Liver (hepatology) - dietetic services

The hepatology dietitian works with patients who have liver problems to reduce the risk of them becoming malnourished.

 

Patients who have liver problems have special dietary requirements. The dietitian cares for the patient, making regular visits and assessments to help the patient to optimise their health through their choices of what to eat and drink.

 

Who we provide a service to

The hepatology dietitians provide a service to all hepatology inpatients including those who will go on to have a liver transplant.

 

The liver transplant dietitians are an integral part of the liver transplant team
> Liver transplant team

 

The dietitians carry out nutritional assessments on all patients who are referred to Addenbrooke's for a liver transplant assessment. Patients who are accepted on to the waiting list often require pre-operative nutritional counselling and monitoring. This is provided for inpatients and in the waiting list clinic once discharged.

 

After a liver transplant, the dietitians provide nutritional support and monitoring to patients on the ward and afterwards in the post-transplant clinic. This support is provided until the patient is well nourished and has no other nutritional issues.

 

Education

The hepatology dietitians provide ongoing education to other health professionals within Addenbrooke's

 

The hepatology dietitians provide specialist education nationally to other dietitians via the D-Liver group

 

Why we provide a service

Patients who have chronic liver disease have a range of nutritional issues including malnutrition and morbid obesity.

 

During the pre and post transplant periods a patient can experience a poor appetite and eat much less than they need to meet their nutritional requirements. Meeting these requirements helps to avoid complications such as infections, frequent hospital admissions and a longer stay in hospital.

 

Muscle wasting can be reduced in patients with cirrhosis by eating starchy carbohydrate snacks between meals and at bedtime.

 

Many patients require advice to increase the energy and protein in their diet through dietary modification and nutritional supplements. Those unable to meet nutritional requirements by mouth, require artificial nutritional support via a feeding tube.

 

Further dietary adaptations may be required eg salt restriction for patients who have ascites, but only if overall nutritional intake and status is not compromised.

 

There are several widespread myths about diet and liver disease which if followed may compromise patients nutritional intake. It is important patients receive accurate and up to date information from a dietitian to prevent this.

 

In the long term post transplant patients may experience excessive weight gain, diabetes or high cholesterol (hypercholesterolaemia). The dietitian can continue to support these patients.

 

Useful links

 

> British Liver Trust

> UK Transplant

 

 

 

 

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