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.
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.
Hepatic encephalopathy if left untreated may damage your brain cells for the rest of your life. This may cause problems in your mood, behavior, and the way you think. Severe damage to the brain may be life threatening and could lead to coma. Ask your caregiver if you have any questions about your condition and its treatments.
WHILE YOU ARE HERE:
is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
A caregiver called a dietitian or nutritionist will talk to you about your diet. You may be asked to decrease the intake of protein and salt in your diet.
This is also called neuro signs, neuro checks, or neuro status. A neurologic exam can show caregivers how well your brain works after an injury or illness. Caregivers will check how your pupils (black dots in the center of each eye) react to light. They may check your memory and how easily you wake up. Your hand grasp and balance may also be tested.
You may have one or more of the following:
- Antibiotics: Certain antibiotic medicines may decrease ammonia-producing germs in the intestines.
- Laxatives: These medicines may increase bowel movements to reduce the chances of ammonia being absorbed into your blood.
You may need one or more of the following:
- Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
- EEG: This test is also called an electroencephalogram. Many small pads or metal discs are put on your head. Each has a wire that is hooked to a machine. This machine prints a paper tracing of brain wave activity from different parts of your brain. Caregivers look at the tracing to see how your brain is working.
- Stool sample: A sample of your stool or bowel movement (BM) is sent to a lab for tests. The stool may show what germ is causing your illness. This helps caregivers learn what medicine is best to treat you.
- Urine sample: For this test you need to urinate into a small container. You will be given instructions on how to clean your genital area before you urinate. Do not touch the inside of the cup. Follow instructions on where to place the cup of urine when you are done.
You may have any of the following:
- Artificial liver support: This uses a dialysis-like machine to clean your blood when your liver cannot. Chemicals and waste products are removed from your blood by a filtering machine. This is done by passing your blood through a special filter, then returning the blood back to you. Caregivers will check your vital signs often during the procedure. Ask your caregiver for more information about liver support for this condition.
- Surgery: Surgery to correct blood flow to the liver and a liver transplant may be treatment options. Ask your caregiver for more information about surgery as a treatment option for this condition.
- Ventilator: This is a machine that gives you oxygen and breathes for you when you cannot breathe well on your own. An endotracheal (ET) tube is put into your airway through your mouth or nose. You may need a trach if an ET tube cannot be placed. A trach is an airway tube put into an incision (cut) in the front of your neck. The ET tube or trach is attached to the ventilator.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.