Dietary taboos for cholestasis

Strictly reduce the intake of fat, especially saturated fat, and cholesterol, and avoid high-sugar, alcohol, and irritating foods that will increase the metabolic burden on the liver. Hard, flatulent foods that are intolerable to individuals should also be avoided as needed.

Don’t think this is a cliche. Last year, I met a 34-year-old young man with cholestasis caused by drug-induced liver injury. When he was discharged from the hospital, his indicators were basically normal. He felt that he was young and recovered quickly. On the day he returned home, he ate braised pork sausage stewed by his mother. He curled up on the sofa in pain three hours after eating. When he was sent to the emergency room, his total bilirubin soared to more than three times the normal upper limit. He stayed in the hospital for another week before he stabilized.

Many people think that they only need to avoid fatty meat, but this is not the case. The invisible saturated fat and trans fat hidden in braised vegetables, braised vegetables, crispy snacks, and milk tea milk caps are even more lethal to patients with cholestasis than the obvious fat meat. Regarding the intake of high-cholesterol foods, there are currently two clinical opinions: the conservative advice of traditional gastroenterology is to completely prohibit high-cholesterol foods such as animal offal, crab roe, fish roe, and squid, and do not touch even one bite. ； However, in recent years, more and more clinical nutrition experts will make adjustments based on the actual situation of the patient - if the patient is in the compensatory stage of stable disease, does not have hyperlipidemia, and has nutritional problems such as iron deficiency and zinc deficiency, he can occasionally eat about half a tael (25g) of braised chicken livers and fried chicken gizzards.

Many people avoid meat dishes and only eat highly processed snacks and milk tea, thinking that vegetarian food is fine. This is completely a misunderstanding. A high-sugar diet will increase the metabolic burden on the liver and promote fat synthesis. On the contrary, it will increase the concentration of cholesterol in bile and aggravate stasis. Last month, there was an aunt who was afraid of eating oil, so she ate white porridge with pickles every day, plus a few steamed cakes bought in the supermarket. When she was rechecked, the index did not drop but rose instead. This was because the steamed cakes added a lot of non-dairy creamer and white sugar, and the high salt content of the pickles also increased the metabolic burden on the liver.

Another point that people often argue about is whether patients with cholestasis should eat more crude fiber? If you are a patient with a mild condition and no varicose veins problem, eating high-fiber foods such as soft spinach, pumpkin, and boiled carrots can indeed promote intestinal peristalsis and reduce the reabsorption of bile acids, which is good for recovery. ； However, if you have progressed to the decompensated stage of liver cirrhosis and have esophageal and gastric varices, you must eat less or even nothing of hard crude fibers such as celery and leeks, as well as dragon fruit and kiwi fruit with hard seeds. Otherwise, it is easy to scratch fragile veins and cause gastrointestinal bleeding, which is not worth the gain.

There are a few things that you should never touch regardless of the severity of your illness or whether you have symptoms. The first one is alcohol. Whether it is liquor, beer, red wine, or alcohol-containing glutinous rice, drunk shrimps and crabs. As long as it contains alcohol, it will directly damage liver cells and aggravate cholestasis. There is no saying that "it's okay to drink a small amount". There are also things that are clearly hepatotoxic, such as moldy food, health products with unknown ingredients, raw fish gallbladder in folk prescriptions, and polygonum multiflorum, so don’t touch them.

When I educate patients, I usually teach them a very simple criterion: every time you add a new food, take one or two bites first and observe it for 48 hours. If there is no pain in the upper right abdomen, nausea, or itchy skin, you can eat a little more next time. If you feel uncomfortable after eating it, stop it first, no matter how nutritious others say it is. After all, everyone's tolerance level is really different, so there is no need to forcefully eat it.

Of course, it must be made clear that diet is only a part of auxiliary conditioning and cannot replace regular drug treatment. Taking medicine on time, regular review of liver function and liver and gallbladder ultrasound are the core of disease control. Eat more snacks, you can avoid a lot of suffering and recover faster.