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Inadequate and excessive intake of nutrients can disrupt ROS homeostasis in cells, affect the signalling pathways and cellular pathways of cells (265, 266)

Treating low appetite in advanced cirrhosis should focus on addressing risk factors (such as active alcohol use, uncontrolled diabetes, and hypothyroidism), triggers (including hepatic encephalopathy, infections, electrolyte imbalances, and excessive medication burden), and related issues (such as removing symptomatic ascites, providing clear dietary recommendations, avoiding overly restrictive diets, and addressing mental health concerns) (Figure 3) ( Figure 3 4 Cirrhosis-related non-cholestatic pruritus 4.1 Prevalence and mechanisms Pruritus linked to liver ailments is particularly pronounced in chronic cholestatic liver conditions like primary biliary cholangitis and primary sclerosing cholangitis

49 Such observations are supported by numerous in vitro and in vivo studies that have demonstrated multiple effects on tumor development

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