Diagnosis and treatment of hepatic encephalopathy

The article was consulted professionally with MSc Vu Tan Phuc - Department of Medical Examination & Internal Medicine, Vinmec Phu Quoc International General Hospital.

Hepatic encephalopathy is a condition in which the liver is unable to remove toxins from the blood, leading to impaired brain function. The disease can progress well if detected and treated early.

Hepatic encephalopathy is a buildup of toxins in the blood that causes impaired brain function. The cause of this condition is when the liver cannot remove enough toxins from the blood. Damaged liver function is less able to remove these toxins causing them to build up in the blood and travel to other organs.
Hepatic encephalopathy develops when toxins enter the brain and damage brain cells causing physical and psychological symptoms. People with hepatic encephalopathy often experience disturbances in consciousness, behavior, and coma caused by liver dysfunction.

Patients will experience different severe and mild symptoms, this depends on the cause of the liver damage and the extent.
Mild symptoms, patients may experience such as:
Difficulty in limb movements Forgetfulness, confusion

Slowness, difficulty concentrating Bad breath Personality changes Severe symptoms such as:
Lethargy, slow movement Difficulty in pronunciation Restlessness, anxiety The mind is no longer clear, memory is poor Convulsion

Hepatic encephalopathy is divided into 3 types, based on the cause of the disease:
Type A : Type A encephalopathy occurs only in a person without pre-existing liver disease experiencing rapid deterioration liver function causing acute liver failure. Causes of hepatic encephaloencephalopathy syndrome type A are due to acetaminophen overdose, heavy alcohol consumption, hepatitis, Wilson disease Type B: Type B hepatic encephalopathy is caused by a portosystemic shunt which is an occlusion. between the portal vein and the vena cava of the collateral circulation or to reduce portal pressure should surgically create a portal-aortic shunt. Therefore, a large flow of blood from the digestive system directly into the circulatory system bypassing the liver is the main mechanism of disease. The two main causes of this condition are congenital and traumatic. Type C: Cirrhotic scarring is the cause of type C hepatic encephalopathy. Cirrhosis develops in late-stage liver disease, where the liver is less able to remove toxins from the blood and perform other functions.

Through a physical exam and gathering of symptoms and medical history, along with other tests, the doctor will be able to diagnose the stages that a person with hepatic encephalopathy has. There are 5 disease stages of hepatic encephalopathy and the severity of a person's symptoms determines the stage of hepatic encephalopathy.
Stage 0: most symptoms appear very little, the signs are mainly related to coordination and concentration
Stage 1: the patient shows some mild symptoms such as insomnia and decreased time attention time.
Stage 2: the patient will experience symptoms: memory loss and slurred speech.
Stage 3: severe symptoms, including personality changes, confusion, and lethargy.
Stage 4: Loss of consciousness and coma.

The doctor can assign the patient to perform some other tests to get the most accurate results such as:
Blood test: through a blood test, the doctor will identify conditions such as infection, bleeding, liver or kidney dysfunction, and toxic elevation in the blood. Brain MRI or CT scan: This imaging test helps doctors identify abnormalities. Electroencephalogram.

Based on the results of the diagnosis, the doctor will recommend appropriate treatment for each patient such as:
Medicines to treat infections Using drugs or surgery to control bleeding Drugs that cause brain syndrome the liver may have to stop taking it Treating kidney problems Medicines to help lower levels of ammonia and other toxins in the blood Use oxygen, mechanical ventilation More serious than a liver transplant

However, in the course of treatment, the doctor also needs to base on the patient's condition to have the appropriate treatment method such as:
Severity of the hepatic encephalopathy syndrome The patient's symptoms The degree of severity severity of potential liver damage The patient's age and overall health Patients need to follow their doctor's treatments to get the best results.