Hepatic Encephalopathy

🧠 Hepatic Encephalopathy

Hepatic encephalopathy (HE) is a decline in brain function that occurs as a result of severe liver disease. When the liver is damaged, it can’t remove toxins from the blood effectively, leading to their buildup and affecting brain function.

🧬 Causes:

• Usually occurs in people with advanced liver disease (like cirrhosis)
• Triggers include:
  • Gastrointestinal bleeding
  • Infection
  • Electrolyte imbalances
  • Constipation
  • Excessive protein intake
  • Certain medications (sedatives, diuretics)

🩺 Symptoms:

• Mild confusion or forgetfulness
• Difficulty concentrating or changes in behavior
• Sleep disturbances (daytime sleepiness or insomnia)
• Asterixis (flapping tremor of hands)
• Drowsiness progressing to stupor or coma in severe cases

🔍 Diagnosis:

• Clinical evaluation of neurological symptoms
• Blood tests (ammonia levels, liver function tests)
• Rule out other causes of altered mental status

💊 Treatment:

• Address underlying triggers (treat infections, stop bleeding)
• Reduce blood ammonia levels:
  • Lactulose (helps remove ammonia via stool)
  • Rifaximin (antibiotic reducing ammonia-producing bacteria)
• Supportive care and monitoring

⚠️ Complications:

• Can progress rapidly to coma
• Life-threatening without prompt treatment