Diet and Nutrition for Chronic Hepatitis

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What should someone with chronic hepatitis eat? This is a common concern and the answer may surprise you. There's no single recommended diet -- because there's not much difference between a healthful diet for someone with chronic hepatitis and someone without the disease. Even though several books and websites suggest otherwise, the guiding principles of basic nutrition can give your body what it needs without putting additional stress on your liver.

We all have very similar nutritional needs, whether we have chronic hepatitis, or not. These only change for people with decompensated cirrhosis, which is such extensive scarring (fibrosis) that the liver can't function properly. Distinguishing whether a person with chronic hepatitis has cirrhosis and the stage of their cirrhosis determines how much attention he or she should pay to a special diet.

Make Sure You're Eating

Enough calories. Anorexia is a symptom associated with advanced cirrhosis that can make it difficult for someone to get enough calories. Usually, this only lasts a short period of time, brief enough for your body to get by on its reserves. However, if it lasts for several days or weeks, you probably aren't getting the nutrition you need. One solution is to discuss with your physician whether you're getting enough food or enough of the right foods.

The right amount of protein. Meats, milk, nuts, and cheese are all good sources of protein. Protein is an important nutrient and it's absolutely necessary for good health. People with chronic hepatitis should be able to enjoy moderate amounts of protein without worry. However, too much protein is bad for people with advanced cirrhosis and can lead to brain disease as the excess protein accumulates in the blood. Again, the liver is responsible for keeping protein at safe levels, but when the liver is damaged as is the case with decompensated cirrhosis, it can't do as much as it did before. While it's important to eat enough protein, too much can be harmful. Talk with your doctor to determine the best amount of protein for you.

Enough vitamins and minerals. Some people with chronic hepatitis, especially those with alcoholic hepatitis or advanced cirrhosis, may not be getting enough of the fat-soluble vitamins and necessary minerals they need through their diet. Your doctor or nutritionist may measure your levels of vitamins A, D and E to check your clotting time. One solution to this deficiency is using doctor-prescribed supplements. Otherwise, you'll need to make certain you get these vitamins and minerals the old-fashioned way: through a balanced diet.

Prepare Meals With Your Liver in Mind

Low-fat meals. The liver is an incredibly important organ to your body. It's involved in many aspects of nutrition. One important function of the liver is to produce bile, which the body uses to emulsify dietary fats, such as from potato chips or hamburgers. Before the body can absorb the fats and use their nutritional energy, all fats must be prepared by this process. However, depending on the damage to your liver, you might not be able to prepare enough bile to handle a meal high in fats. As a result, you might suffer indigestion because of the undigested fat. One solution is simply to eat low-fat foods. An alternative is to eat very small amounts of a high-fat food.

Small meals. If your liver is damaged, it isn't able to store as much energy as it once could. One of the jobs of the liver is to store the chemical glycogen, which it can quickly give back to the body when it needs immediate energy. Most people can store relatively large amounts of glycogen in their livers, but when the liver is damaged with fibrosis, the scar tissue takes away valuable storage space for glycogen. This explains one reason why people with the chronic liver disease often get tired quickly. One solution is to eat small, frequent meals making sure to include carbohydrates. This gives your body the chance to replace its glycogen reserves.

Protect Your Liver

The liver is such a powerful filtering organ. Every five minutes, your entire blood supply is filtered through it. As blood filters through, the liver removes the toxins (anything poisonous to your body). The liver has an amazing capacity to keep doing its job even while damaged, but eventually, too much damage will reduce liver function. Therefore, it's in your best interest to reduce toxins to your liver. Here are some common toxins to the liver:

  • Alcohol. People with chronic hepatitis should avoid alcohol since it speeds progression to cirrhosis. People with cirrhosis should absolutely avoid alcohol.
  • Unnecessary medicines. Even though medicines are beneficial, they are still toxic chemicals that must be processed by your liver. It's important to follow your doctor's advice and take the medicines that you need and avoid the ones that you don't. Check with your doctor before taking a medicine if you have liver disease.
  • Pesticides and herbicides. Though these can absorb through your skin, they are still toxins ultimately processed by the liver.
  • Household chemicals. We use chemicals daily, sometimes without a second thought. People with chronic hepatitis should take extra caution to reduce exposure of these through fumes, ingestion and skin absorption.
  • Vitamins and supplements. Some vitamins (K, A, D, and E) are very important and necessary for people with chronic hepatitis and many doctors will prescribe vitamin supplements. However, aside from physician-recommended vitamins, use caution with additional supplements because they may be toxins.
  • Tobacco products
  • Recreational drugs

Remember the Basics

Healthful foods. Your body needs good nutrition whether you have chronic hepatitis or not. To achieve good nutrition means that you're getting the nutrients you need (vitamins, minerals, protein, fat, carbohydrates, fiber) from the foods you eat. The quality and types of foods are important: fresh fruits and vegetables, lean meats (chicken, turkey, pork) and whole grains (barley, brown rice, whole wheat bread, and oatmeal).

Exercise. Along with nutrition, exercise is an essential part of good health. Some of the common symptoms associated with chronic hepatitis in the setting of no cirrhosis or cirrhosis that isn't too advanced, such as fatigue or depressed mood, may be improved with regular, moderate exercise. You should begin any exercise program gradually and, depending on your level of health, under a physician's guidance. Most exercise, however, small the amount, is very beneficial to your health and well-being. It is an excellent complement to good nutrition.

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Article Sources

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  • Keeffe, EB. Cirrhosis of the Liver. In: DC Dale, DD Federman (eds), ACP Medicine, New York, WebMD Publishing, 2006.
  • Malet, PF. Chronic Hepatitis. In: DC Dale, DD Federman (eds), ACP Medicine, New York, WebMD Publishing, 2006.