Hepatic Encephalopathy Quiz

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Reviewed By:

Maxwell J. Nanes

Maxwell J. Nanes, DO (Emergency department)

Dr Nanes received a doctorate from the Chicago College of Osteopathic Medicine and went on to complete a residency in emergency medicine at the Medical College of Wisconsin. There he trained at Froedtert Hospital and Children's Hospital of Wisconsin in the practice of adult and pediatric emergency medicine. He was a chief resident and received numerous awards for teaching excellence during his time there. | | After residency he took a job at a community hospital where he and his colleagues worked through the toughest days of the COVID-19 pandemic. |

Aiko Yoshioka

Aiko Yoshioka, MD (Gastroenterology)

Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.

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Learn more about Hepatic encephalopathy

Content updated on Sep 20, 2022

What is hepatic encephalopathy?

The liver removes toxins like ammonia from blood. In liver failure, these toxins build up in the body and brain causing confusion and abnormal behavior.

Symptoms of hepatic encephalopathy

  • History of liver cirrhosis

  • My brain is not functioning right now

  • Becoming more dazed or less responsive than usual

  • Nausea or vomiting

  • Swelling of the arms or hands

  • History of dementia

  • Skin or eyes turning yellow

  • Facial swelling

Questions your doctor may ask to check for hepatic encephalopathy

Your doctor may ask these questions to diagnose hepatic encephalopathy

  • Have you ever been diagnosed with cirrhosis?

  • Do you have problems focusing or a reduced sense of awareness in your surroundings?

  • Are you more drowsy or sleepy than usual?

  • Do you have nausea or vomiting?

  • Do you have swelling in your hands or arms?

Treatment for hepatic encephalopathy

Treatment aims at reducing the amount of toxins, hence slowing down the worsening of illness. This is done through laxatives that draw toxins into the intestines and out of the body. Antibiotics can also reduce the amount of bacteria in the colon, making them produce fewer toxins. Ultimately, treatment of the cause (liver failure) is needed for the condition to improve.

View the symptoms of Hepatic encephalopathy

References

  • Weissenborn K. Hepatic Encephalopathy: Definition, Clinical Grading and Diagnostic Principles. Drugs. 2019 Feb;79(Suppl 1):5-9. doi: 10.1007/s40265-018-1018-z. PMID: 30706420; PMCID: PMC6416238.

    https://link.springer.com/article/10.1007/s40265-018-1018-z

  • Wijdicks EF. Hepatic Encephalopathy. N Engl J Med. 2016 Oct 27;375(17):1660-1670. doi: 10.1056/NEJMra1600561. PMID: 27783916.

    https://www.nejm.org/doi/10.1056/NEJMra1600561

  • Rose CF, Amodio P, Bajaj JS, Dhiman RK, Montagnese S, Taylor-Robinson SD, Vilstrup H, Jalan R. Hepatic encephalopathy: Novel insights into classification, pathophysiology and therapy. J Hepatol. 2020 Dec;73(6):1526-1547. doi: 10.1016/j.jhep.2020.07.013. Epub 2020 Oct 21. PMID: 33097308.

    https://www.journal-of-hepatology.eu/article/S0168-8278(20)30466-9/fulltext

  • Patidar KR, Bajaj JS. Covert and Overt Hepatic Encephalopathy: Diagnosis and Management. Clin Gastroenterol Hepatol. 2015 Nov;13(12):2048-61. doi: 10.1016/j.cgh.2015.06.039. Epub 2015 Jul 9. PMID: 26164219; PMCID: PMC4618040.

    https://www.cghjournal.org/article/S1542-3565(15)00917-9/fulltext

  • Said VJ, Garcia-Trujillo E. Beyond Lactulose: Treatment Options for Hepatic Encephalopathy. Gastroenterol Nurs. 2019 May/Jun;42(3):277-285. doi: 10.1097/SGA.0000000000000376. PMID: 31145253.

    https://journals.lww.com/gastroenterologynursing/Abstract/2019/05000/Beyond_Lactulose__Treatment_Options_for_Hepatic.8.aspx

Reviewed By:

Maxwell J. Nanes

Maxwell J. Nanes, DO (Emergency department)

Dr Nanes received a doctorate from the Chicago College of Osteopathic Medicine and went on to complete a residency in emergency medicine at the Medical College of Wisconsin. There he trained at Froedtert Hospital and Children's Hospital of Wisconsin in the practice of adult and pediatric emergency medicine. He was a chief resident and received numerous awards for teaching excellence during his time there. | | After residency he took a job at a community hospital where he and his colleagues worked through the toughest days of the COVID-19 pandemic. |

Aiko Yoshioka

Aiko Yoshioka, MD (Gastroenterology)

Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.

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