Nutritional management in patients with cholestasis
Keywords:
cholestasis, fat malabsorption, fat-soluble vitamins, nutritional therapyAbstract
Cholestasis is a disease which can be found in both children and adults and the causes of this disease can vary greatly. In adults, the common causes are liver disease. It also occur from biliary tract obstruction from tumors (periampullary cancer) as well as diseases caused by autoimmunity, such as primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC). Not only jaundice, the patient's nutritional status is also affected from fat malabsorption, chronic diarrhea, and steatorrhea. All of these symptoms can lead to malnutrition. The absorption of fat-soluble vitamins is also affected, which may cause patients to have either symptomatic or asymptomatic vitamin A, D, E and K deficiency. In addition, patients may develop osteopenia or osteoporosis due to low calcium absorption and vitamin D insufficiency. In terms of treatment, it can be advised to not only treat the underlying cause, but provide appropriate nutritional support by reducing long-chain triglycerides (LCT) and supplementation of medium-chain triglycerides (MCT), along with vitamins level monitoring, can facilitate patients to have a better nutritional status.
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