What is 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.

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

  • Acute fulminant viral hepatitis.This is a severe type of viralhepatitisthat comes on suddenly.
  • Toxic hepatitis.Toxic hepatitis may be caused by exposure toalcohol, chemicals, drugs, or supplements.
  • Reye’s syndrome.This rare and serious condition is primarily seenin children. It causes sudden swelling and inflammation ofthe liverandthe brain.

Acute hepatic encephalopathy may also be a sign of terminalliver 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 severecirrhosis, or scarring of the liver.

Permanent cases are rare and seen in people who don’t respond to treatment and who have permanent neurological conditions, such as:

Symptoms of hepatic encephalopathy differ depending on the underlying cause of the liver damage.

Symptoms and signs of moderate hepatic encephalopathy may include:

Symptoms of severe hepatic encephalopathy are:

Get emergency medical help right away if you develop symptoms of severe hepatic encephalopathy. These symptoms can lead to acomaif they’re not treated quickly.

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. Yourkidneyschange 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.

Hepatic encephalopathy may be triggered by:

Several tests are used to diagnose hepatic encephalopathy.

Blood tests

Acomplete blood countchecks your红细胞,white blood cells, and platelets. A low red blood cell count indicatesblood lossand a lack of oxygen.

Blood tests may also be used to check your blood levels ofsodium,potassium, and ammonia. Having too much of these substances is a sign of impaired liver function.

Imaging tests

An imaging test, such as aCT scanorMRI, can check forbleeding in your headorabnormalities in your brain.

肝功能测试

肝功能测试check for raisedenzymelevels. An increase in enzymes indicates stress on your liver or liver damage.

Tell your doctor if you have kidney disease or liver disease. The symptoms you’re experiencing along with your medical history can sometimes be enough to diagnose hepatic encephalopathy.

Hepatic encephalopathy is divided into stages based on the severity of the symptoms. Common classification systems include the West Haven Criteria and the Glasgow Coma Scale.

The five stages of hepatic encephalopathy, according to the West Haven Criteria, are:

  • Stage 0.At this stage, symptoms are minimal.
  • Stage 1.Symptoms are mild. They may include a shortened attention span and changes to your sleep habits, such ashypersomniaorinsomnia.
  • Stage 2.Symptoms are moderate. At this stage, you may feeldisorientedor lethargic.
  • Stage 3.Symptoms are severe. You’ll be unable to perform basic tasks. You’ll also feel confused and experience personality changes.
  • Stage 4.This stage is characterized bycoma.

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 createa dietthat’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 andlactulose(Enulose), a synthetic sugar. These medications can draw ammonia, created by intestinal bacteria from your blood, into your colon. Your body will then remove the blood from your colon.

In severe cases that causedifficulty breathing, a ventilator oroxygenmask may be necessary.

Some people with the condition may be eligible to receive aliver transplant.

People with chronic hepatic encephalopathy have better recovery rates than those with the acute version of the condition. The rate of recovery increases if you receive treatment before the condition gets worse.

Hepatic encephalopathy and its symptoms can be reversible with proper treatment.

并发症可能irreversible include:

The best way to prevent hepatic encephalopathy is to prevent or manage liver disease. You can lower your chances of getting liver disease by taking these steps:

  • Avoid alcohol or consume it in moderation.
  • Avoid high-fat foods.
  • Maintain a healthy weight.
  • Don’t share contaminated needles.

To avoid getting viral hepatitis:

  • Wash your hands well after using the bathroom or changing a diaper.
  • Don’t share contaminated needles.
  • Avoid close contact with people diagnosed with viral hepatitis.
  • Get vaccinated againsthepatitis Aandhepatitis B.