HEPATIC ENCEPHALOPATHY 

 

The L4L team are busy working on an At A Glance Guide for Hepatic Encephalopathy (HE), however in the meantime, take a look at the below basic
information. We have also been working with Norgine and are delighted to share this Patient Passport, especially designed for people affected by HE to manage their condition better. The passport aims to help you keep track of important information related to your condition. You can use it to record important details, such as the medications you are taking and instructions you have been given from your healthcare team. Having this information to hand will help your healthcare team to understand what you are going through. It is recommended that you take this passport to all of your appointments. You can download it here. 

01

What is Hepatic Encephalopathy?

 

Hepatic encephalopathy (HE) refers to a decline in brain function caused by chronic advanced liver disease (often called cirrhosis). In this condition, the liver cannot adequately remove toxins from the bloodstream; toxins build up in the blood, reach the brain and reduce its ability to work properly. 

 

02

How does HE develop?

 

If the liver is damaged, in cirrhosis, and unable to break down toxins properly, the levels of toxins, such as ammonia, in the blood increase. These toxins then enter the brain and can cause both mental and physical change in your body, which is called HE. 

03

What triggers HE?

 

Triggers for HE may include: 

  • Constipation 

  • Dehydration 

  • Infections (such as pneumonia) 

  • Electrolyte disorder (such as a decrease in potassium after vomiting or taking diuretics) 

  • Use of medications (such as tranquilisers) 

  • Recent surgery or trauma

04

What are the symptoms for HE?

 

HE can reduce both mental and physical function. HE may be a ‘one-off’ occurrence or it may be recurrent, with multiple episodes throughout your life, although repeated cases are usually seen in people with severe liver disease. 

 

The symptoms of HE can vary from mild to severe, can develop rapidly or slowly over a period of time and can be different from person to person. The mild symptoms of HE may be easily missed because they are subtle and difficult to spot, while the moderate-to-severe symptoms are clearly visible and concerning.

Symptoms of mild HE may include:

  • poor concentration

  • poor judgment

  • forgetfulness

  • difficulty thinking

  • personality changes

  • change in sleep patterns

  • a musty or sweet breath odour

  • problems with handwriting or loss of other small hand movements

Symptoms of moderate-to-severe HE may include:

  • anxiety

  • agitation

  • confusion

  • disorientation 

  • shaky hands or arms

  • slow movements 

  • slurred or jumbled speech

  • sleepiness or fatigue 

  • severe personality changes

  • in very serious cases, coma 

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