Dear Dr. Mohamed Ahmed,

It is vitally important that patients with liver disease maintain a balanced diet, one which ensures adequate calories, carbohydrates, fats and proteins. Such a diet will aid the liver in the regeneration of liver cells. Nutrition that supports this regeneration is a means of treatment of some liver disorders.

Patients with cirrhosis, for example, who are malnourished, require a diet rich in protein and providing 2,000 - 3,000 calories per day to help the liver re-build itself. However, some cirrhotic patients have protein intolerance. Too much protein will result in an increased amount of ammonia in the blood, while too little protein can reduce healing of the liver. Doctors must carefully prescribe a specific amount of protein that will not elevate the blood ammonia. Lactulose and neomycin are two drugs that help keep the ammonia down.

I think that the risk of gallbladder disorders can be reduced by avoiding high fat and cholesterol foods and preventing obesity. The gallbladder is a storage sac for the bile produced by the liver. During digestion, the gallbladder releases bile into the small intestine through the common bile duct. Most gallbladder problems are caused by gallstones and 80-90% of all gallstones are produced from excessive cholesterol which crystallizes and forms stones. By maintaining a well-balanced diet and avoiding high cholesterol intake, the incidence of gallstone formation may be lowered.

Regards,

thanks alot

Dr Nader Aghakhani

Dear Dr,

the second part of my question is the use bee honey for cirrhosis, is there any known amount of bee honey should be taken by patients per day as dietry managment and control of cirrhosis.

with regards

For long time it has been believed that cirrhotic patients should receive low-content protein diets due to the possibility of inducing encephalopathy. Nowadays, It has been demonstrated that cirrhotic should receive normal or higher requirements of protein without problems. This may be beneficial since cirrhosis per se is a cause of protein malnutrition. In addition cirrhotic patients should receive high doses of dietetic fiber in order to induce colonic fermentation of soluble fiber and reduce ammonia absorption, thus avoiding ammonia intoxication. In conclusion compensated cirrhotics should receive low-sodium ( 

I agree with Dr. Diego garcia-compean.

thanks Dr Diego

thanks Dr Nader

appreciation

 My Dear colleague,

About your second question. I recommend this article.I think honey is good for liver and there fore is good for prevention of cirrhosis.

 Regards,

Dr.Aghakhani

World J Gastroenterol. 2008 Jun 21; 14(23): 3729–3732.

Published online 2008 Jun 21. doi: 10.3748/wjg.14.3729

PMCID: PMC2719236

Honey prevents hepatic damage induced by obstruction of the common bile duct

B Imge Erguder, Sibel S Kilicoglu, Mehmet Namuslu, Bulent Kilicoglu, Erdinc Devrim, Kemal Kismet, and Ilker Durak

OK dear

very nice

thanks dear Doctor

my appreciation

Actually, potential beneficial effects of honey bee on prevention of liver damage in humans have never been assessed. Therefore it is premature to say that honey is effective for prevention of liver disease in humans. In fact several years ago it was observed a beneficial effects in experimental model of liver damage by bile duct ligation in rats. It prevented inflammation measured by ALT. Authors discussed that these effects may be due to increase of NO (nitric oxide), an agent with antioxidant properties. Of course extrapolation of these results to humans is not adequate.

I think honeybee merits to be tested in human being for prevention of liver inflammation and fibrosis in well conducted trials. Particularly in non alcoholic fatty liver disease (NAFLD). In my opinion besides the effects of NO, as I already, discussed royalactin may have an important role for prevention of liver damage.

Meanwhile, beneficial effects of honeybee for prevention or reversal of liver damage is only a speculation.

thanks Dr Deogo

I agree with you more research are needed to study the positive effect of honeybee on managment and treatment of liver disease in general and liver cirrhosis in particular

The best strategy for the prevention and/or reversal of liver damage and /or cirrhosis is to identify what are the drivers of the condition and then work to eliminate them. So for hepatitis B and C this involves treating patients with antiviral agents. For alcoholic liver disease this involves ceasing alcohol whilst for fatty liver disease this involves diet and exercise (& possibly bariatric surgery in selected cases).

I agree with Diego with respect to the current status of bee honey.

thanks Dr Verran

That is true the condition must be identified first. However, dietary management should go along with the treatment of liver disorders (e.g. cirrhosis).

Dear Dr.

Honey is an ingredient whose properties help stimulate the body's purification capacity; indeed, honey is one of the most recommended ingredients for those recovering from cirrhosis and to mitigate the effects of a hangover. So if everybody wants to know how to eat if he/she has cirrhosis, an ingredient that cannot be absent from diet is honey.

Regards,

thanks Dr

Nader

thanks Dr. Rodrigo

Dietary requirements in cirrhotics depend on the functional activity of their liver. In compensated liver cirrhosis, regardless the Child-Pugh class, no specific requirements are necessary. In presence of malnutrition or, as occurs more frequently, in presence of sarcopenia, specific adjustments of the calorie and protein intake are necessary. Never, reduce protein intake below 0.8-1g/kg, even in presence of hyperammonemia. As far as honey, patients are welcome to use it if they like it and do not have diabetes.

thanks dear Dr Barone,

I think no one will refuse to take bee honey. In our field of research we all together should think about honeybee as supplementary diet not only but also the other dietary management to be used along with treatment of liver cirrhosis. As you mentioned dear Dr Barone, nutrients should be put in mind these including protein, carbohydrate, and vitmins. Adjustment of these nutrients and the amount that necessary for cirrhotic patients was of great important to help in management. 

Dear Dr. Ahmed ,

As a specialist, why don not analyze honey to understand the basic nutrient in honey that can be used along with treatment of liver cirrhosis?

regards,

Thanks dear Dr Nader, 

That is good,

and to know the basic nutrients that honey contains I will do so, and results will be discussed with you and all other researchers who are interested in this topic

thanks. .

Honey contains antioxidants that reduce on rate of cirrhosis. And it's good source of antinflammatory and antibacterial agents. Therefore, It's a good natural supplement in this situation.