A healthy performance and functioning of the liver are essential since it is one of the most crucial parts of the body with many important bodily functions to perform. Ailments of the liver also called hepatic diseases are ones that negatively affect its health. This can be by sudden infections, inherited conditions, and excessive consumption of alcohol. One such liver-related ailment called hepatic encephalopathy develops because of mild or severe liver disorders, causing a decline in brain function. When the liver ceases to work properly, severe toxins start to build up in the bloodstream. Gradually, these toxins begin to travel to the brain and impede its functioning, leading to brain damage. Depending upon the severity of the problem, hepatic encephalopathy can be acute or chronic.
Hepatic Encephalopathy

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Causes Of Hepatic Encephalopathy?

While the exact cause of hepatic encephalopathy is unknown, primarily when the liver is damaged, it is unable to filter the toxins. Toxic hepatitis can happen due to alcohol consumption, the use of drugs, or even toxins building up in the bloodstream. The liver removes toxic chemicals such as ammonia from the body, which is broken down by other organs, and then the kidneys remove them through urination. When the body fails to break them properly, these toxic substances begin to build up and start to damage organs as well as nerves and from the bloodstream, thus getting into the brain. Certain viral infections can also cause acute fulminant viral hepatitis. Another possibility is acute hepatic encephalopathy which can indicate signs of terminal liver failure. People with permanent neurological conditions such as seizures, and people with spinal cord injuries can get episodes of this illness. Liver cirrhosis or scarring of the liver can also cause hepatic encephalopathy.

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Symptoms Of Hepatic Encephalopathy

Broadly the ailment is of two types-moderate or severe. Symptoms of moderate hepatic encephalopathy may include:

  • Difficulty thinking and a confused state of mind
  • Personality changes
  • Poor concentration
  • Amnesia and poor judgment
  • A sweet body odor

Severe hepatic encephalopathy symptoms are as follows:

  • Drowsiness and severe fatigue
  • Anxiety
  • Episodes of seizures
  • Slurring
  • Slow body movements

What Can Trigger Hepatic Encephalopathy?

Infections such as pneumonia, kidney problems, dehydration, hypoxia, oxygen levels in the body, surgery, central nervous system suppressant medication, imbalance of electrolytes, and a sudden decrease in potassium levels possibly due to certain diuretics can trigger this liver disorder. The following are five stages of hepatic encephalopathy based on the severity of the symptoms:

Stage 0- Symptoms at this stage are very minimal.

Stage 1- Symptoms increase at this stage with changes in sleep habits that could be hypersomnia or acute insomnia.

Stage 2- With moderate to high symptoms, at this stage, the mind is in a disoriented state.

Stage 3- Symptoms are severe with an inability to perform basic tasks and severe personality changes.

Stage 4- This stage is defined as when the person slips into a coma.

Diagnosis Of Hepatic Encephalopathy

Besides checking symptoms and medical history, diagnosis of hepatic encephalopathy is done by blood tests to identify red blood cells, white blood cells, and platelets. Blood tests may also be used to see the levels of sodium, potassium, and ammonia. An excess of these substances is a sign of impaired liver function. For detecting bleeding abnormalities in the brain, A CT scan or an MRI is done. A liver function test is done to check raised enzyme levels. An increase in enzymes indicates the percentage of severe problems or liver damage.

Treatment

Depending on the severity and underlying causes, the course of treatment is decided. Medications and antibiotics are given to help slow the rate at which your blood absorbs toxins. Some medications are given to draw ammonia passed by intestinal bacteria from the blood, into your colon. The purpose is to remove the toxic blood from the colon. As a last resort a liver transplant is suggested.

Preventing Hepatic Encephalopathy And Its Complications

People with recurrent infections may need ongoing treatment to help prevent complications such as brain herniation, brain swelling, and organ failure in extreme cases. Besides timely diagnosis and treatment, it is best to prevent hepatic encephalopathy by managing the liver disease at its early stages.  Avoid alcohol or it should be consumed in moderation. Maintaining a healthy weight is also necessary. Getting vaccination against hepatitis A and hepatitis B is also essential besides avoiding proximity to people diagnosed with viral hepatitis.