What Are The Symptoms Of Hepatic Encephalopathy


The largest organ that is located inside the human body happens to be the liver. And with that, it has so many roles to play in the body. The liver is well-known for its detoxification and digestion roles in the body. Even at this, it happens to be one of the most affected organs in the body. There are many liver diseases that exist. And one of them is hepatic encephalopathy. Usually, different diseases would present with different symptoms. That, of course, is how doctors are able to diagnose what the problem is. So in different conditions, it’s important to know the different distinct symptoms. That’s why we will take a look at hepatic encephalopathy symptoms.

Hepatic encephalopathy is actually a condition that causes a decline in the function of the brain. And this happens because of a severe liver problem. The problem is that the liver can’t remove toxins from the body as it should. And this leads to the buildup of toxins inside the blood. That, in the end, would lead to brain damage. This condition can either be acute or chronic. And a person with this condition can go into a coma and later die. That’s why it’s important to know the symptoms so that you can be diagnosed early.

Types and Stages of Hepatic Encephalopathy

As mentioned before, this condition develops as a result of a severe liver problem, most especially the acute type. When a person has acute hepatic encephalopathy it can be a sign of terminal failure.

There are actually certain conditions that can cause acute hepatic encephalopathy. And they are:

  • Toxic hepatitis: This can be caused by a result of exposure to chemicals, drugs, and alcohol.
  • Acute fulminant viral hepatitis: This is a condition that happens to a person suddenly. And it’s known to be a severe form of viral hepatitis.
  • Reye’s syndrome: This condition is quite rare and also severe. It is mostly seen in children. And it is as a result of the inflammation of the brain and liver.

As for chronic, it can either be recurrent or permanent. People that have recurrent type have different episodes of this same condition. And it happens all through their lives. For this type, continuous treatment is needed. And the reason for this is to help prevent other symptoms from coming up. This type can be easily found among people with cirrhosis.

The permanent type is quite rare. And it can be seen in people that either don’t respond to treatment or people that have permanent neuro conditions. Such as spinal cord injury or seizure disorder.

Also, this condition is classified into different stages. And this is based on the severity of the condition. Let’s take a look at the 5 stages of hepatic encephalopathy. This is according to West Haven Criteria.

  • Stage 0: The symptoms at this stage are very minimal.
  • Stage 1: The symptoms at this stage are mild. The symptoms include a short attention span and sleep disturbances.
  • Stage 2: The symptoms at this stage are moderate. At this stage, the patient would feel lethargic or disoriented.
  • Stage 3: The symptoms at this stage are quite severe. And most times at this stage they can’t perform simple tasks. Symptoms like personality change and confusion would be experienced.
  • Stage 4: This is the last stage and in this stage, the patient goes into a state of coma.

Hepatic Encephalopathy Symptoms and Causes

The exact cause of this condition is not known. The thing though is that it is triggered by the building up of toxins in the bloodstream. And this happens when the liver can’t remove toxins properly from the body.

One of the roles of the liver in the body is to remove toxic substances such as ammonia from the body. It is the role of the kidneys to actually change the substances into safe substances. And with that, they are removed from the body through urination.

But when your liver is damaged you can expect that there would be a problem with performing this function. The building up of the toxins would, of course, affect the brain. At the same time, it would cause the damaging of other nerves and organs in the body.

hepatic encephalopathy symptoms

There are certain things that can trigger this condition. And they are:

  • Dehydration
  • Infections like pneumonia
  • Hypoxia
  • Kidney problems
  • Trauma or recent surgery
  • Taking too much protein
  • Medications that suppress the immune system
  • Electrolyte imbalance

There is a long list of symptoms that are experienced when a person has hepatic encephalopathy. And the symptoms would actually vary depending on the cause of the liver damage.

Some of the signs and symptoms of moderate encephalopathy are:

  • Poor concentration
  • Difficulty thinking
  • Confusion
  • Personality changes
  • Problems with small hand movements
  • Poor judgement
  • Forgetfulness
  • Sweet breath odor

For severe encephalopathy the symptoms are:

  • Anxiety
  • Confusion
  • Lethargy
  • Seizures
  • Fatigue
  • Severe personality changes
  • Shaky hands
  • Slow movements
  • Confused speech

If you experience any of the symptoms listed above go see a doctor immediately. That’s because these symptoms can lead to coma if not treated on time.

Treatment and Outlook

So the treatment for this condition is actually dependent on what causes it. But even at that, there are still some things that can be done so as to manage the condition.

Consume less protein if you’ve been taking too much. It’s possible to get just about the right amount of protein that is needed for the body. You can reduce the consumption of high-protein foods like fish, eggs, red meat, and poultry.
Also, there are medications that can help slow down how your blood absorbs the toxins. Some antibiotics and lactulose would be able to do the trick.

In cases where there is difficulty in breathing, an oxygen mask, and a ventilator can be used when needed.

For the outlook, people that have chronic type have better chances of recovery than the acute type. And the chances of recovery increase if you find out this condition early. The good thing is that treatment can help reverse hepatic encephalopathy symptoms.

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