony S. Fauci M.D., protein in the diet needs to be ingested carefully. Too little protein will lead to protein wasting, breakdown and malnutrition. Too high a level in the diet will exceed the capacity of the liver to handle the breakdown products of protein. Waste materials can build up and cause encephalopathy. Symptoms can include weakness, disorientation, a wandering attention and confusion. Drugs such as neomycin and lactulose help decrease the amount of toxins produced, allowing a person to eat more protein, but protein may still need to be limited.
Sodium
Sodium is a common mineral in the blood. High levels in the diet increase the fluid levels in the body because fluids follow sodium. End stage liver disease usually causes fluid imbalances, especially with excess fluids and swelling in the legs and abdomen. It is therefore typically limited in the diet if these symptoms are present.
Fluids
Since the liver plays an important role in fluid balance in the body, fluids may need to be limited in the diet. Excessive fluids can lead to fluid overload in the body, leading to swelling and possibly increased strain on the heart.
Carbohydrates and Fats
Carbohydrate and fat intake is generally recommended to be quite high in liver disease. The liver normally stores carbohydrates to keep the blood sugar within normal limits if it is dropping low. In addition, excess carbohydrates and fats help to prevent malnutrition and provide energy to the body.
References
- "Robbins and Cotran Pathologic Basis of Disease"; Vinay Kumar et al; 8th Ed 2009
- "Harrison's Principles of Internal Medicine"; Anthony S Fauci et al; 17th Ed 2008
