DIETARY THERAPY IMPACT FOR CIRRHOTIC PATIENTS WITH HEPATIC ENCEPHALOPATHY

BACKGROUND: Malnutrition is prevalent in all forms ofliver disease and it is associated with increased number of complications and increased short andlong term mortality. AIM: to evaluate the level of serum ammonia, recurrence of hepaticencephalopathy (HE), improvement of mental status and of the nutritional status after one monthof high protein high calorie (HPHC) diet the effect of a dietary therapy on cirrhotic patients withHE. MATERIALS AND METHODS: Our study was designed as a descriptive prospectiveanalysis of patients with cirrhosis and a previous episode of HE, admitted in GastroenterologyDepartment of Elias Emergency Hospital, during one year (January 2010-January 2011). Thediagnosis of cirrhosis was based on the medical history,physical examination, biochemicalfindings and imagistic methods. It was evaluated mental status, serum level of ammonia andnutritional parameters, before and after one month diet. RESULTS: A significant decrease in theblood ammonia levels was observed.A significant number of patients showed an improvement oftheir mental status assessed by West Haven scale after diet. A significant improvement of numberconnection test (NCT) scores was also noted. Body weight was slightly but significantly increasedafter a month of diet. Mid-arm muscle circumference (MAMC) increased after one month diet,but not statistically significant. CONCLUSIONS: The HPHC diet has a beneficial effect on thepatients with cirrhosis and hepatic encephalopathy, more significant regarding the mental status,level of the serum ammonia and the body weight. It was noted an improvement of mid armmuscle circumference. Key words: hepatic encephalopathy, diet, malnutrition, liver cirrhosis