Aspects nutritionnels des hépatopathies chroniques stables

Patients with chronic liver disease are often malnourished, and the provision of adequate nutritional support is essential to help minimize its detrimental effects on clinical outcome. Certain complications of chronic liver disease, such as fluid retention, are managed with dietary manipulation or restriction, but this should not be at the expense of the adequacy of the diet as a whole. It is, therefore, essential that nutritional status is assessed in this patient population not only at presentation but also at long-term intervals. A reasonably reliable assessment can be made by combining data from clinical and dietary histories, the physical examination and an anthropometric evaluation. With such information, feeding can be targeted and optimized on an individual basis. The inclusion of nutritional management in the mainstream rather than the periphery of patient care is essential.