How to Choose the Best Diet for People with Cirrhosis

Liver cirrhosis, illustration

Many people diagnosed with cirrhosis of the liver want to know how to change their diet to improve their health. Ironically, if you have cirrhosis, the best diet is very close to the one you needed before you had the condition.

A good rule of thumb is that a healthful diet is helpful for just about anyone—and this is especially true if you have cirrhosis. Foods like fruits, vegetables, whole grains, and proteins of proper types and in proper amounts are very appropriate.

In addition, it is a good idea to take a daily multivitamin. Depending on the degree of cirrhosis, some people might not have enough of the key minerals and fat-soluble vitamins (vitamins K, A, D, and E) that the body requires. While a balanced diet should easily provide these, in the rare case when it doesn't, your doctor can prescribe a supplement.

What to Avoid

There are two things you should avoid if you have cirrhosis: alcohol and high-fat foods. For people with cirrhosis, regardless of the cause, alcohol should be completely avoided. And, diets high in fat for people with cirrhosis may cause potential digestion problems. The body digests (breaks down) fats using bile, which is a yellow-green fluid made in the liver. When the liver is damaged, the production and supply of bile may be affected.

However, it is important not to avoid fat entirely because the body requires a daily supply to remain healthy.

In the case of fats—as is the case with many other elements of a healthy diet—moderation, and good selection is the key. For your dietary fat, choose foods like nuts, avocados, fish, and plant oils.

With that said, you may need to further adapt your diet if you have complications from cirrhosis, according to your doctor's recommendations.

Three relatively common complications are ascites, hypoglycemia, and encephalopathy.

Ascites and Diet

Ascites, which is the accumulation of large amounts of fluid in the abdomen, is aggravated by a diet high in salt, so doctors usually require a strict no-salt diet for people who have cirrhosis with ascites. This is difficult to follow in today's highly processed marketplace because most prepackaged foods contain a lot of added sodium (salt). When shopping for groceries, some good advice would be to skip the middle aisles and buy most of your food from along the walls, where stores generally keep fresh meats, fruits, and vegetables—all foods relatively low in sodium.

Hypoglycemia and Diet

Hypoglycemia, or low blood sugar, is another common problem of cirrhosis. If you experience this, you will need a diet of small, frequent meals that include complex carbohydrates such as bread, pasta, and rice. Hypoglycemia, also known as low blood sugar, causes many symptoms including fatigue, confusion and heart flutters because—in the case of cirrhosis—the liver isn't able to store enough energy (in the form of glycogen, a chemical the body uses for quick energy). Since the body is able to quickly break down carbohydrates and use them for energy, this can help smooth out the problems caused by hypoglycemia.

Encephalopathy and Diet

When the liver is injured, as it is in the context of hepatitis, it can't handle normal amounts of protein. Protein, which the body uses for growth, maintenance, and energy, is supplied from the diet in animal products like meat and eggs, and from plants like beans. When the body gets too much protein, a serious complication called encephalopathy can result. This is because of the accumulation of large amounts of ammonia, a byproduct of the digestion of too much protein, which is toxic to the brain. This is a life-threatening condition that can be prevented in people with cirrhosis by eating small amounts of protein from plant sources.