Hepatic Encephalopathy

What is Hepatic Encephalopathy?

Hepatic encephalopathy is a brain disorder that develops when a weakened liver can no longer remove toxins from the blood. Those toxins, especially ammonia, build up and travel to the brain, causing mental and motor function impairment. In advanced stages, it can even lead to coma. This condition is captured in medical records under ICD-10 code K72.90.

Common Symptoms

You may experience one or more of the following warning signs:

• Confusion or difficulty thinking clearly
• Memory lapses or forgetfulness
• Irritability, mood swings or personality changes
• Daytime sleepiness and nighttime restlessness
• Hand tremors or shakiness (asterixis)
• Slurred or slowed speech
• Difficulty with fine motor tasks, such as writing

Causes

This condition arises when factors lead to an accumulation of toxins in the bloodstream, most notably ammonia:

• Chronic liver disease, such as cirrhosis
• Bleeding in the gastrointestinal tract
• Infections anywhere in the body
• Diets extremely high in protein
• Kidney dysfunction reducing toxin clearance
• Dehydration
• Certain medications that affect liver or brain function

Treatment Options for Hepatic Encephalopathy in Cypress

Treatment includes medications, dietary therapy, and close monitoring:

• Lactulose: A non-absorbable sugar solution that binds ammonia in the gut and speeds its removal through stools.
• Xifaxan (Rifaximin): A gut-targeted antibiotic that lowers ammonia-producing bacteria.
• Zinc supplements: Supports enzymes involved in ammonia detoxification.
• Probiotics and vitamins: Enhance gut flora balance and overall nutrition to reduce toxin generation.
• Diet modifications: Moderate protein intake (favoring plant-based sources), high-calorie, low-sodium meals to limit ammonia formation.
• Fluid & electrolyte management: Ensure proper hydration and salt/mineral balance to prevent dehydration-triggered HE episodes.
• Regular monitoring: Periodic checks of blood ammonia levels, liver function tests, and cognitive assessments.
• Caregiver education: Training family members to spot early signs-confusion, sleepiness, tremors-and know when to seek urgent care.