• The liver has many roles within the body. One role is to store and release glycogen, a chemical which is used to provide energy. In chronic liver disorders, the ability to store and release glycogen (i.e. energy) decreases. Therefore, the body must use other energy sources such as protein (e.g. muscle) and fat stores.

Chronic liver disease is a disease process of the liver that involves progressive destruction and regeneration of the liver parenchyma leading to fibrosis and cirrhosis. Chronic liver disease refers to disease of the liver which lasts over a period of six months. 

Protein energy malnutrition is observed in chronic liver diseases due to muscle and body fat loss.   In addition, there is a decreased concentration of Branched Chain Amino Acids (BCAA) in the body. Protein Energy malnutrition is associated with a number of complications and increased surgical morbidity and mortality, reduced survival, and worsening hepatic function. Patients with cirrhosis (particularly those with advanced disease) may also have micronutrient deficiencies. Recognition of macro- and micronutrient deficiencies is important since supplemental nutrition has been associated with a reduction in the risk of infection and in-hospital mortality and improved liver function parameters.

Chronic Liver disease includes the following conditions:

• Cirrhosis, or scarring of the liver

• Inflammation (hepatitis) from infectious (hepatitis B, hepatitis C) or non-infectious causes (chemical or autoimmune hepatitis)

• Tumours, benign and malignant (liver cancer)

• Metabolic disorders