Hepatic Encephalopathy

Occurring in close to half of those diagnosed with cirrhosis of the liver, hepatic encephalopathy is a condition that can affect brain function and cause cognitive impairment.

There are three types of hepatic encephalopathy:

  • Type A, which is brought on by acute liver failure
  • Type B, which can occur in patients who have a shunt that connects veins inside the liver
  • Type C, which is brought on by chronic liver disease and cirrhosis (scarring of the liver)

Causes of Hepatic Encephalopathy

It is believed that hepatic encephalopathy is triggered when the liver fails to break down toxins effectively, causing them to build up in the bloodstream and travel to the brain and other organs. This condition is most often a byproduct of chronic liver disease.

There are a variety of factors that can trigger hepatic encephalopathy in individuals dealing with chronic liver disease, including:

  • Alcohol use
  • Drugs that affect the nervous system
  • Kidney problems
  • Dehydration
  • Recent surgery or trauma
  • Digestive tract bleeding
  • Infection

Symptoms of Hepatic Encephalopathy

The symptoms of hepatic encephalopathy can vary depending on the causes of the liver damage. Some early symptoms involve:

  • Loss of concentration
  • Personality changes
  • Forgetfulness
  • A musty breath odor
  • Handwriting changes

For individuals with severe hepatic encephalopathy, symptoms include:

  • Confusion
  • Anxiety
  • Loss of balance
  • Seizures
  • Drowsiness
  • Shaky hands
  • Slurred speech

Diagnosing Hepatic Encephalopathy

Diagnosing hepatic encephalopathy can be difficult, and testing may be needed to rule out conditions that cause similar symptoms, such as strokes and brain tumors.

If your healthcare provider has reviewed your symptoms and medical history and performed a physical exam, the following tests may help confirm a diagnosis of hepatic encephalopathy:

  • Blood tests to evaluate liver function
  • An imaging procedure, such as an MRI or CT scan, to look for brain abnormalities
  • Liver function tests to check enzyme levels

Treatments for Hepatic Encephalopathy

The most important step in treating hepatic encephalopathy is for the patient to undergo the lifestyle changes needed to help reverse the underlying liver disease. This can include refraining from drinking alcohol, losing excess weight and controlling sugar intake. Additionally, steps can be taken to help reduce the toxins in the body. Antibiotics can help stop the growth of bacteria that produce natural toxins, and laxatives can help stimulate frequent bowel movements to help remove toxins.

Tampa General Hospital’s liver disease and hepatology specialists offer comprehensive hepatology services to patients with diseases of the liver, biliary tree, gallbladder and pancreas.