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by Ronnenberg A

Lifestyle Changes to Manage Cirrhosis

Lifestyle changes cannot cure cirrhosis , but they can help to delay or stop progression of the disease, reduce the severity of symptoms, and help prevent complications.
The majority of cirrhosis cases in North America are related to alcohol abuse. Abstaining from alcohol helps to stop liver damage.
An appropriate diet can help your liver tissues regenerate and can reduce the severity of symptoms in more advanced disease. To reduce the chances of infection, you may be advised to avoid raw seafood and dishes that contain raw seafood, such as sushi. Raw fish can be contaminated with hepatitis A, as well as other viruses, bacteria, and parasites, which could further stress liver function. Raw oysters can be especially dangerous.
In the early stages of recovery, you may be advised to eat more calories and protein than you are used to. Adequate amounts of amino acids from proteins and other nutrients are necessary to regenerate liver tissue.
You may also be advised to take a vitamin and mineral supplement. This can help correct deficiencies that may have developed from cirrhosis itself or from changes in your normal eating pattern that resulted from your disease.
Supplements and supplemental nutritional beverages also may help support tissue growth and repair, but don’t take any without your doctor’s knowledge and approval.
Certain vitamins and minerals may be problematic. Avoid taking excessive amounts of vitamins A and D, and try to avoid foods that have been supplemented with iron.
In some cases, a salt-restricted diet may be necessary. Salt contributes to fluid retention. Restricting salt can help alleviate fluid-related swelling in the abdomen and legs.
If your disease is advanced, you may be placed on a protein-restricted diet. Decreasing the amount of protein you eat helps reduce the production of nitrogen-containing wastes, like ammonia. In a severely damaged liver, detoxification of ammonia is impaired, which can lead to high blood levels of ammonia. These, in turn, can produce mental changes, known as encephalopathy, which eventually may lead to coma and death.
Do not take any medicine, including over-the-counter drugs and herbal remedies, without your doctor’s approval.
The liver is responsible for metabolizing medication; when your liver is damaged because of cirrhosis, drug metabolism may be altered. Dangerously high levels of medications can remain in your blood and interfere with drugs you may be taking to treat cirrhosis. Always get your doctor’s approval before taking any medication. Even drugs that seem relatively harmless, such as acetaminophen (Tylenol) can be dangerous in some circumstances. The same is true of all nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprfen and naproxen.
You should be vaccinated for flu, pneumonia, and hepatitis. Vaccinations will help to reduce your likelihood of becoming infected and help reduce the severity of disease if you do become infected.
Gravity helps to pull fluid down into your feet and legs. Sit down, relax, and put up your feet. This will help reduce the swelling and relieve some of the pain in swollen legs and feet.
Contact your doctor if:
  • You need help with alcohol cessation
  • You need help planning an appropriate diet or if you have questions about a specific food or supplement
  • You have questions about a certain medicine or over-the-counter product
  • You have questions about whether you should receive vaccines
  • Swelling in your feet and legs is severe or is not alleviated by elevating them

References

Cirrhosis. American Liver Foundation website. Available at: http://www.liverfoundation.org/abouttheliver/info/cirrhosis. Updated December 3, 2012. Accessed April 24, 2013.
Cirrhosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 27, 2012. Accessed April 24, 2013.
Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis/index.aspx. Updated February 21, 2012. Accessed April 24, 2013.
Daniels NA. Vibrio vulnificus oysters: pearls and perils. Clin Infect Dis. 2011;52(6):788-792.
Neuschwander-Tetri BA: Lifestyle modification as the primary treatment of NASH. Clin Liver Dis. 2009;13:649-665.

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