Tag Archives: SALT
Top Five Symptoms of Hepatic Encephalopathy

Top Five Symptoms of Hepatic Encephalopathy

Hepatic Encephalopathy

Hepatic Encephalopathy

Hepatic encephalopathy, seen in advanced liver disease and cirrhosis, results in a number of neuro-psychiatric symptoms, that cover a wide spectrum of manifestations. Being aware of the clinical presentations are important for both the patient and their caretaker, as well as healthcare professionals involved in their care. These include:

 

 

  1. Personality changes.
  2. Changes in sleep-wake cycles, associated with excessive daytime somnolence and nighttime insomnia.
  3. Disorientation to person, place and time.
  4. Development of inappropriate behavior, associated with confusion.
  5. Coma.

Individuals with hepatic encephalopathy have serious live problems, and should be considered for liver transplant evaluation.  All of us at Liver Specialists of Texas are experienced to care for these complex patient needs.

 

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AASLD Liver Meeting 2015

AASLD Liver Meeting 2015

LiverMtg-logo

 

 

For the next several days, liver disease experts from around the world will be in San Francisco learning and sharing the latest developments in liver disease at the annual Liver Meeting.

Today, the one-day postgraduate course covered common clinical conditions, including non-alcoholic fatty liver disease, hepatitis C, liver cancer/hepatocellular carcinoma, and complications of cirrhosis, including volume overload/ascites, malnutrition, and hepatic encephalopathy.

More updates will be posted through the meeting.

Dr. Joe Galati

Liver Meeting 2015

 

 

 

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New Hepatitis C Cure FDA Approved: Daclatasvir for Genotype 3 Patients

This past week, the FDA gave approval to Bristol-Myers Squibb and their first drug in the hepatitis C market. Daclatasvir was given FDA approval for patients with the genotype 3 variety of chronic hepatitis C. Daclatasvir, commercially available as Daklinza, is approved to be taken with previously approved sofosbuvir (Sovaldi)-manufactured by Gilead-in this two-drug combination. Of note, Ribavirin nor interferon are required in the combination.

Published cure rates, also know as sustained virologic response (SVR) range from 86-90%. If you are non-cirrhotic, and naive to therapy, one can expect a 96% SVR. Unfortunately, prior treatment failures with past combinations, plus the presence of cirrhosis, carries a poor response rate of 63% in this most difficult group of patients.

For more information on hepatitis C and current therapies available, visit our website at Liver Specialists of Texas .

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Liver Transplant Houston: Is There a Special Diet to Follow?

A common question I am asked daily is in regard to “what kind of diet do I need to be on while waiting for my liver transplant?”. There is a great deal of misunderstanding surrounding this, that it deserves a few simple comments.

The simple answer is that there is no special diet you have to follow if you have cirrhosis. The central area of concern is dietary sodium or salt. The goal is to have a reduced salt diet, in the neighborhood of 1,500-2,000 mg per day. This is a very restrictive diet compared to the standard American diet (aka SAD). The SAD may include well over 6,000 mg per day. Too much!

The simplest way to achieve such a restricted diet is to eliminate all processes foods, avoid all foods in a can, bag, or box. If it has more than 5 ingredients on the label, keep away.

Salt is the enemy to anyone with chronic liver disease and cirrhosis. The body’s handling of salt and sodium are malfunctioning, resulting in fluid retention, edema, and the development of ascites. In many circumstances, diuretics (water pills) need to be used to remove the excess salt and fluid from the body.

All of our patients need to consume fresh fruits and vegetables, lean fresh meat and fish, and foods found in their natural state. This may be an overwhelming challenge to those accustomed to eating out and or consuming large quantities of processed foods. It is impossible to meet this less than 2,000 mg salt intake by eating out.

I highlight numerous tips from
past entries that will help you with this mission. Read labels, stop eating out, and eat foods found in their natural state.

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Thirty-One Days of Wellness: A Recap of the Month

During the month of January, Chuck Garcia and I posted 31 entries to reflect a broad range of topics related to health and wellness – topics that you can review for the entire year. To make them easily accessible, I have re-posted them on a single blog entry. Enjoy them again, and share them with your friends and family.

