Hepatic Encephalopathy: Causes, symptoms, and treatment

Hepatic Encephalopathy is one of the severe diseases which occurs due to severe liver diseases such as cirrhosis or hepatitis, resulting in loss of brain function. Since your liver doesn’t function properly, it fails to remove toxins from your blood as a result the toxins build up in the bloodstream and end up causing brain damage.

It can be short-term or long-term and in severe cases lead to coma. It is a rare condition with fewer than 1 million cases per year in India. However, urgent medical attention may be required in some cases. 

Hepatic encephalopathy causes

It is not known what causes this condition, however, the liver fails to function appropriately and break down the toxins leading to the build-up of toxins in the bloodstream. The liver removes ammonia and similar kinds of toxins that are left over when the protein is broken down. These toxins are filtered by the kidneys and peed through urination. 

These toxins are unable to filter out when the liver is damaged resulting in the build-up in the bloodstream that might get to the brain and cause damage to the nerves. 

Diseases or conditions that may trigger hepatic encephalopathy

1. Infections, for instance, pneumonia
2. Dehydration
3. Low oxygen levels
4. Kidney problems
5. Recent surgery or trauma
6. Having too much protein
7. Medicines that suppress or affect the immune system
8. Medicines that suppress the central nervous system
9. Electrolyte imbalances or decline in potassium levels. 

Hepatic encephalopathy diagnosis

Diagnosis can be done in the form of three tests

Blood Tests- 

A complete blood count reveals your report of red blood cells, white blood cells, and platelets. If the red blood cells are less in the amount it indicates loss of blood and lack of oxygen. Apart from this blood tests also reveals potassium and ammonia levels, which can be dangerous if found in large amounts.

Imaging Tests-

Imaging tests such as CT scans and MRIs can check for internal bleeding in the brain or abnormalities. CT scan is a computerized tomography scan inclusive of x-rays from different angles of your body whereas MRI refers to Magnetic resonance imaging that uses strong magnetic fields and radio waves to develop images of the organs in the body. 

LFTs-

LFTs or liver function tests check the level of enzymes. This shows stress on the liver or liver damage. If there is a liver disease or a kidney disease and any of these tests are found similar, immediate consultation with your healthcare provider is required. 

Hepatic encephalopathy stages

Hepatic encephalopathy is divided into five stages-

Stage 0- Symptoms are minimal

Stage 1- At this stage, the symptoms are mild and symptoms showcase in the form of loss of attention span and insomnia or hypersomnia. 

Stage 2- Symptoms are moderate and may cause disorientation.

Stage 3- Severe symptoms, Extreme personality changes, and confusion

Stage 4- Hepatic Coma

Hepatic encephalopathy symptoms

The symptoms are prominently known but may differ from person to person and in severity as moderate to severe symptoms include-

1. Difficulty in thinking
2. Changes in personality
3. Perplexity 
4. Lack of hand movements
5. The constant state of forgetfulness
6. Sweet breath odor 
7. Poor judgment

Severe symptoms include- 

1. Perplexity
2. Feeling drowsy
3. Anxiety
4. Seizures 
5. Severe personality changes
6. Unclear speech
7. Tiredness 
8. Slow movements
9. Shakiness in hand

In severe cases and symptoms, it is advisable to directly head to seek medical help as it can lead to coma. 

Types of hepatic encephalopathy 

It is either acute or chronic. Acute hepatic encephalopathy mainly occurs in people with liver diseases such as- 

1. Acute fulminant viral hepatitis, which occurs suddenly
2. Reye’s syndrome, a rare condition seen in children causes swelling and inflammation in the liver and the brain. 
3. Toxic hepatitis is caused by supplements, drugs, chemicals, and alcohol. 

Chronic hepatic encephalopathy can be recurring or permanent. 

Hepatic encephalopathy treatment

The treatment depends upon the severity of the condition. Avoid eating high-protein foods such as poultry, red meat, and fish, and consult your doctor for a proper diet and medications. The medications can help take out ammonia from your blood and slow the rate of absorbing toxins. 

The doctor may suggest an oxygen mask or ventilator for serious cases of difficulty breathing, whereas some people are suggested a liver transplant. 

Prevention of hepatic encephalopathy

To prevent encephalopathy, it is necessary to prevent liver damage, and to do so, below are listed a few ways. 

1. Avoiding alcohol
2. Avoiding intake of high-fat food
3. Being healthy
4. Avoid sharing contaminated needles
5. Avoiding close contact with people with viral hepatitis
6. Getting vaccinated for both hepatitis A and B
7. Washing your hands properly with soap and water after using the loo. 

If you find similar symptoms or, liver cirrhosis encephalopathy, hepatic liver, or some other chronic liver diseases, kindly consult your healthcare provider. Bansal Hospital Bhopal has the best department for liver transplants and hepato-pancreato- biliary surgery. 

The department has credible doctors and support staff to provide you with proper consultation and apt diagnosis and treatment. It has successfully participated in multiple surgeries and performed critical liver transplants in Bhopal.