An Overview Of Hepatic Encephalopathy

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What Is Hepatic Encephalopathy?

The serious condition known as hepatic encephalopathy occurs when a malfunction with the liver leads to brain and nervous system damage. Encephalopathy means “disease of the brain”. It is actually a collection of different diseases affecting the organs within the nervous system.

In the case of this condition, the encephalopathy is actually caused by liver diseases known as cirrhosis or hepatitis. Cirrhosis is liver disease in which the normal liver tissue is replaced by scar tissue. This result after various factors have caused damage to normal liver cells and is a chronic condition. Hepatitis is an inflammation of liver tissue. It can be either an acute or chronic condition.

The problem with both of these conditions is that they lead to an increase in toxins within the blood because the liver is unable to properly filter and remove wastes. As concentrations of toxins increases, the brain and nervous system is affected, leading to encephalopathy. There have been some cases in which encephalopathy has occurred suddenly without the presence of long term disease, but chronic liver disease is usually the most common feature.

Main Symptoms and Signs of Hepatic Encephalopathy

Hepatic encephalopathy can present itself in various clinical signs and symptoms from mild confusion to sever coma. The most common signs and symptoms are cerebral edema, inability to think clearly, neuromuscular dysfunction, and drowsiness with potential unconsciousness. The condition might be reversed if the underlying liver disease is treated early before more serious brain herniation, coma, or neuro-motor/muscular loss occurs.

The Hepatic Encephalopathy Diet

One of the major ways it was thought to lessen the damage done was to reduce the amount of toxic ammonia that the body produces. In order to produce a hepatic encephalopathy diet, the main goal in treatment was to restrict the amount of proteins in the dirt. However, scientists have discovered this leads to protein malnutrition. In some patients, the diet of someone who is intolerant to animal protein can be switched to include vegetable protein. The use of vegetable protein has a better outcome on improving the nitrogen balance, but not in causing the hepatic encephalopathy to become worse.

Another way that might improve the hepatic encephalopathy diet is to include more branched chain amino acids found in fish and dairy, or including more sugars such as lactulose in the diet. The three branch chain amino acids are valine, isoleucine, and leucine. When administered early to patients with hepatic encephalopathy, they did show some improvement in the nervous system changes associated with this condition. However any type of treatment that will reduce the amount of ammonia produced by the body and located in the bloodstream, may improve hepatic encephalopathy.


Web Source: U.S. National Library of Medicine and the National Institutes of Health. “Hepatic Encephalopathy” 2009. Available at: