What is the treatment for PN associated liver disease?
The standard treatment for PN associated liver disease to reduce the dextrose and lipid calories given parenterally and to encourage oral or provide enteral nutrition. The benefits of oral or enteral nutrition may be independent of a patient’s ability to absorb nutrients in the gut. In parenteral nutrition, infused nutrients go first to the heart, then to the kidneys, and last of all to the liver. This is just the reverse of a normal metabolic sequence in which the liver is first in line after the digestive tract. Although the effects of the “reversed metabolism” of intravenous nutrition are understood poorly, there is no question whatsoever that oral and enteral nutrition promote the health of the liver. A second course of treatment commonly employed involves nutrient supplementation. It is widely suspected that the parenterally nourished liver is deficient in one or another of numerous nutrients that are critical to normal liver function. Choline, carnitine, taurine, vitamin E and gl
