General measures
- Alcohol abstinence (complete abstinence from alcohol).
- Nicotine restriction (refrain from tobacco use) including passive smoking – smoking promotes fibrosis of the liver.
- Review of permanent medication due topossible effect on the existing disease.
- Avoidance of environmental stress:
- Arsenic
- Formaldehyde
- Carbon tetrachloride
Vaccinations
The following vaccinations are advised, as infection can often lead to worsening of the present disease:
- Flu vaccination
- Hepatitis A vaccination
- Hepatitis B vaccination
- Pneumococcal vaccination: immunocompromised individuals should be vaccinated sequentially with the 13-valent conjugate vaccine PCV13 and six to 12 months later with the 23-valent polysaccharide vaccine PPSV23 against pneumococcus.
Regular checkups
- Regular medical checkups
Nutritional medicine
- Nutritional counseling based on nutritional analysis
- Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
- A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
- Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
- High-fiber diet (whole grains, vegetables).
- Observance of the following special dietary recommendations:
- Wg. malnutrition: in cirrhosis of the liver, especially the energy and protein (protein) intake is usually insufficient due to a decreased appetite and impaired sense of taste. Often, a feeling of satiety sets in quickly. The recommended daily energy intake should be 35-40 kcal per kilogram of body weight (with a protein content of 1.2 g/kg, in severe malnutrition 1.5 g/kg protein per day) and adapted to physical activity.
- Dietary salt restriction in patients with liver cirrhosis and ascites (abdominal fluid) [S2k guideline: see below]:
- At least patients with refractory and difficult-to-treat ascites should take a maximum of 5 g sodium chloride (85 mmol sodium) daily
- In cases of marked hyponatremia (sodium deficiency; < 125 mmol/l): fluid restriction to 1.5 liters/day
- Most often, glycogen reserves (reserves of stored carbohydrates) are decreased, so hypoglycemia (low blood sugar) may occur in liver cirrhosis. If hypoglycemia is imminent, carbohydrates with a high glycemic index (e.g., white flour products, glucose) are helpful because they are quickly available to the organism. Otherwise, complex carbohydrates should preferably be consumed in small distributed meals. Carbohydrate-rich late meals are also recommended, because it can also come at night to hypoglycemia.
- Selection of suitable food based on the nutritional analysis.
- See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
- Detailed information on nutritional medicine you will receive from us.
