What Is Hepatic Encephalopathy?
Hepatic encephalopathy (HE) is a condition that causes temporary worsening of brain function in people with advanced liver disease. When the liver is damaged, it can no longer effectively remove toxins from the blood—particularly ammonia—which then accumulate and affect the brain.
HE can range from mild confusion to severe coma and is often reversible with proper treatment.
Common Causes & Risk Factors
- Cirrhosis (scarring of the liver)
- Acute liver failure
- Gastrointestinal bleeding
- Infections or kidney problems
- High protein intake in susceptible individuals
- Use of sedatives or diuretics
Symptoms
Symptoms vary depending on severity:
- Mild: Forgetfulness, poor concentration, mood changes
- Moderate: Confusion, slurred speech, personality changes
- Severe: Disorientation, extreme drowsiness, coma
Note: Early detection is crucial. If you or someone you know has liver disease and shows mental changes, seek medical attention immediately.
Diagnosis & Treatment
Diagnosis typically involves:
- Blood tests (ammonia levels, liver function)
- Neuropsychological testing
- Imaging (MRI or CT scans in some cases)
Treatment focuses on reducing toxin buildup:
- Lactulose: A laxative that helps remove ammonia through stool.
- Rifaximin: An antibiotic that reduces ammonia-producing bacteria.
- Dietary changes (moderate protein intake)
- Avoiding triggers like alcohol and certain medications
Living with Hepatic Encephalopathy
Managing HE requires a multidisciplinary approach:
- Regular follow-ups with a hepatologist
- Monitoring for symptom recurrence
- Support from caregivers and mental health professionals
- Educating family members about warning signs
With consistent care, many patients maintain a good quality of life.