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Hepatic Encephalopathy


Hepatic encephalopathy is diagnosed as a reduction in brain functioning that is caused by chronic liver disease. Patients of hepatic encephalopathy have poorly functioning livers that are not equipped to remove any toxins in the blood. With a build-up of toxins in the bloodstream, brain damage results. It is seen in patients who suffer from cirrhosis of the liver.

Mental impairment, personality changes and poor concentration are the key symptoms of hepatic encephalopathy.

Hepatic encephalopathy can take the form of being acute or short-term or chronic or long-term. It is not uncommon for patients in this condition to stop responding and become comatose.

Signs and Symptoms

Depending on the underlying cause of liver damage, the symptoms of this condition can differ. They include:

  • Lack of concentration
  • Difficulty thinking
  • Personality changes
  • Inability to perform functions with hands
  • Difficulty with writing
  • Confusion
  • Musty odor
  • Forgetfulness
  • Poor judgment

If not treated in time, lack of medical attention can lead to a coma.


Though the exact cause of this condition is yet unknown, it is set off due to a build-up of toxins in the bloodstream. This happens when the liver can no longer break down toxins. It is also set off by:

  • Pneumonia
  • Renal issues
  • Dehydration
  • Surgery or trauma
  • Low oxygen levels
  • Medications that quashthe immune system
  • Overeating protein
  • Use of barbiturates or benzodiazepine tranquilizers
  • Imbalance of electrolytes

Risk Factors

While undergoing treatment for hepatic encephalopathy, the mental status of some patients may not be affected. However, others may show extreme damage to the memory, despite being under treatment. Both these types of patients will experience an extreme form of this condition.


Patients with severe liver disease generally suffer from acute hepatic encephalopathy. It occurs due to these conditions:

  • Acute fulminant viral hepatitis. A severe variant of viral hepatitis, it appears suddenly.
  • Toxic hepatitis.This is caused due to drugs, chemicals, supplements or alcohol.
  • Reye’s syndrome.Rare and chronic, this condition is seen mainly in children. It is recognized for the inflammation and swelling of the brain and liver.


Management of the liver is the best way of preventing liver disease. Further, hepatic encephalopathy can be prevented by following these pointers:

  • Avoid alcohol completely or use it in moderation
  • If you are obese, lose weight.
  • Avoid fatty foods.
  • Don’t accept contaminated needles.

Diagnosis & Treatments:

The tests to diagnose hepatic encephalopathy are:

Blood tests

Your doctor will ask for a complete report of blood count which checks your red and white blood cells and platelets. If your red blood cell count is low, it means that there’s been some blood loss and insufficient oxygen.

With the help of the blood tests, your doctor will also check blood levels of ammonia, sodium and potassium. If an individual consumes too much of these three substances, it could impair his regular liver functioning.

Imaging tests

A CT scan or an MRI will check for any bleeding or abnormalities in the head and brain.

Liver function tests

With the results of these tests, your doctor will check for raised enzyme levels. A high level of enzymes denotes a stressed liver or already pre-existing liver damage.

If you have pre-existing liver disease, inform your doctor at this stage.

Treatment Options

Depending on the severity of the patient’s condition and its underlying cause, your doctor will suggest treatment options.

Diet. If your doctor detects that you’ve been eating excess protein, he will ask you to cut down on your protein intake so that your symptoms don’t worsen.

You should avoid these protein foods:

  • Poultry
  • Fish
  • Red Meat
  • Eggs

Medication. With medication, the rate at which the blood absorbs toxins will slow down, so your doctor will prescribe certain antibiotics, lactulose and a synthetic sugar. With these medicines, your body will be able to draw out ammonia and send it to your colon. Your blood will now be removed from the colon. In case you have difficulty breathing, you might be asked to wear an oxygen mask or you might be put on a ventilator.

Preparing for Your Appointment

It can be very overwhelming and frightening to be told that you suffer from hepatic encephalopathy. Since this is a medical condition that has a direct impact on your cognitive abilities, memory and concentration, it is advisable to bring a family member or a friend with you to the doctor’s appointment.

In a condition like Hepatic encephalopathy, it’s common for symptoms to be so small that no one really notices it. So, it’s good to have someone close to you who can help you fill in any gaps relating to your symptoms and overall medical history.

To be well-prepared for your appointment, you should come with information relating to this checklist:

  • Any symptoms that you experience in recent times and those that close friends or relatives have noticed about you
  • Issues pertaining to your driving skills and job performance
  • Have a ready list of all the medication you’re currently on
  • Any questions you may want to ask or things you want the doctor to know


Medical Management

Lifestyle & Others

In order to make lifestyle changes so that you prevent the recurrence of hepatic encephalopathy, do the following:

  • Avoid alcohol
  • Avoid fatty foods
  • Don’t be overweight
  • Refuse to use contaminated needles



Dr.Rela Institute and Medical Centre has been set up under the leadership of a world-renowned Liver Surgery and Transplantation surgeon, Prof. Mohamed Rela.

To cater to all kinds of liver ailments and surgeries, this liver hospital in Chennai is home to one of the world’s largest dedicated liver intensive care units.It also provides primary and secondary medical care to the local people of Chennai.

The impressive Dr. Rela Institute & Medical Centre has been established on a 36-acre estate in Chromepet, Chennai, Tamilnadu, India. This 450-bedded hospital comprises 130 critical-care beds, 14 operating rooms and state-of-the art reference laboratories and radiology services.

Top liver specialists in Chennai are empanelled here for immediate service to patients. This is an extremely beneficial service for patients of a variety of liver ailments to get state-of-the-art treatment from top-notch medical professionals. In fact, past patients recommend this hospital as the best liver transplantation hospital in Chennai, India.

It is conveniently located near road, rail and air transport.

Should you ever need to see a liver specialist, please give us a call or make an appointment with us on +91 9384681770



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