Hepatic Encephalopathy: A Comprehensive Review
Wani Mubashir1, Mehraj Sharik1, Wani Ahad2, Shafi Aamir3* and Ifrah Riaz3
1Junior Resident, Department of General Medicine, Sheri Kashmir Institute of Medical Sciences Medical College Bemina Srinagar, Jammu and Kashmir, India
2Assistant Professor, Department of General Medicine, Sheri Kashmir Institute of Medical Sciences Medical College Bemina Srinagar, Jammu and Kashmir, India
3Registrar, Department of General Medicine, Sheri Kashmir Institute of Medical Sciences Medical College Bemina Srinagar, Jammu and Kashmir, India
*Corresponding Author: Shafi Aamir, Registrar, Department of General Medicine, Sheri Kashmir Institute of Medical Sciences Medical College Bemina Srinagar, Jammu and Kashmir, India.
June 01, 2022; Published:
Hepatic encephalopathy is a reversible disorder seen in patients with advanced cirrhosis. It is manifested by wide spectrum of neurological and psychiatric abnormalities which occur due to accumulation of toxic substances specially ammonia in the brain. The common triggers include constipation GI bleeding infection, TIPS etc. it is seen in 30 to 45% of patients with cirrhosis. Presence of liver disease together with factoring out other causes of altered mental status is essential for diagnosis of HE. Management includes proper identification and treatment of underlying cause of underlying cause. Antibiotics like rifaximin, metronidazole are often given empirically to take care of infections. In addition osmotic laxatives, L-ornithine and L-aspartate (LOLA) are also used to decrease the levels of ammonia. Feacal microbiota transplant is gaining significant progress in the management of refractory hepatic encephalopathy.
Keywords: Hepatic Encephalopathy; Ammonia; Liver
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