Table 1.

Factors That Contribute to Malnutrition in Chronic Liver Disease2, 3

Inadequate nutrient intake

• Early satiety (ascites)

• Anorexia (nausea, vomiting, abdominal distention)

• Dysgeusia (zinc deficiency)

• Hepatic encephalopathy

• Restricted diet (low protein, low sodium, fluid restriction)

• Alcohol intake

• Socioeconomic barriers

Metabolic changes

• Hypermetabolic state

• Increased gluconeogenesis

• Insulin resistance

Malabsorption

• Portosystemic shunting (bowel wall edema, portal venous stasis)

• Bile acid deficiency

• Small‐bowel bacterial overgrowth