Chronic hepatic encephalopathy. Long-term therapy with a branched-chain amino-acid-enriched elemental diet

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Abstract
Therapy of chronic hepatic encephalopathy is often frustrating, limited by the ability to nourish patients adequately. Protein is needed for repair, but such patients are intolerant of protein. Previous work suggested that the distorted plasma amino acid pattern may be causally related to hepatic encephalopathy. A well-studied, long-term patient received therapy with a branched-chain amino-acid-enriched elemental diet that enabled adequate nutrition with protein and resulted in improvement in hepatic function and reversal of some aspects of hepatic encephalopathy that had been deemed irreversible. Branched-chain-enriched amino acid diets previously successful in the i.v. mode may be successfully used in chronic long-term support of patients with protein intolerance, with hepatic function improvement secondary to nutrition improvement.

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