Nutrition & Rehabilitation Support

Liver disease changes how the body uses food and energy. Patients may carry excess fat in the liver, or they may become malnourished and lose muscle even when they look well. Weakness, frailty and poor nutrition increase infections, hospital stays and complications, and they lower the chances of recovering from surgery or transplant. Our Nutrition & Rehabilitation Support service treats nutrition and strength as core parts of care.

Nutritional Assessment

Every patient is assessed by a clinical dietitian, using:

• Detailed diet history and food habits, including cultural and religious preferences
• Height, weight, BMI and body composition where available
• Muscle strength tests, such as handgrip strength
• Screening tools for malnutrition and frailty
• Blood tests for albumin, vitamins, minerals and electrolytes
• Assessment of appetite, swallowing, gut symptoms and medications
• Review of associated conditions such as diabetes, kidney disease and obesity

Personalised Diet Plans

Fatty liver disease

• Gradual weight loss, balanced portions and reduced sugar and refined carbohydrates
• Mediterranean-style eating using familiar Indian ingredients
• Guidance on physical activity and diabetes control

Cirrhosis

• Adequate calories and protein to prevent muscle loss, without unnecessary protein restriction
• Small frequent meals with a late-evening snack
• Sodium restriction for ascites, with practical low-salt cooking tips
• Safe food practices to lower infection risk

Hepatitis, autoimmune and cholestatic disease

• Tailored plans, with fat-soluble vitamin, calcium and vitamin D support when needed

Metabolic conditions

• Diet guidance for Wilson disease and hemochromatosis, together with medical treatment

Before and after surgery or transplant

• Nutritional optimisation before surgery
• Early feeding after surgery
• Food safety and weight management after transplant

Nutritional Support Options

• Oral nutrition supplements: Energy and protein drinks or powders when food alone is not enough
• Enteral (tube) feeding: For patients unable to eat adequately, in the ward or ICU, with training for caregivers when continued at home
• Parenteral nutrition: In selected cases when the gut cannot be used
• Micronutrient correction: Zinc, vitamin D, B vitamins and others, based on tests
• Management of diabetes and electrolytes alongside diet

Physiotherapy and Physical Rehabilitation

Frailty and sarcopenia are common in advanced liver disease. Physiotherapists provide:

• Prehabilitation: Strength, endurance and breathing exercises before surgery or transplant
• ICU rehabilitation: Early mobilisation, passive movements and positioning to prevent stiffness and clots
• Post-surgical recovery: Breathing exercises, walking programmes and core strengthening
• Home exercise plans: Simple, safe routines using body weight, resistance bands and walking
• Balance and fall prevention: Especially for older or weak patients
• Guidance for patients with varices or ascites: Safe exercise modifications

Swallowing, Speech and Occupational Therapy

Patients recovering from ICU stay or encephalopathy may face swallowing difficulty, speech changes or trouble with daily tasks. Speech and occupational therapists assess and support recovery, helping patients regain independence.

Psychological and Emotional Support

Living with liver disease can bring anxiety, low mood, fear and stress. Our counsellors offer:

• Individual and family counselling
• Support during long waits for transplant
• Coping strategies for chronic illness
• Alcohol-cessation counselling and relapse prevention, with referral for medical treatment when needed
• Support groups and peer connections
• Guidance for caregivers to manage stress and fatigue

Education Programmes

Patients and families learn through:

• One-to-one dietitian sessions
• Cooking demonstrations and practical tips for low-salt, high-protein meals
• Group workshops on fatty liver, cirrhosis and transplant recovery
• Written and visual material in simple language
• Guidance on reading food labels and avoiding misleading "detox" products

Rehabilitation in the Transplant Journey

• Before transplant: Building strength and nutritional reserves improves surgical outcomes.
• After transplant: Early walking, breathing exercises, protein-rich diet and gradual increase in activity help recovery.
• Long term: Weight management, cardiovascular health and bone strengthening reduce late complications.

Special Groups

• Children: Growth monitoring, age-appropriate feeding plans and school-friendly meal advice
• Elderly patients: Attention to appetite, swallowing, muscle mass and polypharmacy
• Patients with diabetes or kidney disease: Coordinated dietary adjustments
• Vegetarian and vegan patients: Plans to meet protein needs from pulses, dairy, soy and other sources

Working With the Treating Team

Nutrition and rehabilitation plans are coordinated with hepatologists, surgeons, intensivists and nurses. Progress is reviewed regularly, and plans change as the condition improves or worsens. Regular follow-ups help track weight, strength and lab markers.

Practical Support at Home

Families receive checklists, sample menus, shopping lists and emergency contacts. Teleconsultations and follow-up calls help patients who live far from the hospital. Patients are encouraged to report sudden weight change, loss of appetite, vomiting, diarrhoea or new weakness early.

Begin Your Nutrition and Rehabilitation Plan

Whether you have fatty liver, cirrhosis, are preparing for transplant or recovering from surgery, the right nutrition and rehabilitation can strengthen your recovery. Contact LiverMitra to consult our dietitians and physiotherapists.