Is Hepatic Encephalopathy?
Hepatic encephalopathy is a decline in brain function that occurs
as a result of severe liver disease. In this condition, the liver cannot
adequately remove toxins from the blood. This causes a buildup of toxins in the
bloodstream, which can lead to brain damage.
Hepatic encephalopathy can be acute (short-term) or chronic
(long-term). In some cases, a person with hepatic encephalopathy may become
unresponsive and slip into a coma.
encephalopathy develops because of severe liver disease. This
condition mainly occurs in people with:
- acute fulminant viral hepatitis: a severe type
of viral hepatitis that comes on suddenly
- toxic hepatitis: may be caused by exposure to
alcohol, chemicals, drugs (recreational or prescription), or supplements
- Reye’s syndrome: a rare and serious condition
primarily seen in children that causes sudden swelling and inflammation of the
liver and brain
Acute hepatic encephalopathy may also be a sign of terminal liver
encephalopathy may be permanent or recurrent. Those with the
recurrent version will have multiple episodes of hepatic encephalopathy
throughout their lives. They will also require continuous treatment to help
prevent the development of symptoms. Recurrent cases are usually seen in people
with severe cirrhosis (scarring of the liver).
Permanent cases are seen in people who don’t respond to treatment
and who have permanent neurological conditions, such as a seizure disorder or a
spinal cord injury. This condition is rare.
Causes Hepatic Encephalopathy?
The exact cause of hepatic encephalopathy is unknown. However, it’s
usually triggered by a buildup of toxins in the bloodstream. This occurs when
the liver fails to break down toxins properly.
The liver removes toxic chemicals such as ammonia from the body.
These toxins are left over from proteins that are metabolized or broken down
for use by various organs in the body. The kidneys change these toxins into
safer substances that are then removed from the body through urination.
When the liver is damaged, it’s unable to filter out all the
toxins. Toxins can then build up in the bloodstream and potentially get into
the brain. Toxic buildup can also damage other organs and nerves.
Hepatic encephalopathy may be triggered by:
- Infections such as pneumonia
- kidney problems
- low oxygen levels (hypoxia)
- recent surgery or trauma
- use of medications to suppress the immune system
- eating too much protein
- use of medications (such as barbiturates or
benzodiazepine tranquilizers) that suppress the central nervous system
- electrolyte imbalance, especially a decrease in
potassium after vomiting or taking diuretics
Are the Symptoms of Hepatic Encephalopathy?
Symptoms of hepatic encephalopathy differ depending on the
underlying cause of the liver damage.
Symptoms and signs of moderate hepatic encephalopathy may
- difficulty thinking
- personality changes
- poor concentration
- problems with handwriting or loss of other
- poor judgment
- a musty or sweet breath odor
Symptoms of severe hepatic encephalopathy are:
- drowsiness or lethargy
- severe personality changes
- confused speech
- shaky hands
- slow movements
Go to the emergency room or call 911 right away if you develop
symptoms of severe hepatic encephalopathy. These symptoms can lead to a coma if
they’re not treated quickly.
Is Hepatic Encephalopathy Diagnosed?
Several tests are used to diagnose hepatic encephalopathy.
A 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.
Blood 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.
An imaging test, such as a head CT scan or MRI, can check for
bleeding in your head or abnormalities in your brain.
Liver Function Tests
Liver function tests may be given to check for raised
enzyme levels. An increase in enzymes indicates stress on the liver or liver
Tell your doctor if you have kidney disease or liver disease. The
symptoms you’re experiencing along with your medical history can sometimes be
enough to diagnose hepatic encephalopathy.
Are the Treatment Options for Hepatic Encephalopathy?
Treatment options for hepatic encephalopathy differ depending on
the severity and underlying cause of the condition.
You will likely need to eat less protein if eating too much
protein caused the condition. Since protein is necessary for the body to
function properly, a dietician or doctor can create a diet that will allow you
to get enough protein without making your symptoms worse. High-protein foods to
avoid include poultry, red meat, eggs, and fish.
Medications can also help slow the rate at which your blood
absorbs toxins. Your doctor may prescribe antibiotics and lactulose (a
synthetic sugar). These medications can draw ammonia that intestinal bacteria
from your blood creates into the colon, where your body will remove it.
In severe cases that cause difficulty breathing, a ventilator or
oxygen delivered through a mask may be necessary.
Is the Long-Term Outlook for Hepatic Encephalopathy?
People with chronic hepatic encephalopathy have better recovery
rates than those with the acute version of the condition. The rate of recovery
increases if treatment is given before the condition gets worse.
Complications that may be irreversible include:
- brain herniation
- brain swelling
- organ failure
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 liver disease by
taking these steps:
- Avoid drinking alcohol, or consume alcohol in
- Avoid high-fat foods.
- Lose excess weight and maintain a healthy weight.
- Don’t use drugs or share needles.
To avoid getting viral hepatitis:
- Wash your hands well after using the bathroom or
changing a diaper.
- Don’t share needles.
- Avoid close contact with people diagnosed with