Diet

Watch Jill Johnson, Specialist Dietitian (Liver Unit) talk about PSC: Eating for Health at the 2016 PSC Support patient meeting at QEH, Birmingham.

 

Does PSC affect the absorption of vitamins, and should we take vitamin supplements?

Roger Chapman at the 2011 Oxford PSC Support Meeting answered: “The Mayo clinic finds that both male and female patients display osteoporosis and osteopenia.  This is diagnosed with a Dexa bone density scan, which we should be recommending on a more regular basis. 

Calcium and vitamin D3 is prescribed, it must be vitamin D3, not just vitamin D.  Vitamins A & K should only be prescribed if the patient is severely ill, and has been jaundiced for some considerable time.”

Weincke and Boberg (2011) say dietary supplementation with calcium and vitamin D should be considered in all patients with cholestatic liver disease although this advice is not evidence-based.

Fat soluble vitamin replacement is recommended in patients with jaundice. (Chapman, 2011)

There is no specific diet recommended for PSC patients other than to eat a balanced healthy diet. In general you should make reductions in your consumption of fat, salt and alcohol.

Around 70% of PSCers also have Inflammatory Bowel Disease. If so, you must follow the dietary advice given to you for that disease.  Some patients experience heartburn, usually caused by acid backing up from the stomach. Long gaps between meals will exacerbate this. Make sure you eat small quantities often. Remember your longest gap between food is through the night and you may find it helpful to have a small evening snack.

Ensure that you do not become dehydrated; drink sufficient water throughout the day.

Only use the dietician or nutritionist recommended by your hospital: you must receive dietary advice from a professional who has a clear understanding of PSC.

Reviewed  25 May 2017

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References

Chapman, 2011. Primary sclerosing cholangitis. Medicine (Autoimmune Liver Disease) 39:10
Wiencke and Boberg, 2011. Current consensus on the management of primary sclerosing cholangitis. Clinics and Research in Hepatology and Gastroenterology 35:786-791

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