title: Supplement improves nutrition and stresses caused by examination-associated fasting in patients with liver cirrhosis.
abstract: OBJECTIVE
  Cirrhotic patients tend to develop malnutrition by fasting, yet the importance of nutritional care during examination-associated fasting has not been investigated. This study aimed to examine the effects of a nutritional supplement on nutrition and stresses caused by examination-associated fasting in cirrhotic patients.
  
  
  METHODS
  Twenty-nine cirrhotic patients were enrolled in this study. No energy was supplied to patients in the fasting group (n = 11) prior to computed tomography or magnetic resonance imaging examination. A supplement of 200 kcal was given to the patients in the supplement group (n = 18) prior to computed tomography or magnetic resonance imaging examination. The effect of the supplement on stresses was evaluated by self-rating questionnaire. Changes in biochemical parameters were also investigated before and after computed tomography or magnetic resonance imaging examinations.
  
  
  RESULTS
  There were no significant differences in age, sex, body mass index, or liver function tests between the two groups at the start of the study. In the supplement group, stress scores for physical symptoms (thirst and light-headedness) and mental symptoms (hunger, hypodynamia and fatigue) were significantly lower compared to those in the fasting group. Also in the supplement group, peripheral 3-hydroxybutyric acid and free fatty acids levels were significantly decreased compared to those in the fasting group, to within normal ranges. In addition, a decrease in prothrombin time was significantly inhibited by intake of the supplement.
  
  
  CONCLUSIONS
  We demonstrated that a nutritional supplement improved nutrition and reduced both the physical and mental stresses associated with examination-associated fasting in cirrhotic patients.
authors.affiliation: Department of Digestive Disease Information & Research, Kurume School of Medicine, Kurume, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Eitaro
authors.initials: E
authors.lastname: Taniguchi
authors.forename: Minoru
authors.initials: M
authors.lastname: Itou
authors.forename: Michiko
authors.initials: M
authors.lastname: Mutou
authors.forename: Ryoko
authors.initials: R
authors.lastname: Ibi
authors.forename: Satomi
authors.initials: S
authors.lastname: Shiraishi
authors.forename: Teruyo
authors.initials: T
authors.lastname: Okada
authors.forename: Yuki
authors.initials: Y
authors.lastname: Uchida
authors.forename: Momoka
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authors.lastname: Otsuka
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Tonan
authors.forename: Kiminori
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authors.lastname: Fujimoto
authors.forename: Tetsuharu
authors.initials: T
authors.lastname: Oriishi
authors.forename: Suiko
authors.initials: S
authors.lastname: Tanaka
authors.forename: Machiko
authors.initials: M
authors.lastname: Takakura
authors.forename: Michio
authors.initials: M
authors.lastname: Sata