Mendez-Guerrero O, Carranza-Carrasco A, Chi-Cervera LA, Torre A, Navarro-Alvarez N. Optimizing nutrition in hepatic cirrhosis: A comprehensive assessment and care approach. World J Gastroenterol 2024; 30(10): 1313-1328 [PMID: 38596498 DOI: 10.3748/wjg.v30.i10.1313]
Corresponding Author of This Article
Nalu Navarro-Alvarez, MD, PhD, Assistant Professor, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 15 Vasco de Quiroga, Mexico City 14080, Mexico. nalu.navarroa@incmnsz.mx
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Mar 14, 2024; 30(10): 1313-1328 Published online Mar 14, 2024. doi: 10.3748/wjg.v30.i10.1313
Optimizing nutrition in hepatic cirrhosis: A comprehensive assessment and care approach
Osvely Mendez-Guerrero, Anaisa Carranza-Carrasco, Luis Alberto Chi-Cervera, Aldo Torre, Nalu Navarro-Alvarez
Osvely Mendez-Guerrero, Anaisa Carranza-Carrasco, Aldo Torre, Nalu Navarro-Alvarez, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
Luis Alberto Chi-Cervera, Clínica de Especialidades Gastrointestinales y Hepáticas, Hospital Star Medica, Merida 97133, Yucatan, Mexico
Nalu Navarro-Alvarez, Molecular Biology, Universidad Panamericana School of Medicine, Campus México, Mexico City 03920, Mexico
Nalu Navarro-Alvarez, Department of Surgery, University of Colorado Anschutz Medical Campus, Denver, CO 80045, United States
Author contributions: Mendez-Guerrero O, Carranza-Carrasco A, Chi-Cervera LA, and Torre A performed the literature revision, collected the data, and wrote the manuscript; Navarro-Alvarez N wrote, reviewed, and edited the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nalu Navarro-Alvarez, MD, PhD, Assistant Professor, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 15 Vasco de Quiroga, Mexico City 14080, Mexico. nalu.navarroa@incmnsz.mx
Received: November 28, 2023 Peer-review started: November 28, 2023 First decision: January 5, 2024 Revised: January 23, 2024 Accepted: February 25, 2024 Article in press: February 25, 2024 Published online: March 14, 2024 Processing time: 107 Days and 13.1 Hours
Abstract
Cirrhosis is considered a growing cause of morbidity and mortality, which represents a significant public health problem. Currently, there is no effective treatment to reverse cirrhosis. Treatment primarily centers on addressing the underlying liver condition, monitoring, and managing portal hypertension-related complications, and evaluating the potential for liver transplantation in cases of decompensated cirrhosis, marked by rapid progression and the emergence of complications like variceal bleeding, hepatic encephalopathy, ascites, malnutrition, and more. Malnutrition, a prevalent complication across all disease stages, is often underdiagnosed in cirrhosis due to the complexities of nutritional assessment in patients with fluid retention and/or obesity, despite its crucial impact on prognosis. Increasing emphasis has been placed on the collaboration of nutritionists within hepatology and Liver transplant teams to deliver comprehensive care, a practice that has shown to improve outcomes. This review covers appropriate screening and assessment methods for evaluating the nutritional status of this population, diagnostic approaches for malnutrition, and context-specific nutrition treatments. It also discusses evidence-based recommendations for supplementation and physical exercise, both essential elements of the standard care provided to cirrhotic patients.
Core Tip: Currently, there is a wealth of information on the ideal nutritional treatment for cirrhosis. Yet, a critical gap persists: The absence of a concise clinical document encompassing the entire nutritional care process. The significance of nutritional management is increasing, given its profound influence on both patient prognosis and quality of life. We here strongly emphasize the need to offer a practical foundation for managing nutrition in cirrhosis, grounded in scientific evidence.
