Hepatic Encephalopathy Quiz
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Reviewed By:
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, 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
Diseases related to 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, 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, 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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Obstetrics and gynecology (OBGYN)
National Center for Child Health and Development, Japan