What Is Hepatic Encephalopathy?
The liver filters toxins from the blood. When you have liver disease, ammonia and other toxins can build up in your brain, causing you to lose brain function.
This condition is hepatic encephalopathy (HE).
HE is often a complication of cirrhosis of the liver.
About 7 out of 10 people with cirrhosis develop some form of HE. The exact number is unknown because the symptoms can be subtle in the early stages.
Types of hepatic encephalopathy
There are two types of HE.
- Acute HE comes on fast and may be a sign of liver failure.
- Chronic HE takes longer to develop. Sometimes people recover only to have it recur later.
Doctors classify the severity of HE by stages.
- Stage 0: Minimal HE. Slight changes in memory and concentration.
- Stage 1: Mild HE. Mood changes and sleep problems.
- Stage 2: Moderate HE. Inappropriate behavior, slurred speech, trouble doing basic math.
- Stage 3: Severe HE. Disorientation, extreme sleepiness, or anxiety.
- Stage 4: Coma.
Risk factors and complications of HE
Risk factors that make it more likely you'll get HE include:
- Cirrhosis or other severe liver disease.
- Having a TIPS procedure.
- Having a previous episode of HE.
- Having portal hypertension.
If you've had HE once, these things can trigger another bout:
- Not drinking enough water.
- Low levels of salt in the blood.
- Eating too much protein.
- Bleeding from digestive tract.
- Kidney failure.
- Lack of potassium.
- Low oxygen levels.
- Taking drugs that act on the central nervous system, including antidepressants, sleeping pills, opiates, and opioids.
Untreated, HE will get worse. It will not get better on its own.
How to prevent HE
The only sure way to prevent HE is to keep your liver healthy. People who drink too much alcohol or have hepatitis are at risk for liver disease.
If you have liver disease, you can prevent further damage by:
- Eating a healthy diet.
- Maintaining a healthy weight.
- Not drinking alcohol.
- Seeing your doctor on a regular basis.
Why choose the UPMC Center for Liver Diseases for hepatic encephalopathy care?
- Our doctors are experts at treating complications from liver disease, including HE.
- We offer cutting-edge treatments and therapies for those with cirrhosis and other liver disease.
- UPMC is also home to one of the most experienced liver transplant centers in the country.