Long-standing Hepatitis C Cirrhosis in Medicine / Internal Medicine — 58yo Man | Hepatology | SMLE Q#7681

SMLE Question #7681

Medicine / Internal Medicine Hepatology

Objective: OBJ-HEP-01

A 58-year-old man with long-standing hepatitis C cirrhosis is seen in the hepatology clinic for progressive abdominal distension and discomfort. He has required multiple large-volume paracenteses over the past 3 months, but his tense ascites recurs quickly despite adherence to spironolactone and furosemide. He has no history of hepatic encephalopathy and denies confusion or GI bleeding. Physical examination shows shifting dullness and bilateral pitting edema; there is no fever or abdominal tenderness. The team plans further outpatient management of his refractory ascites. Which of the following is the most appropriate dietary recommendation to help control his ascites?

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