Hepatic Encephalopathy Stages and How to Deal With Them


A number of health conditions can adversely affect the overall health and wellness of individuals. While some are mild and can be treated with lifestyle changes or simple medical intervention, there are some conditions that can be life-threatening and debilitating. One example of such a medical condition is known as Hepatic Encephalopathy. This is because the end result of chronic hepatic encephalopathy that is left untreated can lead to patients eventually becoming unresponsive with some even slipping into a coma. But why does this happen? What is hepatic encephalopathy and how does one deal with the different stages of this condition? In this article, we attempt to answer these questions so read on to find out more!

Hepatic Encephalopathy: A General Overview

Hepatic Encephalopathy is a condition where the brain will experience a decline in its functions and is commonly caused by a disease of the liver that is severe. When one has this condition, the liver is unable to adequately have the toxins in the blood removed. This can lead to toxins accumulating and building up in the blood which can eventually result in damage to the brain. This condition can be short term (acute) or long-term (chronic). In other cases, an individual suffering the said medical condition won’t be able to respond properly and can enter a state of coma.

Individuals with acute hepatic encephalopathy may most probably be afflicted by the aforementioned condition due to severe liver disease. This may occur in individuals with the following issues:

  • Acute Fulminant Viral Hepatitis: This is a form of hepatitis that is severe and viral in nature and can have a sudden onset.
  • Toxic Hepatitis: Hepatitis that is toxic can be due to the exposure of the individual to supplements, drugs, chemicals, and alcohol.
  • Reyes’ Syndrome: This condition is serious and rare is most commonly observed in children. It can lead to the inflammation and swelling of the brain and the liver.

All of these conditions under acute hepatic encephalopathy can be a sign that there is probably a terminal failure of the liver.

Chronic Hepatic Encephalopathy, on the other hand, maybe recurrent or permanent. People with recurrent version will have a number of episodes of the said encephalopathy through different times in their lives. These individuals may also need treatment that is continuous to aid in the preventing of further symptoms developing. People with scarring of the liver or severe cirrhosis may have a recurrent version of this illness while those with permanent cases are commonly observed in individuals that do not get any positive response from treatments and those who may have neurological conditions that are permanent such as spinal cord injury and seizure disorder.

Symptoms of Hepatic Encephalopathy

The symptoms of hepatic encephalopathy will mostly depend on the actual cause of the damage to the liver. Some of the signs and symptoms of hepatic encephalopathy that is moderate include a sweet or musty odor of the breath, a judgment that is poor, forgetfulness, confusion, issues with small movements of the hands (such as writing), a concentration that is poor, changes in the personality, and difficulty thinking.

On the other hand, symptoms associated with hepatic encephalopathy that is severe include movements that are slow, hands that are shaky, speech that is confused, fatigue, personality changes that are severe, seizures, anxiety, lethargy or drowsiness, and confusion. It is important that people seek immediate medical attention if they observe severe symptoms of liver disease as if not treated quickly, these can lead to a coma.

Causes of Hepatic Encephalopathy

The experts are still uncertain as to what exactly causes hepatic encephalopathy.but it has already been established that this condition is the result of toxin build-up and accumulation in the blood. This occurs happens when there is a failure in the part of the liver to have the toxins broken down properly. This is because the liver is responsible for filtering out harmful substances such as ammonia from the bloodstream. The toxins come from when the metabolization of proteins occurs in the blood with these toxins serving as the leftovers. For livers functioning properly, then the toxins can be transformed into something safe and ready for excretion via urination.

Once there is significant damage to the liver, it won’t be able to have all the toxins removed from the body. This can lead to the buildup of toxins in the blood which may eventually make it to the brain and damage it. This can also occur to other nerves and organs. This condition may be triggered by the following:

Diagnosing Hepatic Encephalopathy

A number of diagnostic tests may be conducted to check for the aforementioned condition. These include:

  • Blood tests: A CBC or a complete blood count can check the platelets, white blood cells, and red blood cells. A red blood cell count that is low, for example, means that a loss of blood may be due to a lack of oxygen. This blood test can also check for the presence of other minerals which may indicate an impaired function of the liver
  • Imaging tests: These include MRIs and CT scans which can check for brain abnormalities
  • Liver Function Tests: Enzymes are checked for this test and increased levels may mean damage to the liver

The Stages of Hepatic Encephalopathy

Below is a simplified description of the stages of this health condition.

  • Stage 0- Minimal Symptoms
  • Stage 1- Mild Symptoms
  • Stage 2- Moderate symptoms
  • Stage 3- Severe symptoms
  • Stage 4- Symptoms lead to coma

Dealing with Hepatic Encephalopathy

Some of the most common treatments for hepatic encephalopathy include lifestyle changes such as reducing protein intake. Some medications may also help such as lactulose and antibiotics to help get rid of toxins from the blood. For those already having breathing difficulties, an oxygen mask or ventilator may be prescribed.

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