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A male asked:

Is it recommended for a patient w/ ascite to take protien suppliment such as whey protien mix and pure protien shake? ascite is a condition where by a person starts collecting fluid in his/her abdominal cavity due to liver failure. my friend is currently

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Dr. John Fung
General Surgery 41 years experience
Ascites : Ascites is a fluid build up within the abdominal cavity that can be caused from a variety of reasons, but most commonly from liver disease. In this case, scarring within the liver, called cirrhosis caused elevated blood pressures within the intestine and other abdominal organs, also known as portal hypertension. This causes fluid to leak into the peritoneum and when the amount of fluid formation exceeds the capacity of the abdominal lining to absorb the fluid, then accumulation of fluid occurs. In some liver conditions, such as portal vein thrombosis (sometimes related to liver cancer), ascites accumulation may be severe. The fluid consists of protein, including albumin. Patients that have the fluid removed, called paracentesis, to relieve the pressure from the ascites, also lose the protein and exacerbate protein loss. Together with the liver disease (liver makes essentially all of the proteins that circulate in the blood), patients will lose a large amount of muscle mass, called muscle wasting. Patients with liver disease may also experience mental confusion, called hepatic encephalopathy, which calls for dietary protein restriction, which also exacerbates muscle wasting. The recommendations for protein intake in liver failure patients has changed. The american association for the study of liver diseases currently recommends that protein intake should be at least 1 g/kg/day and increased to 1.75 - 2 g/kg/day as tolerated. A late night meal with the highest amount of protein will minimize the risk of encephalopathy interfering with daily routine. At this point, your friend should be under the careful management of a liver specialist, called a hepatologist and possibly evaluated for liver transplantation.
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Last updated Mar 22, 2020

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