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NUTRITIONAL MANAGEMENT ON HEPATIC DISORDERS

macrophage within the liver reveals body’s defense . phagocytic’s (RES) The occurrence of Kupffer cell. play a role in maintain and providing to perform implementing life process As metabolism centre. formation and enzymatic arrangement. fashioned clotting factors Act in detoxification.HEPAR / LIVER  One of the largest vital organ   25 % parenchymal tissue’s function in normal     condition still sustainable life Has multicomplex important function.

Energy nutrients metabolism. glukoneogenesis . glikogenolisis. SGPT. globulin. B12 and mineral Cu & Fe . -GT. and bile) and regulate the value of blood glucose and cholesterol. such as glikogenesis. deliver numerous enzymes (SGOT. vit. prothrombine and coagulation/clotting factors)  Storage place for fat soluble vitamins. Plasma protein synthesis (albumin. 2.Concerred on 1. fibrinogen.

 The liver metabolized 40% up to 80% amino acids depends on its configuration perform degradation (catabolism) of 7 sort essential amino acids includes Aromatic Amino Acid. Isoleucine & Valine) be metabolized and yielding energy in the muscle . while Branch Chained Amino Acid (BCAA : Leucine.

HEPATITIS .

VH-non A non B. VH-D. alcoholic (drunk)  Incomplete recover / healing of Viral Hepatitis also in addition with repeated infection and nutritional intake especially in extremly in adequacy of protein will lead to become necrotics and fibrotics.Acute (Inflammatory) Hepatitis  Viral Hepatitis VH-A. toxins. VH-B. etc  Acute Recurrence Hepatitis May caused by medications. VH-C.  Necrotics resulting from hepatic cellular damage will stimulate to regenerate in effort healing liver function as well as compensation in liver parenchyme performance / feature accompany with fibrosis .

diabetic cirrhosis Catabolism of BCAA (energy sources in the muscle) . Furthermore reveals “pseudolobulasi” with “noduls”     as spesifics mark for Chirrosis Hepatis. it will makes lack of lipoprotein such as lipotropics factors (choline. tends to get ascites. methionine) resulting fat accumulation  Fatty Liver. will appear “shunt” between portal circulation and systemic circulation  half part of glucose enterred systemic  hyperglycaemia  hyperinsulinaemia . In case of chronic liver failure. Lack of protein in long time. It will happened obstruction post sinusoid / vena porta and decrease of albumin syntesis.

Nutritional Management on Hepatitis .

Acute (Viral) Hepatitis  The aim – to effort the improvement of liver cell parenchyme.around 0.2/3 requirements (65% normal)  Protein . Function of the liver have to recover absolutely. unirritation taste.  Soft-food’s meal in a few portion consumed and frequent. and improve the complaints.  Energy needs . Giving the liver to rest.5 gram/kg BW (animal protein : plant protein = 1 : 2-3) . kinds of chopped food. The value of enzymes tends back to normal.

which is substance      food stuff easy to digest Refined simple carbohydrate Adequate vitamin and mineral (B1.75 gram/kg BW. Fe) If there is ascites . Cu. Fat maximally 20% total energy.a few or without salt.increase gradually (suitable tolerance) . Energy and lipid . Better or improve condition and better or improve appetite  protein can be increased 0.

can be strained (filtered). mind in source of BCAA  Carbohydrate 65% total energy .3 – 0.  Beginning 0.Chronic Hepatitis Chrirrosis without complication  Soft food stuff.75 gram. appropriate and tolerance with the appetite can be gradually increase up 45 Kkal/kgBW/day. chopped meal uniritation taste  Sufficient energy  initially 40 Kkal/kgBW/day. mineral . which 60-70% from animal source (high biological value) arise 0.  Protein also gradually arise depends on it illness.5 gram/kg BW/day.20% from refined CH or complex CH  Lipid / Fat 15-20% from total energy  Supplement  for vitamin.

leads to disturbance of metabolism process . . might be / mostly parenteral  Amonia yielding from the urolysis process taken by gut / bowel bacterias can not be enterred the urea cycle.Chirrosis hepatis with cemplication (encephalo hepatic)  Conform with condition.  The existence of “Portal Systemic Shunt” . resulting ammonia and other toxical substances yielding pathological central sign and symptom.

 Energy has to be positive anabolic. recommend  0.3 gram/kg BW/day Carbohydrate 65% from total energy (simple CH : complex CH = 1 : 3) Fat  20% total energy Vitamin & mineral (includes some antioxidants) .The aim nutritional treat is to prevent the interference of neuropsichiatric’s disorders. 35-40 Kkal/kg      BW/ day Protein especially BCAA.

and its product (soy bean curd – tahu/tofu.tempe). soy bean.  Legumes / beans especially red/kidney bean. soy bean cake .SosIalIze  Intended for suffer post hepatitis virus. have to give food sources from BCAA compound in daily food pattern consumed. green/mung bean and four sided bean (kecipir)  are plant sources which rich contents of BCAA . the possibility getting relapse and recurrence or have got cirrhosis (in early stage).

kidney bean and soy bean cake. . Pass through animal experiment (wistar albino rat  240 gam) could be proved by microphotoes in anatomical pathology that chirrosis hepatis can be obstructed / blocked or can be restrained and controlled by (pure-powdered) BCAA.