Question

Mr. Collins is a 55-year-old physician’s assistant with a history of chronic hepatitis C. Past history was remarkable for a needle stick injury on the job that occurred two years ago. Following the injury, he initially experienced sporadic episodes of mild flu-like symptoms with fever, chills, and diaphoresis. Over the past six months, his complaints increased to include generalized muscle weakness, fatigue, and weight loss. Mr. Collins is 5’9” tall and weighs 150 pounds with a usual weight of 162. On examination he was noted to have hepatomegaly and be markedly pale with icteric (jaundiced) conjunctiva and skin.

Mr. Collins complains of a poor appetite. He generally eats two meals a day and prefers meat, potatoes, salted snacks, and an occasional beer. He dislikes sweets, and some vegetables and fruits. He states that he often has nausea and feels bloated after eating, but is unable to pass the gas. He feels most comfortable when his stomach is empty.

1. What advice would you give Mr. Collins about drinking alcohol?
2. What general dietary recommendations should be given to Mr. Collins?
3. Suppose Mr. Collins develops steatorrhea. Recommend daily energy (based on his EER; light activity), protein, and total fat intakes for him.

Answer 1

Hepatitis is the inflammation of liver.Mr. Collins is suffering from chronic hepatitis C.Certain foods and drinks must be avoided when a person is having hepatitis such as high fat and dairy products, meat, cookies, cakes, soda and alcohol is one among them.The advice Mr. Collins should get regarding drinking alcohol is

Alcohol damages the liver

Advice him that the liver is already inflamed and drinking alcohol further leads to serious complications.

The general dietary recommendations Collin should get is as recommended below.Actually to say there is no special diet for hepatitis but to have a well balanced diet but definitely there are some restrictions in the dietary pattern.Foods to be taken are

• Lots of fresh fruits and vegetables.
• Skinless chicken, beans, egg whites and fish
• Dairy products which are low in fat
• Healthy fats such as nuts and avocados
• A plate should contain high amounts of carbohydrates and more amount of fluids must be consumed.

Steotorrhoea is the oily stools because of consuming excessive fat diet.This is the most common symptom exhibited in acute and chronic hepatitis.So dietary recommendations in terms of carbohydrates, proteins and fats should be as follows.

Proteins - 60 to 120 gms

Carbohydrates - 3 to 4 ounces

Fats - Only 30% of fats from carbohydrate intake should be consumed.

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