Malnutrition and sarcopenia in liver cirrhosis: Indian expert opinion perspective on screening and managements

Malnutrition and sarcopenia in Liver cirrhosis led to poor outcomes, complications, quality-of-life and increased mortality. This review discusses the prevalence of malnutrition and causative factors from an Indian patient and clinician perspective, nutritional assessment strategies, and management of malnutrition and sarcopenia. A group of experts discussed the dietary and lifestyle factors leading to malnutrition, screening tools and management algorithms to assess severity of malnutrition, and imaging modalities for diagnosing sarcopenia. They discussed the lack of routine screening in cirrhotic patients and advocated the use of quick and practical screening tools such as hand grip strength (HGS), gait speed, and body mass index (BMI) in clinical settings for early assessment of nutritional status and sarcopenia. Following screening and diagnosis of nutritional deficiencies, a comprehensive nutritional management plan consisting of adequate dietary protein and caloric intake, along with multivitamin and BCAA supplementation is recommended and has shown better clinical outcomes. Suitable screening and management strategies were considered essential to improve prognosis of cirrhotic patients.