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Dietary management of hepatic encephalopathy in cirrhotic patients: survey of current practice in United Kingdom

1999; BMJ; Volume: 318; Issue: 7195 Linguagem: Inglês

10.1136/bmj.318.7195.1391

0959-8138

Clare Soulsby, MY Morgan,

Folate and B Vitamins Research

In the early 1950s it was shown that some patients with cirrhosis given "nitrogenous substances," including excess dietary protein, developed hepatic "precoma." 1 These largely uncontrolled observations led to the introduction of dietary protein restriction to treat hepatic encephalopathy.Recent research has shown, however, that protein requirements are increased in these patients, 2 that high protein diets are well tolerated, and that their use, particularly in patients who are malnourished, is associated with sustained improvement in mental state. 3 4In response, the European Society for Parenteral and Enteral Nutrition has recommended that traditional protein restriction should be abandoned in patients with hepatic encephalopathy particularly as other effective treatments are available. 5 We undertook this survey to review the current dietary management of these patients in hospitals throughout the United Kingdom.