Learn About Causes of Hepatic Encephalopathy

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What Is Hepatic Encephalopathy?

Hepatic pertains to the liver and encephalopathy is a disorder of the brain. Hepatic encephalopathy is a condition in which the brain function is impaired because the liver is unable to remove the toxins from the blood.

Your liver, the largest solid organ in the body, cleans the blood, produces bile to aid in digestion and stores glycogen. As a natural process, the liver removes toxins from the blood and the bile carries the toxins to the intestine to leave the body through the stool.The causes of hepatic encephalopathy include a diseased liver that allows the toxins to remain in the blood and travel to the brain.


Cirrhosis, as reported by the Mayo Clinic, is scarring of the liver that occurs from repeated damage from diseases and conditions such as:

Symptoms of cirrhosis may include fatigue, fluid retention, bloody stools, poor appetite, itchy skin, jaundice and easy bruising, according to WebMd. Diagnostic procedures include blood tests to check bilirubin, CT or MRI scans to look for liver damage and an ultrasound imaging needle biopsy of the liver. Treatment options depend on the cause and extent of the liver damage.

The liver is an amazing organ that can make repairs and continue functioning when damage is minimal. In advanced cirrhosis, as more scar tissue forms in the liver, your liver can no longer function properly. Chronic cirrhosis eventually causes HE that can lead to coma and death.


Hepatitis is inflammation of the liver that is caused by viral infections, such as hepatitis A, B,or C; medications, such as acetaminophen, some seizure drugs and antibiotics; alcoholic toxicity; and disorders, such as cystic fibrosis and Wilson’s disease.

Hepatitis may be acute or chronic, and symptoms vary with the source of the hepatitis. Many of the symptoms resemble the flu and are not identified as hepatitis until the condition becomes chronic. The hepatitis A virus is spread through contact and ingestion of fecal matter from an infected person. Hepatitis B is transferred through contact with body fluids, such as blood and semen, from an infected person. Hepatitis C is spread through the blood of an infected person, such as in organ transplants or blood transfusions.

The Centers for Disease Control and Prevention reports an estimated 4.4 million Americans are living with chronic hepatitis, and most don’t know they are infected. Chronic hepatitis B or C can lead to cirrhosis of the liver and HE.


Dehydration is one of the possible causes of hepatic encephalopathy. Dehydration occurs when your body doesn’t have adequate replacement fluids for fluids lost through sweating, urination, vomiting and diarrhea. MedlinePlus reports symptoms that include:

  • dry mouth
  • limited or no urine ouptut
  • no tears
  • sunken eyes
  • comatose

Complications of dehydration can include an electrolyte imbalance and shock, which can damage the nervous system and lead to HE. You should consider severe dehydration a medical emergency.


Mayo Clinic: Cirrhosis Causes

WebMD: What Are the Symptoms of Cirrhosis of the Liver?

MedlinePlus: Hepatitis

Centers for Disease Control and Prevention: Viral Hepatitis

MedlinePlus: Dehydration