In hepatic encephalopathy, which dietary modification is indicated?

• A. Increase protein intake
• B. Restrict protein intake
• C. No protein change
• D. Protein supplementation

Answer: (B)

During hepatic encephalopathy the goal of diet is to lower ammonia production. Protein breakdown creates ammonia, and a damaged liver cannot efficiently convert this ammonia to urea, allowing it to accumulate and affect brain function. By restricting dietary protein, you reduce the nitrogen load the liver must handle, helping to lessen encephalopathy symptoms. It's important to maintain adequate calories to prevent catabolism and malnutrition, and branched-chain amino acids may be considered if longer-term protein restriction is needed. Increasing protein would raise ammonia production and worsen the condition, while no dietary change or protein supplementation would not address the problem. Therefore, restricting protein intake is indicated.