A practical approach to nutritional support in liver disease.

Nutritional problems are very common in patients with liver disease. The underlying liver disease will cause anorexia, nausea, and a poor appetite. In addition, alcohol acts as "cheap calories" and may be an added problem. Physicians taking care of patients with liver disease often place them on restrictive diets that compound the nutritional problem. Patients must be addressed for both the liver disease and the nutritional problems its treatment may create. One very important fact is that the majority of patients with liver disease will tolerate standard formulas that are much more "cost-effective" for the patients. How to calculate caloric and protein needs and how to select certain formulas are addressed. The results that show nutritional support is beneficial in decreasing mortality and morbidity are reviewed.