Because ghrelin is one of the key hormones in regulating feeding behavior and caloric status, it was suggested that ghrelin behavior might be closely associated with protein energy malnutrition (PEM) in patients with liver cirrhosis since plasma ghrelin levels reflect the malnutrition state of patients with CLD and could be related to anthropometric parameters in those patients [5]. Here, GHRL is linked to congenital secretory chloride diarrhea 1.