What is hepatic encephalopathy (HE)? - Eastern Liver Network
5094605-35115500hepatic encephalopathyWhat is hepatic encephalopathy (HE)?Hepatic encephalopathy (HE) is a decline in brain function that occurs as a result of liver disease. HE can be episodic, always present or a combination of the two.What causes HE?One of the functions of the liver is to breakdown and remove toxins from the blood stream. When the liver fails to function, chemicals enter the brain and interfere with brain function, leading to physical and mental symptoms.Signs and SymptomsSymptoms may come on quickly or gradually and may only be noticed by friends and family.ConfusionPoor attention and judgementForgetfulnessDisorientationPersonality changesAggressionChanges in sleep pattern (sleep during the day and awake at night)Shaky handsSlurring of speechSluggish movementsHow is HE diagnosed?HE is usually diagnosed on the basis of assessment by your doctor or nurse. Blood testing, psychometric testing, brain scanning and electrical brain activity recordings may be required to make the diagnosis or exclude other causes.Is HE treatable?HE is treated by addressing any underlying triggers and treating liver disease. Common triggers for HE follow:Constipation InfectionsSedating medicationAlcoholDehydrationKidney impairmentBleeding in the stomach and intestinesRecent surgeryBlood salt imbalanceSome medications are specifically used for treatment:Lactulose and enemasLactulose is a type of sugar that changes the stool acid levels to prevent growth of certain types of bacteria, which may produce toxins that cause HE. Its laxative effect leads to faster stool transit, which probably reduces the buildup of toxins. Enemas have a similar effect.RifaximinRifaximin is an antibiotic that stops the growth of a number of toxin producing gut bacteria and has been shown to reduce the number of hospital admissions for patients with HE. DrivingHE causes prolonged reaction times. For your own safety and the safety of others, you should inform the DVLA and refrain from driving if you suffer from it.Emotional issues HE can be an unpredictable condition and can be stressful for you and anyone caring for you. It is likely that you and your carer/s will need to find ways to share your emotions, rest, balance your personal life and communicate your experiences. Speak to your GP, specialist nurse or hepatologist if you want help in this area; they should be able to give you advice and point you in the right direction should you require further assistance.Further informationYou may find the following internet links useful.British Liver Trust – .ukEastern Liver Network – ................
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