Randomized Open Label Clinical Study on Assessment of Effect of Liquid and Solid Meal Intake in Cirrhotic Patients

Abstract

Portal hypertension is almost unavoidable complication of cirrhosis. The physiological stimuli like food intake will affect the splanchnic circulation in cirrhotic patients. Hence the present study has been designed to measure the portal blood flow pressure after ingestion of solid and liquid meal in normal and cirrhotic patients. It is a randomized open label clinical study. The study included 32 male healthy volunteers (52 to 74 years) and 10 clinically proven cirrhotic patients (54-76years). The portal blood flow velocity was measured by Doppler method. The portal flow velocity in the fasting and in post prandial period was measured at the time interval of 15,30,45,60 and 90 minutesafter either solid or liquid meal ingestion. Solid meals include 4 idli’s each weighing 50 gmswith dhal and chutney. The liquid meal includes Ensure healthy mix in 270ml of water. Both the liquid and solid meals’ calorific value is 405. The results indicate that, the basal blood flow velocity in cirrhotic patients is on higher sidein comparison to normal subjects. Intake of solid as well as liquid meals increased the portal velocity in both normal as well as cirrhotic patients and it was found to be high at 45 minutes. In cirrhotic patients the liquid meal itself is able to increase the portal pressure in comparison to normal volunteers. The study can be concluded that being cirrhotic patients are more susceptible to vein puncture through increase in blood flow velocity low food load or liquid food might help them to control the velocity induced blood vessel rupturing. The observation has direct clinical implications and first time we are reporting with such a study in Indian population.