CCRN Hepatic Encephalopathy

CCRN Hepatic Encephalopathy Overview

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.

Signs and Symptoms

Symptoms of hepatic encephalopathy differ depending on the underlying cause of the liver damage.
Symptoms and signs of moderate hepatic encephalopathy may include:

• Difficulty thinking
• Personality changes
• Poor concentration
• Problems with handwriting or loss of other small hand movements
• Confusion
• Forgetfulness
• Poor judgment
• A musty or sweet breath odor

Symptoms of severe hepatic encephalopathy are:

• Confusion
• Drowsiness or lethargy
• Anxiety
• Seizures
• Severe personality changes
• Fatigue
• Confused speech
• Shaky hands
• Slow movements

Causes

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. Your kidneys change 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.

Treatment

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 create a diet that’ll allow you to get enough protein without making your symptoms worse.

Medications can also help slow the rate at which your blood absorbs toxins. Your doctor may prescribe antibiotics and lactulose (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.