Cirrhosis of the Liver and SodiumSodium is a mineral that the body requires to maintain precise water balance. Sodium occurs in nature only in combination with chloride another mineral (sodium chloride or salt). The body requires only about 50 to 400 mg of sodium per day. Yet, the average American consumes about twenty -five -to- thirty -five times that amount! While this over- consumption of salt is not necessarily dangerous for most healthy individuals, it can create problems for someone with advanced liver disease.Cirrhosis may lead to ascites (an abnormal accumulation of fluid in the abdomen). If not treated in a timely manner, this ascitic fluid may become infected, a condition known as subacute bacterial peritonitis or SBP. Patients with ascites must be placed on a severely salt-restricted diet. For every gram of sodium consumed, the accumulation of 200 milliliters of fluid results. The lower the consumption of sodium in the diet, the better controlled this excessive fluid accumulation is. For people with ascites, sodium intake should be restricted to under 1,000 milligrams(mg) each day, and preferably under 500 mg. This goal is difficult, yet attainable. Remember - the lower the salt content in the diet, the better the fluid accumulation will be controlled and the less need there will be for water pills (diuretics). Strive to avoid the vicious cycle of eating foods high in sodium content, leading to worsening of ascitic fluid accumulation, leading to increasing dosages of diuretics, or, even worse, to having the fluid drained with a needle (paracentesis) . Wouldn’t it be easier to refrain from excessive salt consumption in the first place? In order to successfully adhere to a salt-restricted diet, it is important to become a knowledgeable food shopper and must diligently read all food labels. People are often surprised to discover which foods are high in sodium content (see table below for the sodium contents of some common foods). General guidelines are as follows : the amount of sodium in fresh foods is significantly less than that in the same foods after they have been processed, cured, canned or frozen; therefore, one should choose fresh foods whenever possible. Table salt and salt used for cooking should be totally eliminated from the diet. One teaspoon of table salt contains 2,325 mg of sodium! All canned foods and fast food restaurants should be avoided. Some over- the- counter medications have high sodium contents. For example, one tablet of Rolaids contains 53 mg of sodium, 2 tablets of Alka-Seltzer contains 567 mg of sodium, and one serving of Bromo-Seltzer contains 717 mg of sodium. These medications should be substituted with ones having a lower sodium content. If the label on a medication or other product does not clearly state the sodium content, a pharmacist should be able to supply such information or offer a way to obtain it. Meats, especially red meats, have a high sodium content. Consequently, adherence to a vegetarian diet may become necessary for individuals who develop severe ascites. Spices such as basil, dill pepper, and vinegar, to name a few, may be used in place of salt to season one’s food. Salt substitutes containing potassium chloride should be avoided. These substitutes tend to raise potassium levels in the body. This can be especially dangerous to people taking spironolactone (Aldactone), a potassium-sparing water pill (diuretic) used in the management of ascites. We are fortunate that in this day and age there are many foods on the market which have been specifically manufactured as low sodium products. Furthermore, as of 1986, the FDA has required the sodium content of all processed foods to be listed on the package label. This regulation has been a boon to the consumer. People with liver disease without ascites, are advised to refrain from excessive salt intake, although they need not limit their consumption as severely. liverdisease.com |