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Hepatic Encephalopathy

Hepatic Encephalopathy

What is hepatic encephalopathy? — Hepatic encephalopathy is a condition that causes confusion and other thinking problems. It can also cause changes in a person's mood, sleeping patterns, and body movements.
What causes hepatic encephalopathy? — Most people who get this condition also have a type of liver disease called "cirrhosis." In people with cirrhosis, hepatic encephalopathy can be caused by:
Bleeding in the stomach, intestines, or other parts of the digestive tract (figure 1)
An infection
Changes in diet
Taking certain medicines
Worsening of the liver disease
What are the symptoms of hepatic encephalopathy? — Symptoms include:
Being confused
Memory problems
Mood changes
Trouble speaking, drawing, and writing clearly
Problems with sleep – Some people have trouble falling asleep. Others sleep too much.
Moving more slowly than normal
Flapping hands
People with hepatic encephalopathy usually have symptoms of serious liver disease, too. These include:
A swollen belly and legs
Fluid buildup in the lungs, which can cause trouble breathing
Yellow skin and a yellow tint to the whites of the eyes – This is called "jaundice."
Red palms
Shrunken muscles
Tiny blood vessels that can be seen just under the skin
Bad breath
Is there a test for hepatic encephalopathy? — Yes. Doctors can do many different tests. Some are used to make sure you do not have problems besides hepatic encephalopathy. The tests include:
Blood tests
Tests for your memory and thinking – The doctor or nurse will ask some questions to check your memory and thinking. For example, the doctor might have you do simple number and word tests.
An EEG – This test measures electrical activity in your brain and records your brain wave patterns.
A CT or MRI scan of your brain – These are imaging tests that can create pictures of your brain.
How is hepatic encephalopathy treated? — The treatment depends on what is causing the problem. Treatment can include:
Taking medicine to have more bowel movements – If you take one of these medicines, such as "lactulose," your doctor or nurse will explain how to figure out the right amount. For example, you will need to adjust your dose until you are having 2 to 3 bowel movements a day.
Taking antibiotic medicines
Changing your diet – This might involve eating small amounts throughout the day, instead of 2 or 3 big meals. Your doctor or nurse can also help you figure out if you should change the foods you eat.
Stopping medicines that might be causing the problem
Can hepatic encephalopathy be prevented? — You can lower your chances of getting hepatic encephalopathy by asking your doctor or nurse what types of foods you should eat. You should also always check with your doctor or nurse before starting any new medicines.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 16979 Version 6.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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