Calories and ProteinPeople with cirrhosis may need more calories and protein than other people. They may lose their appetite and experience nausea, vomiting, and severe weight loss. This can lead to a shortage of the minerals calcium and magnesium. Signs of low calcium and magnesium levels can include:
- Muscle cramps
Poor appetite, vomiting, and weight loss can also lead to a shortage of zinc (signs of a zinc shortage can include a reduced ability to taste and/or changes in taste).
It can help to eat small, frequent meals (four to seven times a day), including an evening snack. Your doctor may even recommend high-nutritional supplement drinks, such as Ensure® or Boost®.
When the scarring from cirrhosis prevents blood from passing through the liver, pressure increases in the veins entering the liver. This is called "portal hypertension." The body is forced to reroute the blood away from the liver and into the general blood circulation. This causes large blood vessels, called "varices," to form.
Because the rerouted blood bypasses the liver, it contains high levels of amino acids, ammonia, and toxins that normally would have been handled by the liver. When these substances reach the brain, they can cause confusion and temporary loss of memory (a condition called "hepatic encephalopathy").
Amino acids and ammonia come from protein in the diet. Some evidence shows that patients with cirrhosis do better when they get their protein from vegetables (such as beans, lentils, and tofu) and from dairy products (including eggs, milk, and yogurt) instead of from meats.
Doctors can prescribe a syrup called lactulose (Acilac®, Enulose®, Constulose®, Generlac®) to push food through the bowels more quickly. This way, less food is absorbed, the liver has less work to do, and fewer toxins make their way to the brain.