Hepatic encephalopathy

Hepatic encephalopathy is a decline in brain function that occurs as a result of severe liver disease. In this condition, your liver can’t adequately remove toxins from your blood. This causes a buildup of toxins in your 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.

Types of hepatic encephalopathy

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

  • Acute fulminant viral hepatitis. This is a severe type of viral hepatitis that comes on suddenly.
  • Toxic hepatitis. Toxic hepatitis may be caused by exposure to alcohol, chemicals, drugs, or supplements.
  • Reye’s syndrome. This rare and serious condition is primarily seen in children. It causes sudden swelling and inflammation of the liver and the brain.

Acute hepatic encephalopathy may also be a sign of terminal liver failure.

Chronic hepatic encephalopathy may be permanent or recurrent.

Those with the recurrent version will have multiple episodes of hepatic encephalopathy throughout their lives. They’ll also require continuous treatment to help prevent the development of symptoms. Recurrent cases are usually seen in people with severe cirrhosis, or scarring of the liver.

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 include:

  • difficulty thinking
  • personality changes
  • poor concentration
  • problems with handwriting or loss of other small hand movements
  • confusion
  • forgetfulness
  • poor judgment

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 your liver fails to break down toxins properly.

Your liver removes toxic chemicals such as ammonia from your body. These toxins are left over when proteins are metabolized or broken down for use by various organs in your body. Your kidneys change these toxins into safer substances that are then removed through urination.

When your liver is damaged, it’s unable to filter out all the toxins. Toxins can then build up in your bloodstream and potentially get into your brain. Toxic buildup can also damage other organs and nerves.

Diagnose hepatic encephalopathy

Blood tests

A complete blood count checks 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 your blood levels of sodium, potassium, and ammonia. Having too much of these substances is a sign of impaired liver function.

Imaging tests

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

Liver function tests

Liver function tests check for raised enzemy levels. An increase in enzymes indicates stress on your liver or liver damage.

Treatment options for hepatic encephalopathy

Treatment options for hepatic encephalopathy depend on the severity and underlying cause of the condition.

You’ll likely need to eat less protein if eating too much protein caused the condition. Since protein is necessary for your body to function properly, a dietician or doctor can create a diet that’ll allow you to get enough protein without making your symptoms worse. High-protein foodsto avoid include:

  • poultry
  • red meat
  • eggs
  • fish

Medications can also help slow the rate at which your blood absorbs toxins. Your doctor may prescribe antibiotics and lactulose(Enulose), a synthetic sugar. These medications can draw ammonia, created by intestinal bacteria from your blood, into your colon.