Hepatic Encephalopathy

Hepatic Encephalopathy is caused by severe liver disease which is caused when the brain does not function properly. When the liver is unable to get rid of toxins from the blood, it leads to the accumulation of toxins, which can ultimately cause brain damage. Hepatic Encephalopathy can be acute or chronic. However, in some unfortunate cases, patients with hepatic encephalopathy may slip into coma.

Acute hepatic encephalopathy is caused as a result of severe liver damage. It occurs in people with Reye’s syndrome, Acute fulminant viral hepatitis and toxic hepatitis. This condition could also indicate terminal liver failure.

Chronic hepatic encephalopathy can be permanent or recurrent. Those with recurrent encephalopathy have episodes of this condition lifetime, coupled with continuous treatment. This condition occurs in patients with severe cirrhosis. Patients with permanent hepatic encephalopathy have permanent neurological conditions like seizure and are usually untreatable.

Causes:

 

  • Internal bleeding.
  • Hypoxia, a condition where patients have low oxygen levels.
  • Excess of protein intake.
  • Excessive intake of alcohol.
  • Getting infections, like pneumonia.
  • Medications like barbiturates or benzodiazepine tranquilizers.
  • Imbalance in electrolyte.
  • Surgery or trauma.

Symptoms:

  • A state of confusion.
  • Forgetting frequently.
  • Changes in one’s personality.
  • Feeling sleepy.
  • Having a poor judgment.
  • Moving with slow movements.
  • Losing interest in everything.
  • Shaky hands.
  • Breath that is sweet or musty.

Diagnosis:

  • Blood test: Doctors recommend a blood test – a complete blood count to checks the red blood cells, white blood cells and platelets. Blood test can also be used to measure the levels of sodium, potassium and ammonia in the blood. High levels of these substances indicate an impaired liver function.
  • Imaging tests: Doctors recommend imaging tests like a CT scan or MRI to detect if there is any bleeding or abnormalities in the head.
  • Liver function tests: Doctors recommend liver function test to detect increase in the levels of enzymes. This indicates liver damage or stress in damage.

Treatment:

  • Antibiotics: Drugs like neomycin (Neo-Fradin) and rifaximin (Rifagut, Xifaxan) may help treat this condition.
  • Lactulose: This helps you get rid of toxins like ammonia from the body.
  • Stop taking certain medicines like sedatives, narcotics.
  • The generation of urea is increased by a preparation of L-ornithine and L-aspartate (LOLA). This procedure removes ammonia by turning it into urea.
  • Treat blockage of urine which triggers Hepatic encephalopathy.
  • Treat constipation – treat constipation, which if left untreated restricts bowel movements and causes buildup of toxins.
  • Avoid alcohol.
  • Liver transplant.

Life after surgery:

Liver transplants are usually a great success. According to the most recent year computed UNOS/OPTN (2004) national average one-year graft survival at 83%, and patient survival at 87% for patients receiving a deceased donor liver and 92% for those transplanted with an organ from a living donor.

After a liver transplant, a patient is recommended to stay in the I.C.U for a few days and then later shifted to the transplant recovery area for 5-10 days. The patient can then go back to normal day-to-day activities. Regular follow-ups are advised and patients have to take the medicines for lifetime.

 

Risks involved:

Risks involved in a liver transplant include:

  • Organ rejection.
  • Failure of the donated liver.
  • Clots of blood.
  • Bile duct leaks.
  • Shrinking of bile ducts.
  • Long-term complications may also include recurrence of liver disease in the transplanted liver.

 

Prognosis:

Patients who have cirrhosis, are at a risk of developing hepatic encephalopathy is 20% per year, and at any time about 30–45% of people with cirrhosis exhibit evidence of overt encephalopathy. . Approximately 30% of patients dying of end-stage liver disease experience significant encephalopathy, approaching coma.

People with chronic hepatic encephalopathy have better recovery rates than those with the acute Hepatic encephalopathy of the condition.

Prevention:

  • Follow the treatment plan given by the doctor to keep the Hepatic encephalopathy levels under check.
  • Take all the medicines prescribed regularly.
  • Follow the recommended diet.

Cost:

A typical dose of rifaximin currently costs around $1900 per month while lactulose therapy is running less than $100 per month.

 

New Life Clinics offers a low-risk way to treat Hepatic encephalopathy. Our team of experienced and skilled doctors make life at hospital a painless one and guarantee a speedy recovery.

 

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