©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Dec 28, 2015; 7(30): 2940-2954
Published online Dec 28, 2015. doi: 10.4254/wjh.v7.i30.2940
Published online Dec 28, 2015. doi: 10.4254/wjh.v7.i30.2940
Nutritional assessment in cirrhotic patients with hepatic encephalopathy
Fernando Gomes Romeiro, Laís Augusti, Gastroenterology Division, Department of Internal Medicine - Botucatu Medical School, UNESP-Univ Estadual Paulista, Botucatu 18608-917, São Paulo, Brazil
Author contributions: Romeiro FG designed the study, obtained the data, drafted and corrected the final article; Augusti L obtained and organized the data, drafted and corrected the article. Both authors read and approved the final manuscript.
Supported by São Paulo Research Foundation (FAPESP), CAPES and PROPe/UNESP, Nos. 2013/15121-8 and 2013/11761-2.
Conflict-of-interest statement: No potential conflicts of interest.
Correspondence to: Dr. Fernando Gomes Romeiro, Gastroenterology Division, Department of Internal Medicine - Botucatu Medical School, UNESP-Univ Estadual Paulista, Distrito de Rubião Jr. s/n, Botucatu 18608-917, São Paulo, Brazil. fgromeiro@fmb.unesp.br
Telephone: +55-14-38801173 Fax: +55-14-38801667
Received: April 28, 2015
Peer-review started: May 6, 2015
First decision: September 8, 2015
Revised: September 23, 2015
Accepted: December 13, 2015
Article in press: December 14, 2015
Published online: December 28, 2015
Processing time: 243 Days and 10.2 Hours
Peer-review started: May 6, 2015
First decision: September 8, 2015
Revised: September 23, 2015
Accepted: December 13, 2015
Article in press: December 14, 2015
Published online: December 28, 2015
Processing time: 243 Days and 10.2 Hours
Core Tip
Core tip: Ammonia metabolism, inflammation and muscle wasting are relevant processes in hepatic encephalopathy (HE) pathophysiology and malnutrition worsens the prognosis in this condition, requiring early assessment of nutritional status in these patients. Body composition changes induced by liver disease and limitations superimposed by HE make difficult to accomplish exams properly in this population, but there is a growing evidence that assessment of muscle mass and muscle function is mandatory due to the role of skeletal muscles in ammonia metabolism. In this article, we review HE pathophysiology and discuss the main methods of nutritional assessment, suggesting the best approaches in HE patients.