Cirrhosis of the Liver Community
Eating
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Cirrhosis is the end result of chronic liver damage caused by chronic liver diseases. The purpose of the community is to share support and information with Cirrhosis of the Liver patients and their loved ones. Topics in the community include: causes, clinical trials, complications, family issues, living with Cirrhosis of the Liver, prognosis, research, surgery, treatments

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Eating

Anyone else have trouble eating often enough?  I need to eat every 3-4 hours or my body starts burning muscle.  Is this typical of anyone else?  Makes sleeping a little tough.  I usually wake up with hunger pains, but if I happen to sleep longer I can be wrecked in a few hours.  I am naturally a lean person.
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446474_tn?1385271190
This is typical for those with advanced cirrhosis of the liver. Patients whos livers are failing are usually reduced to skin and bones and lose all muscle mass before getting a transplant. Muscle wasting will go away after transplant.

Cirrhotic patients have limited capability to store nutrients in the liver.  For that reason, you need to eat very frequently in order to preventing use of your own muscle mass as a source of nutrition for vital organs; we recommend you eat at least three meals a day and three to four
snacks between meals. Patients who are overweight should be careful to eat low-calorie meals and low-calorie snacks.  Patients who are under-nourished should have high-calorie meals and snacks.  Bedtime snacks are especially important. Patients with malnutrition and/or loss of
muscular mass can improve their nutrition and muscular mass by drinking two cans of EnsurePlus, or Boost-Plus at bedtime, or in case of overweight or diabetes, 2 cans of Glucerna, or Boost Glucose-Control at bedtime, or 1 can of Boost VHC at bedtime.

Malnutrition is commonly seen in endstage liver disease and adversely affects prognosis. You should eat at least 130-150 grams of protein daily. You do NOT need to worry about restricting fat intake when it comes from food such as olive oil and avocados.  In general, we recommend lean cuts of chicken, avocados, olive oil, and cooked fish like tuna or salmon sardines. A carbohydrate intake between 50-100 grams per day will definitely result in belly fat loss. No red meat as it causes hepatic encephalopathy.

Hasn't your doctor or dietitian given you a diet and exercise program? They should have. All transplant center have a dietitian. Talk to a hepatologist at a transplant center about getting a diet plan to help you maintain your weight. It will help you to stay as healthy as possible.

Good luck.
Hector
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317787_tn?1373214989
Great information.  I noticed while tx the HCV that my mucles were wasting.  7 months post they are coming back.  It gives me hope
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Avatar_m_tn
Thanks--I'm not sure what is going on.  My GP thinks I am crazy, as my enzymes are all normal but my AST/ALT is 19/19, which he thinks is great.  I know it is not a good sign.  I have discomfort which they all attribute to muscle pain.  Starting to get minor HE.  Don't sleep much, but not too tired--almost feels like I have adrenaline going all the time, or hyperthyroid issues.  Short of breath when I stand and walk, which is abnormal since I am an athelete.  This has been going on a few weeks now.  So I'm on my own right now.  

I feel pretty hopeless.  It seems that many people never make it to new liver status, particularly if their kidneys still work.
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446474_tn?1385271190
I would suggest getting a second opinion from a different GP who can perhaps give you a diagnosis of what is causing your issues.

Food issues, weight loss, sleep problems can be caused by many things. If the new GP thinks it is related to the liver they can find out if you have liver disease by performing a biopsy.

AST/ALT doesn't tell the whole story by any means. Although it would be strange to have normal blood tests if you had advanced cirrhosis which is late stage liver disease. advanced cirrhosis has many tell-tale signs such as an enlarged spleen, varices, ascites, nodules seen on an ultrasound, low platelet count, elevated bilirubin, etc. and many more.
Google End-Stage Liver Disease or decompensated cirrhosis.

From the Cleveland Clinic:
"Serum aminotransferase levels—ALT and AST—are two of the most useful measures of liver cell injury, although the AST is less liver specific than the ALT level. Elevations of the AST level may also be seen in acute muscle injury, cardiac or skeletal muscle. Lesser degrees of ALT level elevation may occasionally be seen in skeletal muscle injury or even after vigorous exercise. Diseases that primarily affect hepatocytes, such as viral hepatitis, will cause disproportionate elevations of the AST and ALT levels compared with the alkaline phosphatase level. The ratio of AST/ALT is of little benefit in sorting out the cause of liver injury except in acute alcoholic hepatitis, in which the ratio is usually greater than 2 and the AST level is 400 IU/mL or lower."

Cheers!
Hector
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Avatar_m_tn
Thanks for the info.  I have an appointment on Wednesday at the liver clinic.  I can't seem to keep weight on and cant sleep at all.   Eating all the time is not helping.  Feels like I have cirrhosis masked by thyroid or something.  Dr. mentioned that I have low sodium.  We'll see.
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