Know the basics
What is hepatic encephalopathy?
Hepatic encephalopathy refers to changes in behavior, mental state and nervous system in people with liver failure. High levels of ammonia in the bloodstream and brain are thought to cause these changes. Bacteria in the stomach and intestines make ammonia. Usually, the livers normally metabolize the ammonia (makes ammonia harmless). However, people with liver disease have more ammonia because their liver doesn’t work. Ammonia enters the blood, gets to the brain, and causes symptoms by interfering with brain function.
How common is hepatic encephalopathy?
This encephalopathy occurs in more than 50% of all people with liver cirrhosis. Untreated, it can lead to coma and death. It’s not contagious and cannot be passed from parents to children.
Know the symptoms
What are the symptoms of hepatic encephalopathy?
Main symptoms of hepatic encephalopathy include being disoriented, forgetful, and confused. People feel sleepy and have mood changes, lethargy, memory loss, and even coma.
Other symptoms include jaundice, problem speaking, tremors, being agitated and uncoordinated movements.
Besides, people usually have signs of liver disease such as jaundice, enlarged breasts and small testicles (men), fluid in the abdomen (belly), and swelling in the legs.
Hepatic encephalopathy is divided into grades 1 to 4. Grade 1 involves mild confusion, poor attention, being irritable, and decreased ability to do mental tasks. In grade 2, people have lethargy, drowsiness, personality changes, and great trouble doing mental tasks In grade 3, people are sleepy (but can be aroused), cannot do mental tasks, and are disoriented (place and time). Int grade 4, coma occurs.
There may be some signs or symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
Call the doctor if you or any of your relatives have any signs above, especially for those with pre-existing liver disease. The disease might progress rapidly and severely endangered .Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
Know the causes
What causes hepatic encephalopathy?
Disorders that destroy the liver and cause liver failure can lead to hepatic encephalopathy. Some of these disorders are viral hepatitis (such as hepatitis B and hepatitis C), severe infections, autoimmune diseases, cancer, and Reye’s syndrome.
Other causes may be medicines such as nonsteroidal anti-inflammatory drugs and toxins such as alcohol.
People with cirrhosis can get encephalopathy from using sedatives and analgesics.
Know the risk factors
What increases my risk for hepatic encephalopathy?
Certain factors may increase your risk of developing Hepatic encephalopathy:
- Eating too much protein;
- Bleeding from the intestines, stomach, or esophagus;
- Kidney problems;
- Low oxygen levels in the body;
- Medicines that suppress the central nervous system (such as barbiturates or benzodiazepine tranquilizers).
Understand the diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is hepatic encephalopathy diagnosed?
The doctor will do a complete physical examination. The doctor may order blood tests and x-rays to rule out other problems, because hepatic encephalopathy mimics symptoms of other disorders. These disorders include alcohol withdrawal, sedative overdose, meningitis, low blood sugar, brain cancer, and blood clots in the brain.
How is hepatic encephalopathy treated?
Hepatic encephalopathy can be a medical emergency that requires a hospital stay. Treatment goals are to find and treat causes, such as drugs, GI bleeding, and metabolic problem. Especially, if the cause is GI bleeding, it must be treated immediately.
A drug called lactulose acts as a laxative and helps empty the intestines, so bacteria cannot make ammonia. Sometimes, an antibiotic called neomycin is used. This drug kills bacteria in the intestine so that there is less ammonia.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage hepatic encephalopathy?
The following lifestyles and home remedies might help you cope with hepatic encephalopathy :
- Remember that hepatic encephalopathy may be reversible. However, the chance of death is high if coma occurs.
- Call your doctor if a family member with liver disease has behavior, personality, or mental changes.
- Don’t drink alcohl, especially if you have cirrhosis
- Don’t forget that common over the-counter and prescription sleeping drugs can cause the disorder in people with liver disease.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Ferri, Fred. Ferri’s Netter Patient Advisor. Philadelphia, PA: Saunders / Elsevier, 2012. Print edition, page 307
Porter, R. S., Kaplan, J. L., Homeier, B. P., & Albert, R. K. (2009). The Merck manual home health handbook. Whitehouse Station, NJ, Merck Research Laboratories.Print edition, page 219
Hepatic encephalopathy. http://www.nlm.nih.gov/me dlineplus/ency/article/000302.htm. Accessed August 12, 2016.
Review Date: May 30, 2016 | Last Modified: January 4, 2017