Dietary Dos and Don'ts for Patients with Advanced Cirrhosis and Liver Cancer

When cirrhosis or liver cancer (including primary liver cancer and secondary hepatic metastatic tumors) reaches an advanced stage, portal hypertension and hepatic decompensation are usually present, and the liver can no longer meet the body's basic metabolic needs. Moreover, because cirrhosis or a liver tumor can compress the hepatic portal vein and obstruct portal venous return, the portal venous blood must find other pathways to form a collateral circulation and then return through the superior and inferior vena cava systems. As blood flow increases, these collateral channels become enlarged and tortuous, forming varices, which leads to a series of problems. Therefore, patients with advanced cirrhosis and liver cancer should choose foods that are easy to digest and relatively soft.

Such patients should avoid hard, rough foods, such as fried dough sticks, nuts, and hard biscuits. Because portal venous blood enters the esophageal venous plexus through the left gastric vein, eating rough, hard food can rupture the esophageal venous plexus and cause hematemesis. Moreover, the volume of hematemesis is very large; after the esophageal venous plexus ruptures, the patient may, as the ancients recorded, "vomit blood filling a basin"—enough blood to fill a washbasin—and the consequences are extremely severe.

Patients should also not eat too much high-protein food. After hepatic decompensation, excessive high-protein food cannot be digested normally and will produce a large amount of ammonia in the body, sharply raising the patient's blood ammonia level. This not only causes abdominal distension but also leads to hepatic encephalopathy. Once a patient enters a state of hepatic encephalopathy, the prognosis is very poor; among the hepatic encephalopathy patients I have seen, almost none survived beyond 72 hours.

Patients should eat more vegetables and fruits to ensure normal bowel movements. Constipation is a high-risk factor for patients with portal hypertension: their portal venous blood also enters the rectal venous plexus through the inferior mesenteric vein, leaving the rectal venous plexus in a varicose state. Constipation can trigger rupture of the already varicose rectal venous plexus, causing hematochezia.

In addition, spicy, greasy, and pickled foods should also be avoided. These foods will also aggravate the patient's symptoms, increase suffering, and shorten life.

Whether in TCM or Western medicine, patients of this kind are asked to avoid certain foods during treatment. But family members often feel that such patients are weak and need tonifying, and they give wrong dietary support; the result is that good intentions backfire and make the patient's condition progressively worse.