SUMMARY
Functions of Liver.—To transform fuel foods into available energy; to detoxify those poisonous substances produced as the result of metabolism of body tissue or brought in in food, and to select those available for use; to secrete bile.
Factors Influencing Disorder of Liver.—Errors in diet: (a) overeating; (b) excessive drinking; and (c) unbalanced diet, especially as regards the amount of fats and carbohydrates in the diet.
The Bowels, in most of the disturbances affecting the liver, become constipated, thus causing much additional work on the part of the liver in handling the products produced as the result of putrefactive bacteria upon the accumulated mass in the colon.
Tissue Changes in the liver have been caused by the taking of alcohol, which should therefore be avoided by all individuals having any disease involving the liver and by those with a predisposition to liver disturbances.
Exercise and Lack of Exercise are potent factors in the treatment of conditions involving the liver. First, because the liver requires exercise to enable it to empty itself more completely and assure a free flow of bile; second, because exercise directly affects the energy output of the body, causing an increased rate of metabolism and a better utilization of the food ingested. Lack of exercise acts in exactly the opposite direction, and it has been found that with the majority of patients suffering from diseases of the liver too little exercise and too much food are at the bottom of the trouble.
Dietetic Treatment in the majority of diseases affecting the liver is much the same. The keynote in each is a balanced diet. Constant overeating and excessive drinking have proved the foundation of the majority of such diseases, especially of the bilious type, while an excess of fat and carbohydrates in the diet lead to the more serious disorders.
Biliousness requires abstinence from food for a short period and a cleansing of the entire gastro-intestinal tract, the measures being directed by the physician. After the bilious symptoms have subsided, a simple, well-regulated diet should be established, in which no rich foods of any sort are allowed. All condiments and spices which have an astringent effect upon the bowels are strictly prohibited, and alcoholic beverages had best be eliminated from the diet.
Cirrhosis of the liver is apt to be insidious in its development, taking a firm hold before the character of the disorder is discovered. Dietetic treatment of this disturbance is most important and should be directed toward overcoming not only the liver symptoms but other symptoms as well.
Gastro-intestinal Disturbances, manifested in cirrhosis of the liver, are treated by the diet used in chronic gastritis (see p. [250]).
Heart Symptoms sometimes occur during the course of the disease and require especial attention to the diet. The fluids at times must be restricted, in which case a modification of the Karell Cure will prove valuable (see p. [342]).
Kidney Complications develop in a certain percentage of cases, and it then becomes necessary to institute one of the various diets devised to meet the needs of those special conditions (see Chapter [XVIII]).
Restricting the Diet will be found to be necessary for those individuals showing a tendency to cirrhosis, also for those in whose family diseases of the liver are of frequent occurrence. Such individuals should be warned of the dangers arising from overindulgence in food or alcoholic beverages.
Prohibited Foods are those which by reason of their astringent qualities favor the development of constipation, such as condiments and spices; those foods which exert a stimulating and irritating effect upon the liver and bile passages, such as alcohol, malt extractives, etc.; and fats and carbohydrates in excessive quantities, on account of the extra amount of work required of the liver in order to make them available in the body.
Gallstones develop as the result of inflammation or clogging of the bile passages.
Treatment is dietetic in character and is directed toward relieving or preventing inflammation in the bile passages, also in stimulating the flow of bile in order that it may not become sluggish and thus give rise to the development of the gallstones.
The Fats, therefore must be restricted in the diet, as they, more than any of the other food constituents, favor the above conditions.
Peristalsis in the intestinal tract must be stimulated to facilitate a free flow of bile, which will not occur where the movements are sluggish. Stasis of the bile must be prevented or stones will be apt to form.
Dietetic Treatment for gallstones is therefore directed to increase the flow of bile and to avoid the inflammation of the gall bladder and bile passages which may result from the product of intestinal putrefaction.
The Diet consists of foods simple in character, low in fats, but abundant in quantity, in order to prevent constipation. It must be selected carefully that digestional disturbances may not develop.
The Meals should be frequent, from four to six a day, in order to encourage a free flow of bile.
Breakfast should be ample in order that the bile secreted and accumulated during the night may be utilized as soon as possible.
Constipation must be avoided, and the foods particularly adapted to prevent or overcome this condition should have a prominent place in the diet. Any accumulation of unabsorbed food in the lower intestines becomes a breeding ground for putrefactive bacteria, the product of whose activity imposes a serious tax upon an already overworked organ.