Liver disease due to parenteral and enteral nutrition.
Liver disease due to parenteral and enteral nutrition is a well-recognized iatrogenic phenomenon, but its cause and pathogenesis have not been clearly elucidated. Various mechanisms have been postulated, but it is likely that the cause is multifactorial with significant interplay among several factors. A preventive approach to management is ideal but awaits a more complete understanding of the pathophysiology. A variety of management strategies has been proposed in small case series, but level 1 evidence-based guidelines have yet to be established. Although an abundance of both clinical and animal studies exist regarding liver disease associated with parenteral nutrition (PN), there is a paucity of data regarding enteral nutrition (EN)-associated hepatic disease. The latter probably reflects differences in the frequency and severity of PN- versus EN-associated liver disease. This article addresses the two routes of nutritional support individually, with the major focus on PN-associated liver disease.
Department of Gastroenterology and Hepatology, Westmead Hospital, Hawkesbury Road, Westmead, Sydney, NSW 2145, Australia.
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Kwan
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George
D004750:Enteral Nutrition / Q000009:adverse effects*; D006801:Humans; D008107:Liver Diseases / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D009752:Nutritional Status; D010288:Parenteral Nutrition / Q000009:adverse effects*; D012307:Risk Factors