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What diet to be given to a patient with diabetes, grade three oesophageal varices and liver cirrosis?

Jan 2013
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Internal Medicine Specialist
Practicing since : 2003
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What diet to be given to a patient with grade three oesophageal varices & liver cirrosis. The patient is diabetic too?
The patient has undergone endoscopy with bands in lower oesophagus to stop bleeding varices, three to four times in past six months but the condition is not improving as the varices starts bleeding again and again. Patient has gone blood transfusion four times during this period as haemoglobin fell down to 4 to 5 units.

Patient is diabetic and takes insulin to regulate glucose.
Please advise medicines and diet ( powder supplements etc.) which can be given.

Posted Tue, 9 Oct 2012 in Diet Plans
Answered by Dr. Mayank Bhargava 1 hour later
Thanks for posting your query.
You have asked very important and common question.
Regarding jaundice to any body, each & every body gives his/ her opinion and try to give opinion like a doctor.
And no body listen to doctor's advise.
Since many years, when no research had been made in liver pathology...each & every patient is forced to avoid oily, turmeric and take sweets for recovery.
This is still practiced by many doctors even by allopathic doctors....which is absolutely wrong.
Dear friend, you may be unsatisfied with me but this is true.
1st thing to understand is that as such there is no dietary restriction for cirrhotic patient except for salt. He/ she can take turmeric/ oily and high protein vegetarian diet.
As our body require carbohydrates, fat and sugar....liver also need all these ingredients.
Let me explain my views one by one.
Read each & every line clearly.
1) Salt
Has some doctor given you advice regarding salt restriction?
Has some doctor given exact quantity of salt which patient has to take daily?
If no, then this amount is 2 gram/ day means 1 gram in morning and 1 gram in evening.
Patient has to avoid all other things which include sodium such as bread, toast, sweet and namkeen biscuits, injection such as piperacillin and tazobactum injection and DNS drip (contain high salt).
Taking meal with 1 gram salt at a time is very difficult to take, but mind it is the only wonderful thing which can increase the life of patient.
As a doctor, by applying this formula with other concepts, I personally saved the life of many patients.
You can go to sunar (goldsmith) and measure 1 gram salt and tell him to make one spoon for 1 gram salt. By this you can give him 1 gram salt to patient independently.
Apart from salt, he/ she has to take diuretics for control of ascites.
Ascites (abdominal fluid) is the root of all problems. If we are able to abolish ascites by salt restriction and diuretics then you have won the battle.
Patient must avoid non-veg proteins as these are very easily digested and patient may go in hepatic encephalopathy.
So patient has to take High protein veg diet.
Patient should take dal, all vegetables, paranta, rice, ghee, oil, samosa, kachori but all will be prepared in home by using 1 gram of salt at a time.
Regarding varices and band application, by following above dietary changes with few medication for reducing portal hypertension, risk of bleeding can be decreased very much.
Bleeding from varices occur due to high portal hypertension.
Medicines which are generally advised for reducing portal hypertension are propranolol, ACE inhibitors, iso sorbide mono nitrate.
You can take on written prescription.
If all these formulas get failed then you can also go for TIPPS, but it is costly and chances of getting hepatic encephalopathy is increased.
This is practical guideline and I have put all in my ways......and also beneficial for many of my patients
Put your views also.
Best regards,
Dr. Mayank Bhargava

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