What is the primary dietary recommendation for a patient with liver cirrhosis and ascites?

The primary dietary recommendation for a patient with liver cirrhosis and ascites is dietary sodium restriction. In individuals with ascites, the fluid accumulation in the abdominal cavity is often due to portal hypertension and impaired liver function, which can lead to water retention. Sodium plays a critical role in fluid balance within the body; therefore, reducing sodium intake is essential to help manage fluid retention.

Restricting sodium reduces the osmotic pressure that draws water into the vascular space, which in turn helps decrease the fluid buildup in the abdomen. This can lead to improved symptoms related to ascites and may even help reduce the need for therapeutic paracentesis (a procedure to remove fluid).

While protein intake is often a concern in patients with liver disease due to the risk of hepatic encephalopathy, many patients with compensated liver disease can tolerate a normal protein intake unless specifically advised otherwise. Thus, a high-protein diet could be inappropriate for those with severe liver impairment. Increasing fiber intake might have benefits in constipation management, but it does not directly address the management of ascites. A low carbohydrate diet is generally not indicated in this scenario and does not target the specific issue at hand, which is fluid retention related to sodium intake.