Why does loss of appetite occur during the decompensation stage of liver dysfunction?

Generally, patients in the decompensated stage of liver dysfunction may experience reduced appetite due to impaired digestive function, metabolic disturbances, hormonal imbalances, toxin accumulation, portal hypertension, and other factors. Patients should seek timely treatment at a regular hospital. Detailed explanations are as follows:

1. Impaired digestive function: Normally, bile secreted by the liver emulsifies fat, aiding in its digestion and absorption, and also participates in maintaining the normal digestive environment of the intestine. However, in the decompensated stage of liver dysfunction, severe damage to liver cells results in reduced bile secretion and impaired excretion. Fats cannot be fully emulsified, leading to fatty diarrhea, and the digestion of other nutrients is also affected.

2. Metabolic disturbances: During the decompensated phase of liver function, metabolism of carbohydrates, proteins, fats, and other substances becomes disordered. Imbalanced blood sugar regulation may lead to hypoglycemia or significant fluctuations in blood glucose levels, affecting energy supply and metabolic balance. Reduced protein synthesis leads to decreased plasma protein levels, causing the body to enter a state of negative nitrogen balance, resulting in insufficient energy and easy fatigue. This physical condition reduces the patient's desire for food.

3. Hormonal imbalances: In the decompensated stage of liver function, the liver's ability to inactivate hormones such as estrogen, insulin, and gastrin decreases, leading to accumulation of these hormones in the body. Increased insulin resistance affects glucose metabolism and energy utilization, leading to poor physical condition. Abnormal gastrin levels interfere with the regulation of gastric acid secretion; excessive or insufficient gastric acid secretion is detrimental to food digestion and may cause gastric discomfort. The combined effects of multiple hormonal imbalances lead to a decrease in appetite.

4. Accumulation and irritation of toxins: The liver is an important organ responsible for detoxification in the body. During the decompensated stage of liver function, its detoxification capacity is significantly reduced, and harmful substances such as ammonia, bilirubin, and endotoxins produced in the body cannot be promptly removed. Accumulation of these toxins in the body can irritate the gastrointestinal mucosa, causing mucosal edema and inflammatory reactions, which leads to gastrointestinal dysfunction and symptoms such as nausea and vomiting.

5. Portal hypertension: The decompensated stage of liver function is often accompanied by portal hypertension, which can cause gastrointestinal congestion, leading to swelling of the gastrointestinal mucosa and impaired blood circulation. Due to congestion and hypoxia, the normal digestive and absorptive functions of the gastrointestinal mucosa are impaired, gastrointestinal motility slows down, and food emptying is delayed, making patients feel persistently full and rarely experience hunger. At the same time, gastrointestinal congestion may also cause mucosal erosion or ulcers, exacerbating pain and discomfort after eating, making patients reluctant to eat, thus resulting in reduced appetite.

Patients in the decompensated stage of liver function can follow medical advice to use medications such as furosemide tablets, spironolactone tablets, entecavir tablets, etc., and under a doctor's guidance, appropriately adjust their diet structure to increase high-protein, easily digestible foods, and supplement nutritional formulations when necessary to ensure adequate nutritional supply.