Abstract
Hepatic encephalopathy (HE) is a common neurological consequence in patients with cirrhosis and has a healthcare burden of USD 5370 to 50,120 per patient annually. HE significantly hampers the quality of life and is a major cause of morbidity and mortality. Patients with cirrhosis are at a high risk for protein-calorie malnutrition due to altered metabolism. Current evidence has changed the old belief of protein restriction in patients with cirrhosis and now 1.2 to 1.5 g/kg/day protein intake is recommended. Case series and studies with small numbers of participants showed that a vegetarian protein diet decreases the symptoms of HE when compared to a meat-based diet, but the evidence is limited and requires further larger randomized controlled trials. However, vegetable or milk-based protein diets are good substitutes for patients averse to meat intake. Branch chain amino acids (BCAA) (leucine, isoleucine and valine) have also been shown to be effective in alleviating symptoms of HE and are recommended as an alternative therapy in patients with cirrhosis for the treatment of HE. In this review, we provide an overview of current literature evaluating the role of protein intake in the management of HE in cirrhosis.
Highlights
IntroductionPublisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
Most of the patient’s frequency of computer-analyzed EEG (CAEEG) fell below 7, which has been shown in the past to be associated with development of encephalopathy [25]
The peak frequency of CAEEG was lower during the period of animal diet compared to vegetable diet
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Hepatic encephalopathy (HE) is a common neurologic complication of cirrhosis [1,2]. It effects 30 to 80% of patients with cirrhosis, with symptoms ranging from minimal HE) to coma [3,4,5,6]. HE significantly reduces the quality of life by affecting physical and social functioning. Covert HE may be present in up to 84% patients with liver cirrhosis [5]
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