Hepatic Encephalopathy

Hepatic Encephalopathy is a condition in your body that links the issues of the liver to the brain. In simple words, it is a condition where your liver is unable to get rid of toxins from the blood, as it should, because of which these toxins start affecting the brain.

To help you remember this term and its meaning in simple words, here is a breakdown of the two words of the disorder-

• Hepatic, which means about the liver.
• Encephalopathy, which is brain dysfunction.

Usually, it affects the CNS or the central nervous system and changes the way you think, feel, or act.

Mild symptoms like confusion and erratic behavior can occur during these times. Usually, the types of toxins that accumulate in the blood, which should be disposed of by the liver, fall into a category of neurotoxins.

Symptoms

Hepatic encephalopathy is a condition in which the patient has a wide variety of changes. It is very hard to notice that two different people will have the same type of symptoms.

Usually, here are the changes that you may start to notice with the brain functions-

• Mood and personality
• Behavior
• Unable to control the urge or impulse to do something.
• Loss of memory, concentration
• Lack of consciousness
• Changes in sleep patterns
• Lack of body coordination
• Unable to do simple tasks like getting up, sitting, or lying down in bed.

These symptoms can occur in phases, occur all of a sudden without any clue, and then disappear. The doctors generally grade these symptoms from mild to severe to assess the severity of the issue.

Grading System

The West Haven Criteria is the most commonly used standard method to scale the symptoms into different grades.

A scale of 0 to 4 is there, with zero meaning less severe and four meaning more severe symptoms and changes.

Grade 0 Signs

• Short memory
• Low concentration suddenly
• Higher reaction time than usual

Grade 1 Symptoms-

• Mild confusion
• Mood swings
• Unable to do basic math
• Sleep during the day and get up at night

Grade 2 Signs-

• Changes in behavior
• Lethargy
• Slurred speech

Grade 3 Signs-

• Slow thinking
• Disorientation easily
• Drowsiness
• Severe confusion or amnesia
• Twitching

Grade 4 Signs-

Total loss of consciousness or coma

Causes

As we have told you above, this issue occurs only when the brain is not able to get rid of certain types of waste present in your blood.

Liver Disorders

It may occur because the liver itself is suffering from any major type of infection or disease.

Some of the common disorders and infections of the liver that can cause Hepatic encephalopathy are-

• Hepatic disorders
• Liver failure
• Fatty liver

Portosystemic Shunt

It may also occur because of a process known as Portosystemic shunt. To get an idea about this, simply understand that the blood is supposed to pass through the liver, and the cells filter the waste out of it. However, with this Portosystemic shunt, the blood does not pass through certain sections of the liver. In some cases, both reasons can be true.

Types Of Hepatic Encephalopathy

The doctors will figure out the primary cause of the issue, based on which the type will be found.

• Type A occurs because of liver failure.
• Type B, which is caused by to Portosystemic shunt.
• Type C because of severe liver infections.

Triggering Events

Scientists have found that even with a case of severe liver disorder chances of having hepatic encephalopathy are low. However, scientists feel that a combination of other triggers can cause the disorder to occur much sooner. These include-

• Kidney failure
• Surgery
• Constipation
• Electrolytic imbalance
• Use of the wrong medicine or a high dose of medication for years
• Severe alcohol addiction

Risk Factors

Along with the triggering events, scientists feel that there are some risk factors too that can increase the chances of this disorder. Here is a look at some of these problems-

• Diabetes
• Epilepsy
• Low muscle mass
• Low sodium content
• High ammonia levels in the blood
• Genetic factors

Complications

As your behavior and attitude change, you start to show an abnormal attitude. This can be frustrating for other people. The most severe complication you can have is coma, which can lead to death.

Diagnosis

Some of the common tests include-

• Blood tests that check levels of different hormones inside the liver and ammonia
• Liver function test
• Ultrasound imaging tests like CT scans or MRIs
• EEG test to check your brain activity.

Treatment

Here is what the doctors will try to address when they begin your treatment-

• Managing the severe conditions at first
• Gradually curing the main cause of liver damage
• Immediate cure to reduce neurotoxins from the blood.

The method of treatment and cure will depend on the severity of the disorder, the symptoms and, of course, to make it suitable as on the age and health of the patient.

Reducing Brain Toxins From The Blood

Sometimes, it has been found that bacteria present inside the gut will release these toxins, which the liver is not able to get rid of. As a result, it is common for doctors to give antibiotics.

Some common medicines are-

• Neomycin
• Lactulose

Along with this, the doctors can also tell you to use supplements that have-

• Branch chain amino acids
• Probiotic substances

Hemodialysis

In this process, the doctors will conduct dialysis of the liver and get rid of the toxins from the blood with the help of suitable machines.

Methods To Prevent Hepatic Encephalopathy

According to a study by doctors, it is possible to prevent the issue using some simple tips in your daily life. These include-

• Eating more plant proteins
• Avoid alcohol and the use of sedatives.
• Ensuring enough water intake
• Daily exercise
• Keeping a healthy weight
• Enough sleep
• Having regular liver health checkups

Final Thoughts

Therefore, now you have a much clearer idea about a critical condition, hepatic encephalopathy. As you can see, the most severe way to be hit with this issue leads patients to coma, and from there, death may even occur.

It is important to start an early cure to get rid of the toxins in of blood as soon as possible to reduce the damage to your brain.