| According to the American Liver
Foundation, approximately 25 million Americans, or one out of 10, develop
liver, bile duct, or gallbladder diseases. Liver disease often begins as
inflammation of the liver, that may ultimately lead to chronic
inflammation and irreversible scarring, also known as cirrhosis.
The liver
is remarkably resilient, able to compensate for a significant amount of
damage by regenerating itself, but with time and chronic inflammation its
function declines.
When liver function is impaired by scar
tissue (as in cirrhosis), an increase in blood pressure within the liver
may occur due to portal hypertension. Portal hypertension can result in
the uncomfortable symptoms of fluid retention in the abdomen (ascites) and
enlargement of the blood vessels in the intestinal tract (varices). Excess
sodium and fluids increases the blood volume and can worsen these
symptoms.
Sodium is a naturally occuring mineral
found in small amounts in most foods and abundantly in salt. Sodium
attracts water. In persons who are already experiencing problems with
swelling, as occurs in advanced liver disease, excess sodium in the diet
can increase fluid retention, and discomfort. The adult body only requires
500 milligrams (mg) of sodium each day to maintain health. This is equal
to 1/4 teaspoon of salt and can be reaped from a well-balanced, nutritious
diet. Most people, especially those in Westernized societies, have daily
sodium intakes well above this level due to the prevalence of salt and
processed foods that are high in sodium. Excess sodium not only
contributes to excess fluid retention but may also increase the risk for
chronic diseases such as high blood pressure. For this reason it is
generally recommended that sodium intake be limited to approximately 2,400
mg per day. Further limiting sodium may be recommended by a physician in
those with liver disease.
In some instances, restricting overall
fluid intake may also be indicated. As in the case of sodium, fluid in the
diet can worsen fluid retention. However, some controversy exists among
experts about the appropriate amount of restriction. Also, the use of a
fluid restriction is usually reserved for times of severe fluid retention,
as it is often difficult to adhere to the restriction in the home setting.
A physician and dietitian can help determine individual fluid requirements
and goals.
Achieving a balance of sodium and fluids in
the body, providing the body with necessary amounts while avoiding excess,
is the goal in liver disease and for general good health. This may involve
decreasing current levels of dietary sodium or fluids. Avoiding foods
high in sodium is the first step in reducing sodium intake. Further strategies
for restricting sodium and fluids may be recommended by a physician
and helpful in coping with symptoms of liver disease.
References:
American Liver Foundation. Diet and
Chronic Liver Disease. http://www.liverfoundation.org
American Liver Foundation. Liver Disease
Fact Sheet. http://www.liverfoundation.org
National Digestive Diseases Information
Clearinghouse. Chronic Hepatitis C: Current Disease Management. http://www.niddk.nih.gov/health/digest/pubs/chrnhepc/chrnhepc.htm
Hepatitis Foundation International. Caring
For Your Liver. http://www.hepfi.org/Hepinfo/livercare.htm
Hepatitis Foundation International. Diet
and Your Liver. http://www.hepfi.org/Hepinfo/diet.htm
Hepatitis Foundation Internationa. Excerpts
from Hepatitis C Consensus Conference (Consensus Conference held April
1997). http://www.hepfi.org/s97insert.htm
The Hepatitis Information Network. The
Liver in Health and Disease. http://www.euroliver-foundation.org/englishbri/entree.htm
Zeman, Frances J., Ph.D., R.D. (1983) Clinical
Nutrition and Dietetics. New York:Macmillan. |