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INFECTIVE HEPATITIS - SYMPT OMS AND DIETARY MANAGEMENT
Infective hepatitis is otherwise known as viral hepatitis.
Symptoms : Anorexia, fever, headache, rapid weight loss, loss of muscle tone and abdominal discomfort precede the development of jaundice. Neglected viral hepatitis leads to cirrhosis of liver. Treatment consists of adequate rest, nutritious diet and avoidance of further damage to the liver.
Dietary Management : The objectives of dietary treatment are to aid in the regeneration of liver tissue and prevent further liver damage.
A high protein, high carbohydrate, moderate fat is recommended. Small attractive meals at regular intervals are better tolerated. Over feeding should be avoided.
Energy : Sufficient calories should be given to maintain weight and reduce protein catabolism. A diet which supplies 1600 k cals to 2000 k cals is suggested.
Proteins : 1 g protein per kilogram of body weight daily is needed to overcome negative nitrogen balance, for liver cells to regenerate and prevent fatty infiltration of the liver. With severe jaundice 40 g and in mild jaundice 60 - 80 g of protein is permitted. In hepatic coma protein containing foods are avoided and high carbohydrate containing foods are given.
Fats : In severe jaundice 20 g and moderate jaundice 20-30 g is given. Fat needs to be restricted when there is obstruction to bile flow and in hepatic coma when fats are not metabolized by the liver.
Carbohydrates : High intake of carbohydrate is essential to supply enough calories so that tissue proteins are not broken down for energy. Fruits, fruit juices, vegetable juices, sugar, jaggery and honey are given to supply adequate electrolytes.
Vitamins : Vitamins are essential to regenerate liver cells. 500 mg of vitamin C, 10 mg of vitamin K, and B-complex vitamins are essential to meet the daily needs. If anorexia, nausea or vomiting are present, the vitamins may be given by injection.
Minerals : Oral feeds of fruit juice, vegetable and meat soups with added salt given orally or through a naso gastric tube help in maintaining the electrolyte balance.
Foods to be included and avoided are presented in List.
List : Foods that can be included and avoided in Infective Hepatitis
Foods to be included :
Cereal porridge, soft chapathis, bread, rice, skimmed milk, potato, yam, fruit, fruit juices, sugar, honey, soft biscuits, custards without butter, and cream.
Foods to be avoided :Pulses, beans, meat, fish, chicken, egg, sweets with ghee, butter or oil, bakery products, dried nuts and fruits, alcoholic preparation, whole milk and cream.
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