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Overview

Encephalopathy: Treatment, Procedure, Cost and Side Effects

What is the treatment?

It is also known as spastic paralysis, paralysis agitans, Reye's syndrome, Parkinson's syndrome, epilepsy, logagraphia, Parkinson's, Creutzfeldt-Jakob disease, neurological disorder, brain disorder, shaking palsy, apraxia, cerebral palsy, anorthography etc.

How is the treatment done?

For some patients who are in the early or middle stages of Alzheimer's disease, doctors prescribe the drugs tacrine, rivastigmine, donepezil and galantamine to help delay the worsening of some of the disease's symptoms. Another drug, memantine, has recently been approved for the treatment of this disease that is in its moderate to severe stage. All doctors believe the most important thing for people with multi infarct dementia is to try to prevent further strokes which can be done by monitoring and treating high blood cholesterol, controlling high blood pressure and diabetes. Many patients with dementia need no medication for their behavioral problems. But there are some people for whom the doctors may recommend medications that help reduce agitation, anxiety, depression, or sleeping problems. These troublesome behaviours are commonly seen in people suffering with dementia. Following the doctors prescribed drugs will make most of the patients suffering with dementia more comfortable and it will also make caring for them easier. For people suffering from this disease a healthy diet is important. Studies have shown that there are no special diets or nutritional supplements that prevent or reverse Alzheimer's disease or multi infarct dementia, but a balanced diet will help maintain overall good health. In cases of multi infarct dementia. Family members and friends can assist people with dementia in continuing their daily routines, physical activities, and social contacts. People with dementia should be kept up-to-date about the details of their lives, such as the time of day, where they live, and what is happening at home or in the world. Memory aids may help in the day to day living of patients in the earlier stages of dementia. Some families find that a big calendar, a list of daily plans, notes about simple safety measures, and written directions describing how to use common household items are very useful aids.

Who is eligible for the treatment? (When is the treatment done?)

The treatment of encephalopathy can vary depending on the primary cause of the symptoms therefore, not all cases of encephalopathy are treated the same.

Short-term anoxia which is usually less than two minutes is treated with oxygen therapy.

Short-term alcohol toxicity is treated with IV fluids and no therapy.

Long-term anoxia is treated using rehabilitation

Long-term alcohol abuse (cirrhosis or chronic liver failure): oral lactulose, low-protein diet, antibiotics

Uremic encephalopathy which happens due to kidney failure correct the underlying physiologic cause, dialysis, kidney transplant

Diabetic encephalopathy which is treated by administering glucose for the hypoglycaemia and insulin to treat hyperglycemia

Hypo- or hypertensive encephalopathy: medications to raise (for hypotensive) or reduce (for hypertensive) blood pressure

The key to treatment of any encephalopathy is to understand the basic cause and thus design a treatment scheme to reduce or eliminate the causes. There is one type of encephalopathy

that is difficult or impossible to treat; it is static encephalopathy (an altered mental state or brain damage that is permanent). The best that can be done with static encephalopathy is, if possible, to prevent further damage and implement rehabilitation to allow the individual to perform at his or her highest possible functional level.

Who is not eligible for the treatment?

This treatment is advised to those people who are suffering from curable conditions such as PTSD and amnesia can receive treatment. In case of an early onset, therapy may help the patient and the family support, but there is no treatment for the later stages of the aforementioned diseases. First the doctor needs to administer a few blood tests that will help to detect diseases, bacteria, viruses, toxins, hormonal imbalances. This is followed by a spinal tap in which the doctor will collect a sample of the patient’s spinal fluid in order to look for diseases, bacteria, viruses, toxins. In some cases a CT or MRI scan of the patient’s brain to detect abnormalities or damage.

Are there any side effects?

Patients need to talk to their doctors and give them their full medical history as well as a list of all the medications they are on. The treatment can only be started after the patients have undergone a few tests and come out with positive results.

What are the post-treatment guidelines?

There are no particular side effects to the treatment but as it goes with any brain related treatment, the recovery time is quite substantial and this affects the entire body as well as movement. The patient needs to be kept under observation and the brain needs to be monitored.

How long does it take to recover?

Post treatment guidlines though aren't that much they still need to be followed by the patient. These include medication, regular brain scan, check ups etc.

What is the price of the treatment in India?

The recovery depends on when and how the treatment or procedure was performed. The recovery may take a few days to complete or maybe even a week. Until then, the patient should get plenty of rest and take his medication as instructed.

Are the results of the treatment permanent?

The standard consultation fee can reange from Rs. 1,000 - Rs. 1,500 but the procedure may range from Rs. 20,000 to Rs. 50,000 and/or above depending on the doctor's conclusion.

What are the alternatives to the treatment?

The treatment results are in majority of the cases permanent.

Safety: Condition Effectiveness: Medium Timeliness: Medium Relative Risk: Low Side Effects: Low Time For Recovery: Medium Price Range:

Rs. 1,000 - Rs. 5,000.

Popular Health Tips

Try Surgery For Portal Hypertension!

