Nutritional therapy and liver disease.

In terms of a general approach to these patients, the initial and most important step for the clinician is to have recognition and concern for the magnitude of malnutrition in patients with chronic liver disease. It is best to assume an inadequate diet and to have trained personnel review the individual's nutritional needs and design specific dietary regimens that supply sufficient energy and protein, perhaps in the form of frequent interval feedings. The currently available data support the use of specialized formulations only in selected patients with hepatic encephalopathy who are intolerant of an amount of protein sufficient to meet their nutritional requirements.