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Sub-Category:

Neurological Manifestations of Liver Disease

Number of Conditions: 1

Hepatic Encephalopathy

Specialty: Gastrointestinal

Category: Liver Disorders

Sub-category: Neurological Manifestations of Liver Disease

Symptoms:
confusion; difficulty concentrating; personality changes; disorientation; sleep disturbances; tremors (asterixis); slurred speech; lethargy; in severe cases, coma

Root Cause:
Build-up of toxins like ammonia in the bloodstream due to the liver's inability to properly detoxify them, often secondary to liver dysfunction or portal-systemic shunting.

How it's Diagnosed: videos
Clinical assessment, blood tests (elevated ammonia levels), liver function tests, and imaging studies to rule out other causes of altered mental status.

Treatment:
Reducing ammonia production and absorption using dietary protein restriction, lactulose (to acidify the colon and reduce ammonia absorption), and antibiotics like rifaximin (to reduce ammonia-producing gut bacteria).

Medications:
Lactulose (a non-absorbable sugar that traps ammonia in the colon), rifaximin (a gut-specific antibiotic), and sometimes neomycin or metronidazole (alternative antibiotics for reducing ammonia production).

Prevalence: How common the health condition is within a specific population.
Common among individuals with advanced liver disease, with approximately 30-45% of cirrhotic patients developing some form of hepatic encephalopathy.

Risk Factors: Factors or behaviors that increase the likelihood of developing the condition.
Advanced liver disease, cirrhosis, portal hypertension, gastrointestinal bleeding, infections, dehydration, electrolyte imbalances, and high-protein diets.

Prognosis: The expected outcome or course of the condition over time.
Reversible with treatment in early stages, but recurrent episodes are common unless the underlying liver dysfunction is addressed. Severe or untreated cases may lead to permanent brain damage or death.

Complications: Additional problems or conditions that may arise as a result of the original condition.
Recurrent episodes, progressive cognitive impairment, reduced quality of life, coma, and increased mortality.