Day 1
A New Year, a New You

Day 2
Eating Salad for Breakfast

Day 3
Navigating the Grocery Store: Inner vs Outer Isles

Day 4
Foods Never to Eat 

Day 5
Foods Healing Power

Day 6
The Low Down on Wheat

Day 7
Gym Rules 

Day 8
Charles Barkley and Weight Watchers 

Day 9
Blueberries: A Superfood to Love

Day 10
Benefits of Coconuts 

Day 11
It’s Not Nice to Fool Mother Nature

Day 12
Adding Eggplant to Your Diet

Day 13
Wondering About WonderBread 

Day 14
How Bad is Read Meat: Dr. Galati and Matt Patrick KTRH Radio 

Day 15
The Value of Cross-Training

Day 16
MLK Holiday: Off

Day17
Talking Health and Wellness

Day 18
Ultimate Abdominal Exercise 

Day 19
Zucchini: Another Food to Love

Day 20
Beach Body 10-Minute Trainer

Day 21
Exuberant Animal 

Day 22
Dan Campolieta: Number 1 Meal: Breakfast

Day 23
Salad Dressing: Olive Oil and Vinegar 

Day 24
Beets: Good Nutrition

Day 25
Cuisinart Hand Mixer

Day 26
Health Benefits of Boxing

Day 27
Strength Training: Benefits of Lifting Heavy Things 

Day 28
Frozen Fruits and Vegetables: Dr. Galati Explains

Day 29
Paleo Playground: Chuck Garcia Explains

Day 30
Paleo Playground: Part 2

Day 31
Healthy Recommendations and Books We Like

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Low Salt Diets: More Education Needed

Low Salt Diets: More Education Needed

A delightful new patient was seen in the office today with the diagnosis of non-alcoholic fatty liver disease that unfortunately had progressed to cirrhosis.  She was accompanied by her sister. They we both obese, on the borderline of morbid obesity. The cornerstone of treatment is to get her weight under control, and I estimated that she would have to lose approximately 75 pounds to get anywhere near a reasonable, safe body weight.  We discussed several strategies, but the one point that stood out is that she was consuming massive amounts of dietary sodium (salt). Here diet was a parade of processed, nutrient stripped foods, loaded with enough salt for a week. These were the foods she regularly consumed:

Sodium per serving

Frozen dinners:   800 mg
Commercial vegetable juice:    650 mg
Canned corn: 610 mg
Packaged deli meats:     605 mg
Canned soups:    1025 mg
Chinese food:    3500 mg

Adding it all up, she was consuming well over 7,000 mg of sodium daily. Remember, patients with cirrhosis should shoot for 1800-2000 mg/day. On physical examination, she had well over 30 pounds of fluid hanging on her body.

The lesson once again is to be aware of the foods that are high in sodium.  You must read labels on the food you consume. The public needs to be re-educated on low salt diets. Parents with children equally need to be aware of this fact. It is impossible to maintain a low salt diet if you eat out on a regular basis. If for health reasons (heart failure, liver disease, kidney disease) you must be on a low salt diet, eating out has to be a thing of the past. It will save you money, and the the grief of being scolded by your physician.

Remember: CUT THE SALT!

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More Bad News on Dietary Sodium

More Bad News on Dietary Sodium

A day does not go by on the radio or in the office that I am sitting with a patient discussing the health hazards of dietary salt (a.k.a. sodium).  I believe that this is one of the greatest threats to our health, in addition to excessive intake of calories and obesity. This past week in the New England Journal of Medicine, Dr. Lawrence J. Appel commented on a new study looking to reduce dietary sodium.

Health care reform is front and center on the U.S. political agenda. Actively debated are fundamental changes to the health care delivery system, which largely focuses on the diagnosis and treatment of existing disease. Prevention of disease, commonly accomplished through public health interventions, appears to be an afterthought, perhaps because the benefits are mistakenly perceived as small and the cost savings delayed.

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