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untreatable hep c with stage 4 cirrhosis

Hello,
Can you please help me with information about the right type of diet that will help my friend that is going through a very tough time in his life. I want to make sure he is eating foods and beverages that his liver can process and get the maximium benefit for his health.

Thank you
Marci
2 Responses
446474 tn?1446351282
First, if your friend has cirrhosis they should be under care of a hepatologist at a liver transplant center. This is the most important thing that needs to be done if it hasn't already.

I assume he is having complication from his liver disease. This is known as decompensated cirrhosis or End-Stage Liver Disease (ESLD).

A transplant center will provide him with all the information he needs based on his on particular health needs. In fact the transplant center should be his primary source from all treatment options, diet and exercise to keep him healthy and strong to prevent or slow the progress of his liver disease.

All we can provide is a general diet as we are not aware of his true condition and any other medical problems he may have. He should be talking to his hepatologist regarding any questions he has as only his hepatologist knows the true nature and extent of his illness.

That said, here are some general guidelines regarding diet for patients with cirrhosis.

From About.com hepatitis:

"The best diet for someone with cirrhosis might surprise you: it's very close to the one you needed before you had cirrhosis. A good rule of thumb is that a healthful diet is helpful for just about anyone -- and this is especially true if you have cirrhosis. Foods like fruits, vegetables, whole grains and proteins of proper types and in proper amounts are very appropriate.

What to Avoid:

There are two things you should avoid: alcohol and high-fat foods. For people with cirrhosis, regardless of the cause, alcohol should be completely avoided. And, diets high in fat for people with cirrhosis may cause potential digestion problems. The body digests (breaks down) fats using bile, which is a yellow-green fluid made in the liver. When the liver is damaged, the production and supply of bile may be affected.

However, it is important not to avoid fat entirely because the body requires a daily supply to remain healthy. Here, as is with much of proper nutrition, moderation and good selection is the key. For your dietary fat, choose foods like nuts, avocados, fish and plant oils.

With that said, you may need to further change your diet if you have complications from cirrhosis, according to your doctor's recommendations. Three relatively common complications are ascites, hypoglycemia and encephalopathy.

Ascites, which is the accumulation of large amounts of fluid in the abdomen, is aggravated by a diet high in salt, so doctors usually require a strict no-salt diet for cirrhosis with ascites. This is difficult to follow in today's highly processed marketplace because most prepackaged foods have a lot of added sodium (salt). When shopping for groceries, some good advice would be to skip the middle aisles and buy most of your food from along the walls, where the store keeps fresh meats, fruits and vegetables -- foods all relatively low in sodium.

Hypoglycemia, or low blood sugar, is another common problem of cirrhosis. If you experience this, you will need a diet of small, frequent meals that include complex carbohydrates such as breads, pastas and rice. Hypoglycemia, also known as low blood sugar, causes many symptoms including fatigue, confusion and heart flutters because -- in the case of cirrhosis -- the liver isn't able to store enough energy (in the form of glycogen, a chemical the body uses for quick energy). Since the body is able to quickly break down carbohydrates and use them for energy, this can help smooth out the problems caused by hypoglycemia.

Encephalopathy. When the liver is injured, as with hepatitis, the liver can't handle normal amounts of protein. Protein, which the body uses for growth, maintenance and energy, is supplied from the diet in animal products like meat and eggs, and from plants like beans. When the body gets too much protein, a serious complication called encephalopathy can happen. This is because of the accumulation of large amounts of ammonia, a by-product from the digestion of too much protein, which is toxic to the brain. This is a life-threatening condition that can be prevented in people with cirrhosis by eating small amounts of protein."

In summary he needs to eat healthy unprocessed food no restaurant food with a low sodium/salt content.  
No red meat. Chicken and cooked fish are good sources of protein.
No NSAIDS such as aspirin, Ibuprofen, etc. Only Tylenol/Acetaminophen is limited dose. He should consult his doctor as to how much he can take per day for pain.

Of course no alcohol or any other toxic substance.
All foods, vitamins or supplements need to be approved by his hepatologist FIRST. As some can cause liver failure depending on how damaged the liver is.

Is he listed for a liver transplant? Is he currently taking drugs to manage his complications and symptoms from his cirrhosis?

Good luck to the both of you.

Hector
1840891 tn?1431551393
What would we do without you, Hector? Your impeccable advise and constant calming influence are so invaluable to this forum. Thank you again for being there.
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