Q. Does normal diet cause edema in a liver cirrhosis patient?

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I had gone through the details posted.

• Edema in cirrhosis patients is mainly due to low oncotic pressure in blood vessels because of low albumin.

• Cirrhosis compromise the synthetic function of the liver and so albumin production gets decreased. It is the albumin, which keep water inside the blood vessels.

• Because of low oncotic pressure the fluid escapes out and forms ascites (abdominal swelling), pedal edema (lower leg swelling) and pleural effusion (fluid in the lungs). So, we keep them on a low dose diuretic to decrease the swelling.

• The cause of cirrhosis if treated may help to stop liver damage and help in recovering function. So, the cause (etiology) has to be investigated.

• The patient need to be on low salt diet, if there is both abdominal swelling and leg swelling, low serum sodium and water restriction.

• With low sodium diet, water restriction and diuretics, the liver can become normal in size, but they should be compliant with therapy.

• Coming to diet, cirrhosis patients should not eat animal protein as this can precipitate hepatic encephalopathy. But, they need protein for daily requirement. So, vegan sources like pulses or threptin biscuits are rich sources of vegan proteins that can be given to them.

• Finally, in cirrhosis patients we have a scoring system called Child-Pugh score, which divides them into A, B and C categories to determine their future prognosis.

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