Effect of Daily Fiber Intake Among Cirrhotic Patients With and Without Portosystemic Shunts

Area of Science:

• Gastroenterology and Hepatology
• Nutritional Science
• Medical Research

Background:

• Dietary fiber, particularly soluble fiber, is linked to liver damage in animal models with specific conditions.
• Limited data exists on the effects of dietary fiber in human cirrhosis patients.

Purpose of the Study:

• To examine the association between dietary fiber intake and clinical outcomes in cirrhosis patients.
• To determine if the presence of portosystemic shunts (PSs) modifies the effect of dietary fiber on cirrhosis outcomes.

Main Methods:

• Assessed daily soluble and insoluble fiber intake using food diaries in patients with chronic hepatitis (CH) and cirrhosis (CIRs).
• Verified portosystemic shunts (PSs) via CT scan and calculated Model for End-Stage Liver Disease (MELD) scores in CIRs.
• Analyzed the relationship between fiber intake, MELD score changes, and liver enzyme levels.

Main Results:

• Cirrhosis patients with PSs showed improved MELD scores, inversely associated with soluble fiber intake.
• Cirrhosis patients without PSs showed improved MELD scores, inversely associated with insoluble fiber intake.
• In CIRs with PSs, higher soluble fiber intake correlated with lower normal serum alkaline phosphatase levels.

Conclusions:

• The clinical impact of dietary fiber shifts from beneficial to potentially harmful as chronic liver disease progresses.
• In advanced cirrhosis with PSs, soluble fiber intake significantly influences disease progression and should be limited.
• Dietary fiber recommendations for cirrhosis patients should be tailored based on the presence of PSs and disease severity.