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Patient education: Hepatic encephalopathy (The Basics)

Patient education: Hepatic encephalopathy (The Basics)

What is hepatic encephalopathy? — This 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)

Infection

Changes in diet

Constipation

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:

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, 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 that 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 you some questions. For example, they might have you do simple number and word tests.

Electroencephalography ("EEG") – This measures electrical activity in your brain and records your brain wave patterns.

CT or MRI scan of your brain – These are imaging tests that 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 smaller 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

Avoiding alcohol

Can hepatic encephalopathy be prevented? — You can lower your chances of getting it 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.

When should I call the doctor? — Call for advice if:

Your confusion or memory problems are getting worse.

You have more trouble staying awake or falling asleep.

Your skin or eyes are becoming more yellow.

You have a fever of 100.4°F (38°C) or higher, or chills.

More on this topic

Patient education: Cirrhosis (The Basics)
Patient education: Evaluating memory and thinking problems (The Basics)
Patient education: EEG (The Basics)
Patient education: GI bleed (The Basics)
Patient education: Liver panel (The Basics)
Patient education: Liver cancer (The Basics)
Patient education: Toxic-metabolic encephalopathy (The Basics)
Patient education: Aminotransferase tests (The Basics)

Patient education: Cirrhosis (Beyond the Basics)

This topic retrieved from UpToDate on: Jun 02, 2024.
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