Loss of brain function - liver disease | Health Encyclopedia | UF Health Jacksonville
Home Health Encyclopedia Loss of brain function - liver disease
Loss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy. This problem may occur suddenly or develop slowly over time.
Hepatic coma; Encephalopathy - hepatic; Hepatic encephalopathy
An important job of the liver is to make toxic substances in the body harmless. These substances may be made by the body, such as ammonia. Or they may be substances that you take in, such as medicines.
When the liver is damaged, these "poisons" can build up in the bloodstream and affect the function of the nervous system. The result may be hepatic encephalopathy.
This problem can occur suddenly and you may become ill very quickly. Causes include:
Hepatitis B infection (uncommon to occur this way)
More often, the problem develops in people with chronic liver damage. Cirrhosis is the end result of chronic liver damage. Common causes of chronic liver disease in the United States are:
Body is low on water or fluids
Disorders that can appear similar to hepatic encephalopathy include:
Symptoms may begin slowly and slowly get worse. They may also begin suddenly and be severe from the start.
Strange behavior or severe personality changes
People with hepatic encephalopathy can become unconscious, unresponsive, and possibly enter a coma.
Shaking of the hands ("flapping") when trying to hold arms in front of the body and lift the hands
The first step is to identify and treat any factors that may have caused these changes. Bleeding in the digestive tract must be stopped. Infections, kidney failure, and changes in sodium and potassium levels need to be treated.
Life support may be needed to help with breathing or blood flow. The brain may swell. This can be life threatening.
Medicines are given to help lower ammonia levels and improve brain function. You may need to take these medicines every day.
Lactulose prevent bacteria in the intestines from creating ammonia. It also causes diarrhea and helps to remove blood from the intestines.
If the problem is very bad, you may need to cut down the protein in your diet. Talk to a dietitian about how to change your diet and avoid poor nutrition. People who are very ill may need intravenous or tube feedings.
Certain medicines should be avoided
Acute hepatic encephalopathy may be treatable. Chronic forms of the disorder often continue to get worse and come back.
Both forms of the condition may result in irreversible coma and death. The majority of people who go into a coma will die. The chances of getting better vary from person to person.
Call your health care provider if you or people around you notice any problems with your mental state or nervous system function. This is very important for people who already have a liver disorder. Hepatic encephalopathy can get worse quickly and become an emergency condition.
Treating liver problems may prevent hepatic encephalopathy. Avoiding heavy drinking and intravenous drug use can prevent many liver disorders.
Leise MD, Poterucha JJ, Kamath PS, Kim WR. Management of hepatic encephalopathy in the hospital. Mayo Clin Proc. 2014;89(2):241-53. PMID 24411831 www.ncbi.nlm.nih.gov/pubmed/24411831.
Nevah MI, Fallon MB. Hepatic encephalopathy, hepatorenal syndrome, hepatopumonary syndrome, and systemic complications of liver disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 94.