[Medical Q&A] Can patients with cirrhosis not eat hard foods?

Planner: Chinese Medical Association

Reviewer: Ye Qing, Chief Physician, Tianjin Third Central Hospital

It is not recommended for patients with cirrhosis to eat hard or angular foods such as walnuts, pine nuts, and fried steamed bread slices. A very important reason for this is esophageal and gastric varices.

Cirrhosis is a chronic liver disease characterized by the replacement of normal liver tissue with scar tissue. This structural change can lead to obstruction of blood flow inside the liver, which in turn increases the pressure of the portal vein (the main blood vessel that transports blood from the intestines and spleen to the liver), gradually forming portal hypertension. In order to overcome the state of portal hypertension, the blood will seek other pathways (the so-called collateral circulation). For example, the veins of the esophagus and the fundus of the stomach will be forced to expand, gradually forming varicose veins. The walls of the varicose veins will become very thin and very easy to rupture and bleed. In addition, patients with cirrhosis often have thrombocytopenia, which will affect the coagulation function and increase the risk of bleeding. After the rupture of varicose veins, patients will experience vomiting blood and black stools, and heavy bleeding can lead to shock. If you eat hard or angular food, it is very likely that the thin wall of the varicose vein will be scratched, causing heavy bleeding. Therefore, if patients with cirrhosis already have severe esophageal and gastric varices, it is not recommended to eat such food. Of course, to determine whether patients with cirrhosis have esophageal and gastric varices, gastroscopy and other methods are also needed.