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Hepatic Encephalopathy

What is Hepatic Encephalopathy?

Hepatic Encephalopathy can occur as a result of either acute liver failure or chronic liver. It is defined as a spectrum of neuropsychiatric abnormalities in patients with liver dysfunction, after exclusion of brain disease.

Sometimes the symptoms are so mild that it's hard for anyone to notice. But whether you have obvious signs or just a few subtle changes, it's important to see your doctor. The right treatment can keep your condition under control, but if you don't take care of yourself, you'll get worse and worse.

Acute hepatic encephalopathy develops because of severe liver disease. This condition mainly occurs in people with:

vAcute fulminant viral hepatitis: a severe type of viral hepatitis that comes on suddenly

vToxic hepatitis: may be caused by exposure to alcohol, chemicals and supplements

vReye’s syndrome: a rare and serious condition primarily seen in children that causes sudden swelling and inflammation of the liver and brain

Subtle signs of hepatic encephalopathy are observed in nearly 70% of patients with cirrhosis. Symptoms may be debilitating in a significant number of patients. Overt hepatic encephalopathy occurs in about 30-45% of patients with cirrhosis. It is observed in 24-53% of patients who undergo portosystemic shunt surgery.

What are the symptoms of Hepatic Encephalopathy?

If you have been diagnosed with chronic liver disease, you could have HE if you are experiencing the following symptoms:

  1. Trouble sleeping at night
  1. Difficulty thinking clearly
  1. Poor concentration
  1. Often confused
  1. Anxiety
  1. Tend to forget things
  1. Mental fogginess
  1. Slow reaction time  

 How Is Hepatic Encephalopathy Diagnosed?

Several tests are used to diagnose hepatic encephalopathy.

 Blood Tests

vA complete blood count may be used to check your red blood cells, white blood cells, and platelets. A low red blood cell count indicates blood loss and a lack of oxygen.

vBlood tests may also be used to check the sodium, potassium, and ammonia levels in your blood. Having too much of these substances in the blood is a sign of impaired liver function.

  1. Imaging Tests

vAn imaging test, such as a head CT scan or MRI, can check for bleeding in your head or abnormalities in your brain.

  1. Liver Function Tests

vLiver function tests may be given to check for raised enzyme levels. An increase in enzymes indicates stress on the liver or liver damage.

 Treatments for hepatic encephalopathy?

vLactulose -  This is a type of sugar that can make you have more bowel movements. This helps get rid of some toxins from your body, like ammonia, which can trigger HE.

vAntibiotics - Drugs like neomycin (Neo-Fradin) and rifaximin (Rifagut, Xifaxan) may help. They curb bacteria that create toxins when they digest your food

vTreat infections- They can affect the way your liver works. You may need antibiotics to get rid of them.

  • Treat urinary blockages - If you can't pee normally, it can trigger your HE. Treatment for the infection or disease that's causing it can help.
  • Stop some medications - Certain medicines, such as sedatives or narcotics, may cause problems with your liver.

Can Hepatic Encephalopathy Be Prevented?

The best way to prevent hepatic encephalopathy is to prevent or manage liver disease. You can lower your chances of getting the liver disease by taking these steps:

    Avoid drinking alcohol, or consume alcohol in moderation.

    Avoid high-fat foods.

    Lose excess weight and maintain a healthy weight.

    Don’t use drugs or share needles.

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