Liver Disease and the Importance of a Low Sodium Diet


Living with liver disease is not an easy thing to do.

This is especially true when it comes to cirrhosis of the liver.

Cirrhosis is the result of a fatty liver, viral infections, genetic diseases, or alcohol abuse.  And, because your liver is so important to the digestive process, any time your liver is damaged and loses functionality, your health suffers.

The liver plays a major role in breaking down food into different parts for your body to either absorb or eliminate.  This includes all food, drinks, and drugs you ingest.  And, when your liver is plagued with something as serious as cirrhosis, the resulting hardening, shrinking, or scarring of the liver’s tissue force the liver to work harder to perform its normal everyday functions.

There are several things your Baltimore liver surgeon will advise you to do if diagnosed with cirrhosis of the liver, all of which will help improve and maintain your health.  Take a look:

  • Stop drinking alcohol. The less you drink the better, although this does not prevent all types of cirrhosis.
  • Monitor your medications. Talk to your Baltimore liver surgeon about nonprescription drugs such as acetaminophen (Tylenol), aspirin, ibuprofen (Advil or Motrin), and naproxen (Aleve).  These medications can increase the damage your liver endures during the filtering process.
  • Get immunized against diseases such as hepatitis A and B, influenza, and pneumonia.

However, that’s not all you can do.

In fact, one of the most important things you can do to help stay healthy while living with cirrhosis is to follow a diet low in sodium.

Today we will look at one of the most common complications cirrhosis can cause and how following a low sodium diet helps to alleviate this complication.


Liver Disease and Excess Fluid

As cirrhosis continues to scar your liver, many problems arise that affect your health.  However, fluid buildup because of cirrhosis is one of the complications that is manageable by following a low sodium diet.

A diseased liver has a difficult time excreting the excess fluid in your body on a daily basis.  Typical in cirrhosis patients, fluid buildup occurs in two locations, your ankles/legs and abdomen.



When your blood vessels cannot retain fluid, it leaks into your body’s tissues.  This fluid then pools under the skin of your ankles and legs due to the force of gravity throughout the day.  Called edema, this swelling is usually worse at the end of the day and is extremely painful.



As your liver fails to filter out excess water and salt from your body to keep its optimal balance, this fluid accumulates in your abdominal cavity.  Because of this increased abdominal fluid, your kidneys think that your body is dehydrated and holds onto even more fluid.  This excess fluid will cause your belly to swell and is a sure sign of cirrhosis of the liver.

While each buildup of excess fluid in your body is serious, ascites is much more dangerous than edema.  Look at some of the further complications you may develop if you have ascites:

  • Abdominal Pain. Not only is fluid buildup in your abdomen painful, it may interfere with your ability to breathe causing a lot of concern.  You may also experience difficulty eating since the fluid is taking up so much space within your abdominal cavity.
  • Kidney failure, a blood infection, and mental confusion can result from an infection called spontaneous bacterial peritonitis.  Symptoms include belly pain, tenderness, fever, and nausea.
  • With an excess of fluid built up in your abdomen, a hernia may form because of the pressure it is placing on surrounding organs.  This bulge typically causes pain in your belly and may require surgical repair by your Baltimore liver surgeon.
  • Hepatic Hydrothorax. When the fluid in your abdomen begins leaking into your chest cavity, hepatic hydrothorax occurs.  This can lead to fluid on the lungs, difficulty breathing, and even heart failure.


Liver Disease and a Low Sodium Diet


Both edema and ascites are scary complications that many patients diagnosed with cirrhosis deal with on a daily basis.  However, by following a low sodium diet you may be able reduce both of these fluid buildup complications.


How Your Body Handles Ingested Sodium

Your body is a magnificent machine that strives to maintain balance at all times.  You must have the perfect amount of sodium (salt) and water inside of your body so that you can function as a healthy human being.

When you consume too much salt, your body immediately recognizes this and floods your body with retained water to flush out the excess.  Depending on how much salt you have consumed will affect how much water your body will retain as a way to regain the perfect balance.

If you tend to overdo it on your daily salt intake when you have cirrhosis, your body reacts in a very negative way.  Some of these reactions include:

  • Low Blood Pressure. As cirrhosis scars your liver, its ability to filter your blood lessens.  This lowers the volume of blood your body has and causes the kidneys to retain both water and salt to make up for the low fluid volume.
  • Low Albumin Levels. Scarring of your liver affects the liver’s ability to produce the protein albumin.  Albumin is responsible for holding fluids in your blood vessels.  If your blood vessels lack albumin, the fluid does not stay in your blood vessels.  Instead, it leaks out into your body pooling in the leg and abdomen areas.
  • Portal Hypertension. If there is significant scarring on your liver, your blood cannot flow easily in and out of the liver.  This causes a backup and increases the pressure of blood trying to flow through the open blood vessels.  In order to prevent a vessel from bursting due to this high pressure, fluid leaks out into the body.


Following a Low Sodium Diet

Since fluid buildup is a severe complication related to cirrhosis of the liver, following a well-balanced diet void of excess salt is crucial.

Sodium is present in almost all foods we consume on a daily basis.  This can make managing your total daily intake difficult.

Many condiments such as Worcestershire sauce, soy sauce, and ketchup have a lot of salt per serving.  In addition, processed meats such as bacon, sausage, and ham all have added sodium.  Lastly, canned soups and vegetables, as well as most fast foods contain a lot of added salt that can easily push you above your daily limit with one small serving.

Here are some great tips to keep in mind when you are trying to follow a low sodium diet:

  • Keep a food diary so you can truly see what you consume each day.
  • Cut out all processed foods that come loaded with excess sodium.
  • Use salt sparingly when cooking.
  • Try spices such as cayenne, pepper, and lemon & garlic when cooking to keep food flavorful.
  • Cook fresh veggies instead of using canned ones.
  • Consider a salt substitute.
  • Avoid medications such as Alka Seltzer, which have added sodium.
  • Read all of your food labels and keep track of your daily sodium intake.

In the end, avoiding sodium in your diet can be a hard task, especially if you have never before tracked your daily nutrition.  It is important that you consult your Baltimore liver surgeon, and possibly a dietician specializing in diets for those battling cirrhosis, for advice on how to maintain a healthy diet.

By making a conscious effort to minimize your salt intake, you are taking a huge step in the right direction when it comes to managing the fluid retention that comes with a cirrhosis diagnosis.  In fact, your daily salt intake plays such a large role in your body’s health, it is sometimes thought to be more important than even your prescribed medications.


If you are having problems with fluid retention due to your liver cirrhosis, consider contacting Dr. Fraiman at the Liver and Pancreas Center.  With years of experience treating patients with all types of liver disease, Dr. Fraiman can individualize a treatment plan for you so that you can maintain a healthy lifestyle and avoid even the most serious of complications.  Don’t suffer with swollen ankles and legs or deal with a swollen abdomen any more.  Contact Dr. Fraiman, your expert liver surgeon, so he can help you today.