Hepatic encephalopathy is deterioration of the function of the brain when the liver is unable to flush out toxins from the blood.
Hepatic encephalopathy causes
Hepatic Encephalopathy is caused due to liver disorders. These can include disorders like cirrhosis and hepatitis, known to affect the liver function. There are also disorders that do not allow the blood to reach the liver causing hepatic encephalopathy.
. Liver has an important function to neutralize the toxic substances that are made either by the body or formed due to substances consumed like medicines. Protein, for instance, when digested, produce ammonia which can be harmful. But due to the liver, the ammonia is made harmless. Like this, there are many substances that can harm the body if the liver does not function properly. A malfunctioning liver can also harm the nervous system.
Due to the toxic buildup, the liver is rendered poisonous. Hepatic encephalopathy can also result in people who did not have previous liver problems
.Here are the cause of hepatic encephalopathy
1. Eating too much protein
2. Electrolyte imbalance caused due to potassium reduction in the body, caused due to vomiting, taking diuretics and paracentesis treatment.
3. Dehrydation
4. Lack of oxygen in the body
5. Intestinal bleeding and bleeding of the esophagus, stomach etc.
6. Kidney problems
7. Surgery
8. Taking medicines that can repress the nervous system like intake of barbiturates
9. Other infections
10. High possibility among people with chronic liver problems.
11. Surgery
Hepatic Encephalopathy symptoms
Here are the symptoms of Hepatic Encephalopathy
1. Alternation in sleep patterns
2. Breath or urine smell that is sweet or musty
3. Loss of little hand movements like handwriting becoming skewed
4. Confusion
5. Loss of memory
6. Changes in the thinking pattern
7. Poor concentration and judgment
8. Loss of mental clarity
9. Mood changes frequently, personality changes
10. Inappropriate behavior and slurred speech
11. Slow and sluggish movements
12. Shaking hands, arms etc in an abnormal manner
13. The most severe symptom of hepatic encephalopathy is that the patient can become unconscious and even enter a coma
14. Liver disease like jaundice characterized by yellow skin and fluid buildup in the abdomen
Hepatic encephalopathy diagnosis and tests
Here are the tests done as a part of diagnosis for Hepatic Encephalopathy
1. Complete blood count or hematocrit levels test to check for anemia
2. Liver function tests-This can include Albumin, Alpha-1 antitrypsin,Gamma-glutamyl transpeptidase (GGT),Serum bilirubin, Urine bilirubin etc
3. Prothrombin time-Blood test used to find out how much time it takes for the plasma or the liquid portion in your blood to clot
4. Serum Ammonia levels test
5. Potassium levels in the blood
6. Sodium levels in the blood
7. Creatinine and BUN to check kidney functioning
8. EEG- to detect problems in the brain’s electrical activity
9. CT scan of the head or MRI
Hepatic Encephalopathy Treatment
Hepatic Encephalopathy needs hospitalization; it may become a medical emergency is treatment is not given or if it is done incorrectly. The main thing is to find out the exact causes of hepatic encephalopathy. Electrolyte imbalance, especially potassium deficiency; kidney failure and infections must be treated. The intestines must be emptied of blood. If the person goes into coma, then life support must be given. There is also a chance of brain swelling. Patients who have serious problems may need to be given feeding through special formulation intravenously or through tube.
Patient who have recurring episodes of encephalopathy are told to limit protein in the diet so as to decrease ammonia production. But then even too little protein can lead to malnutrition and dietary problems.
Neomycin works to reduce ammonia production, Lactulose can also be given to suppress ammonia creation by intestinal bacteria. There is a new antibiotic called Rifaximin that has given good results as treatment for hepatic encephalopathy.
Doctors avoid giving medications that contain ammonium and certain types of antacids. Tranquilizers, sedatives and other medicines that are broken down by liver has to be avoided too.
Hepatic Encephaloathy Prognosis
Acute hepatic encephalopathy can be treated. Chronic forms of hepatic encephalopathy is worse and can recur. However, both forms can result in coma that is irreversible and even death. In fact, 80 percent of patients die if they enter coma. Risk and recovery chances can depend on a patient to patient basis.
Hepatic Encephaloathy Complications
The following are the compilication of Hepatic Encephaloathy
1. Swelling of the brain
2. Brain herniation
3. Kidney failure, cardiovascular failure, respiratory failure and sepsis
4. Irreversible coma
5. Permanent damage to the nervous system
Prevent Hepatic Encephaloathy
1. Treat liver disorders in time. If you suspect symptoms or liver disease, call for doctor immediately.
2. Do not drink heavily and do not eat protein excessively
3. Do not dehydrate; drink fluids as often as possible to keep the liver functioning properly
4. Eat a good balanced diet comprising fruits and vegetables. Bananas are good as a source of potassium.
5. Avoid intravenous drug use.
