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Review
. 2022 May-Jun;12(3):927-936.
doi: 10.1016/j.jceh.2021.12.007. Epub 2021 Dec 22.

Encephalopathy in Cirrhosis: Prevention and Management

Amrish Sahney  1 , Manav Wadhawan  1
Affiliations
Review

Encephalopathy in Cirrhosis: Prevention and Management

Amrish Sahney et al. J Clin Exp Hepatol. 2022 May-Jun.

Abstract

Hepatic encephalopathy (HE) is a major neuropsychiatric complication of cirrhosis. The clinical manifestations of HE ranges from mild confusion, disorientation to altered behaviour and coma in advanced stages. HE is an important cause of recurrent admissions in liver cirrhosis patients. HE is the most common cause of altered mentation in a patient of liver cirrhosis. Lactulose and rifaximin are approved treatment options for the treatment of HE. In patients who have localised neurological signs or are not improving with lactulose and rifaximin should be investigated for other causes of altered sensorium.

Keywords: ALF, Acute Liver Failure; AMS, altered mental state; BCAA, Branched-chain Amino Acids; BRTO, balloon-occluded retrograde transvenous occlusion; CARTO, coil-assisted retrograde transvenous occlusion; FMT; HE, Hepatic encephalopathy; LOLA; OP, Ornithine phenylacetate; PARTO, plug-assisted retrograde transvenous occlusion; SIP, Sickness Impact Profile; cirrhosis; hepatic encephalopathy; lactulose; prevention; probiotics; rifaximin; treatment.

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Figures

Image 1
Figure 1
Algorithm for management of altered mental status in patients with liver disease. (algorithm-1).
Image 2
Figure 2
Algorithm for management of an episode of HE in the ward. (algorithm-2)
Image 3
Figure 3
Management of an episode of HE requiring intensive care. (algorithm-3)
See this image and copyright information in PMC

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