The morphological changes in liver damage can manifest as fatty liver, hepatitis, cirrhosis of the liver and cancer of the liver.

A well planned dietary regimen is of utmost importance in the prevention and treatment of most hepatic disorders. It has been proved beyond doubt that some of the proteins derived from animals are responsible for producing persistent symptoms related to liver disease. Thus vegetarian diet, as mentioned below, has gained momentum in the treatment of hepatic disorders.

Viral Hepatitis

Since there are no antiviral agents against hepatitis,rest, abstinence from alcohol and dietary modifications form the mainstay of the treatment. Most patients have nausea and lack of appetite. They should be served with attractive and well cooked foods. Small meals served separately will be better tolerated than three large meals. A diet containing approximately 2000 kcal which can be provided by 20-25 gms fat, 80-90 gms pro teins and 400 gms carbohydrate is suitable. This requirement can be fulfilled by glucose, sugar, fruits, fruit juices, bread, cereals, vegetables, salads, jelly, jam, rice, boiled potatoes and puddings made with cereals and sugar. Though diets high in their fat content do not ultimately influence the course of the disease they are poorly tolerated by jaundiced patients. Fried food, milk and butter cause dyspepsia and should be avoided. Thus a vegetarian diet is better tolerated by the patients suffering from viral hepatitis.

Cirrhosis of Liver

Most of the patients of cirrhosis of liver are severely malnourished and require a high calorie and high protein diet. A high protein diet, particularly if derived from animal proteins, carries a high risk of precipitating hepatic encephalopathy. The best source of vegetarian proteins is milk, its products and Casilan. Choline present in foods like wheat germ, soyabean, peanuts and skimmed milk may prevent the formation of a fatty liver. It is also believed that cerebral disturbances due to liver damage are caused by the type of protein in the diet. Cirrhotic diet prescribed in a standard Indian books on diet and nutrition does not contain proteins derived from animal sources. A diet high in carbohydrate and proteins low in fat and fortified with vitamins would be most suitable. Thus a vegetarian diet is more suited to patients having cirrhosis of liver.

Ascites

In terminal stages of cirrhosis fluid accumulates in the abdominal cavity due to failure of the liver to synthetize plasma albumin. For such patients, a high protein diet which is low in sodium would be most suitable. But since these patients have no appetite, milk is the only practical diet which can supply the above requirements.

Finally when the liver fails - the condition is known as hepatic encephalopathy. There is a strong incidence of animal protein intake increasing the incidence of hepatic encephalopathy. The clinical features of this syndrome are sleep disturbances, restlessness, drowsiness, impaired intellectual function, confusion and stupor progressing to coma. Significant number of these patients develop chronic encephalopathy and can be managed successfully at home. They should be given 20 gms of protein in the diet. This should mainly be derived from skimmed milk.

Thus, it is very obvious that a vegetarian diet is more useful in the treatment of all liver disorders including the last stage of liver failure.

REFERENCES

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