Carbohydrate Metabolism in Chronic Liver Disease

If you have chronic liver disease, a condition known as cirrhosis of the liver in particular, your body is experiencing factors that are likely to contribute to an altered or even impaired digestive process. This, in turn, can lead to impaired processing and absorption of carbohydrates, proteins and lipids (fats) by your liver, which, if not treated, can develop into severe malnutrition.

The Liver and Carbohydrate Metabolism

• Your liver plays an important role in metabolizing the carbohydrates and lipids you eat so that your body can properly use them. It also synthesizes proteins, stores minerals and vitamins, and processes and removes toxins from your system.

  With chronic liver disease, however, scar tissue begins to develop in the liver, replacing normal, healthy liver tissue. This scar tissue gradually diminishes the flow of blood through your liver and disrupts the liver's normal function, particularly in processing and metabolizing carbohydrates, lipids and proteins. As healthy, functioning liver tissue becomes scar tissue, the nutrients, including carbohydrates, are not effectively processed by your liver.

Chronic Liver Disease and Digestive Metabolism

• Because of the growth of scar tissue and other factors, chronic liver disease can lead to an accelerated state of malnutrition, including the absorption of carbohydrates, according to the study "Bile Acid Metabolism in Patients with Cirrhosis" published in the 1971 edition of Gastroenterology by Z.R. Vlahcevic, I. Buhac and J.T. Farrar.

  In addition to scar tissue growth, the study cited other contributory factors to this type of malnutrition, including bile salt deficiency, altered intestinal motility and permeability, bacterial overgrowth in the liver and changes to the gastrointestinal process due to high blood pressure.

Additional Factors

• With chronic liver disease, your intestine absorbs fewer proteins because there is a reduced synthesis of hepatic and urea proteins in your liver and kidneys and you are excreting an increased amount of nitrogen in the urine. Because of this, carbohydrates, in particular, are not properly absorbed, which is then linked to insulin resistance, impaired glucogenesis and reduced glycogen reserves.

  Additional contributory factors to malnutrition include inadequate nutritional intake due to lack of appetite, nausea, gastritis, impaired digestion and absorption of nutrients (all side effects of chronic liver disease), as well as the effects of a necessarily sodium-restricted diet.

Glucose Tolerance Test

• If you have chronic liver disease, your doctor will want to administer a series of glucose tolerance tests to monitor blood sugar levels in your body. A significant decrease in glucose tolerance is often found in patients with hepatitis, liver cirrhosis and chronic liver disease. This decrease in glucose indicates that your liver is not properly metabolizing carbohydrates. It may indicate you need supplemental nutrition.

Dealing with Chronic Liver Disease and Carbohydrate Metabolism

• According to the National Institute of Diabetes and Digestive and Kidney Diseases, liver cirrhosis is the seventh leading cause of death in the U.S. In severe cases, a liver transplant may be the only consideration. But in many cases, additional liver damage can be delayed or even halted with proper nutrition, monitoring and management of liver and cirrhosis complications and avoidance of toxins, such as alcohol and certain drugs, that can no longer be safely processed by the liver.

  Regular glucose tolerance tests are vital in monitoring your carbohydrate metabolism for any decrease. Supplemental nutrition can be of help when carbohydrate, protein and lipid metabolism has decreased.