Hepatic Encephalopathy

WHAT YOU SHOULD KNOW:

• Hepatic (he-PAT-ik) encephalopathy (en-sef-ah-LOP-ah-the) is a condition affecting your brain due to liver disease. One of the functions of the liver is to clean the blood coming from the gastrointestinal system (stomach and intestines). Blood from the gastrointestinal system contains ammonia and other harmful substances. Liver damage due to disease, such as cirrhosis, decreases the liver's ability to clean the blood. Cirrhosis may also prevent blood flow into the liver further increasing ammonia in the blood. Ammonia then goes into the brain damaging the brain cells.
  
  
• The symptoms early in the disease may include mood changes, a short attention span, and drowsiness. Changes in sleeping habits and difficulty in speaking or writing may occur. As the disease worsens, there may be confusion and amnesia (inability to recall past events). Sleepiness, reduced awareness, and coma may occur with severe disease. An EEG or urine and blood tests may be done. A low protein diet and medicines to decrease ammonia in the blood may be given for mild encephalopathy. Severe encephalopathies are often life-threatening and require a hospital stay. With early diagnosis and treatment, the damaging effects of this condition may be reversed and brain function restored. Ask your caregiver for more information on these tests and treatments.

INSTRUCTIONS:

Take your medicine as directed.

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Do not drink alcohol:

Some people should not drink alcohol. These people include those with certain medical conditions or who take medicine that interacts with alcohol. Alcohol includes beer, wine, and liquor. Tell your caregiver if you drink alcohol. Ask him to help you stop drinking.

Diet:

• A caregiver called a dietitian or nutritionist may talk to you about your diet. You may be asked to decrease the intake of protein and salt in your diet.
  
  

CONTACT A CAREGIVER IF:

• You have a fever.
  
  
• You are sleeping more than the usual.
  
  
• You have questions about your disease, medicines, or your treatments.

SEEK CARE IMMEDIATELY IF:

• You have problems thinking clearly.
  
  
• You have trouble breathing all of a sudden.
  
  
• You just had a convulsion.
  
  
• You have a fast heartbeat or trouble breathing. You feel confused, dizzy, or lightheaded.
  
  
  • This is an emergency. Call 911 or 0 (operator) to get to the nearest hospital or clinic. Do not drive yourself to the hospital.
    
    

Learn more about Hepatic Encephalopathy (Aftercare Instructions)