A practical approach to nutrition in people with cirrhosis

Cirrhosis is the end-stage of chronic liver disease and clinically can manifest with a spectrum of disease; patients with compensated cirrhosis may have a normal lifespan, yet those who decompensate have greatly increased morbidity and mortality. Optimising the nutrition of patients with cirrhosis helps prevent decompensation and also addresses the complications of decompensated cirrhosis, with tangible benefit to patients. The prevalence of cirrhosis is rising worldwide, and increasingly, patients with cirrhosis come under the care of non-hepatologists. Multiple society guidelines have been published describing nutritional intervention in the patient with cirrhosis, but these can be inaccessible to a non-specialist. Here, a simple, practical framework for how nutrition can be integrated into the care of patients with cirrhosis at various stages is presented, with reference to a patient narrative.