MS - General Surgery, DNB - Surgical Gastroenterology, Fellow HPB Surgery & Liver Transplant
Surgical Gastroenterologist, Ernakulam
Try Surgery For Portal Hypertension!

There are veins which carry blood from the various digestive organs to the liver. When there is an obstruction in the free flow of blood in the liver, it increases the pressure and is known as portal hypertension. This increased blood pressure stresses the blood vessels in the esophagus, stomach, and other digestive organs and results in internal bleeding.

What causes portal hypertension?
Cirrhosis is the most common cause of portal hypertension. The cirrhosis could be a result of excessive consumption of alcohol, chronic hepatitis, or thrombosis in the liver vessels. Blood clots in the portal vein are schistosomiasis ( a parasitic infection) are some other causes of portal hypertension. It is also important to know that in some cases, the causes of this condition remain unknown.

What are the symptoms?
Although, the symptoms of portal hypertension may not be very evident until you identify that there is some damage in the liver. the chances of developing a portal hypertension are increased if you suffer from a liver disease.

  • Ascites, which is fluid accumulation in the abdominal cavity
  • Bleeding in the abdominal vessels
  • Blood in the stools and/or vomitus (black tarry stools or blood in the vomitus)
  • Reduced platelet count
  • Encephalopathy, fluid accumulation in the brain, which can lead to confusion and other issues

How can it be managed?
Once diagnosed, treatment of portal hypertension is at two levels.
At the first level, dietary and lifestyle changes and medical treatment should suffice.

  1. Alcohol, a street drug, and tobacco use should be completely stopped. Sodium and protein intake should be reduced.
  2. Avoid taking any over-the-counter medications without consulting a medical personnel.
  3. Have a good, balanced nutrition
  4. Medications like propranolol are given to control blood pressure
  5. Medications are also given to prevent internal bleeding
  6. If there is encephalopathy, then lactulose is given to clear confusion
  7. The ends of the bleeding vessels are tied and cut off (ligated) endoscopically, and this is known as sclerotherapy. Alternately, bands may be applied to the cut vessels to prevent further bleeding. This is known as banding.

If this first line does not work, then the next level of interventional therapy is initiated.

  • TIPS, which is a transjugular intrahepatic portosystemic shunt, which is a shunt that is placed into the liver to reduce pressure.
  • Distal splenorenal shunt (DRSR) is when a shunt or link is created between the splenic vein and the left kidney vein. This also helps control variceal pressure and bleeding.
  • Both these shunts are widely performed and require follow up once in 6 months to ensure they are performing well and without any blockages.

Other options:

  • In cases where a shunt is not possible, then devascularization is done. This involves removal of the bleeding varices.
  • The fluid in the abdomen may be removed surgically by paracentesis.
  • As a last option, a liver transplant surgery may also be considered.

So, while portal hypertension definitely is a serious medical condition, there are different levels of treatment. The important thing is to alert yourself once any symptoms set in. Early intervention always ensures minimal intervention and good prognosis.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2707 people found this helpful

The Surgical Treatment For Portal Hypertension!

FELLOWSHIP IN HEPATOBILIARY AND LIVER TRANSPLANT SURGERY, Fellowship in Abdominal Multi Organ Transplant Surgery, MS - General Surgery, MBBS Bachelor of Medicine and Bachelor of Surgery
Gastroenterologist, Delhi
The Surgical Treatment For Portal Hypertension!

There are veins which carry blood from the various digestive organs to the liver. When there is an obstruction in the free flow of blood in the liver, it increases the pressure and is known as portal hypertension. This increased blood pressure stresses the blood vessels in the esophagus, stomach, and other digestive organs and results in internal bleeding.

What causes portal hypertension?
Cirrhosis is the most common cause of portal hypertension. The cirrhosis could be a result of excessive consumption of alcohol, chronic hepatitis, or thrombosis in the liver vessels. Blood clots in the portal vein are schistosomiasis ( a parasitic infection) are some other causes of portal hypertension. It is also important to know that in some cases, the causes of this condition remain unknown.

What are the symptoms?
Although, the symptoms of portal hypertension may not be very evident until you identify that there is some damage in the liver. the chances of developing a portal hypertension are increased if you suffer from a liver disease.

  • Ascites, which is fluid accumulation in the abdominal cavity
  • Bleeding in the abdominal vessels
  • Blood in the stools and/or vomitus (black tarry stools or blood in the vomitus)
  • Reduced platelet count
  • Encephalopathy, fluid accumulation in the brain, which can lead to confusion and other issues

How can it be managed?
Once diagnosed, treatment of portal hypertension is at two levels.
At the first level, dietary and lifestyle changes and medical treatment should suffice.

  1. Alcohol, a street drug, and tobacco use should be completely stopped. Sodium and protein intake should be reduced.
  2. Avoid taking any over-the-counter medications without consulting a medical personnel.
  3. Have a good, balanced nutrition
  4. Medications like propranolol are given to control blood pressure
  5. Medications are also given to prevent internal bleeding
  6. If there is encephalopathy, then lactulose is given to clear confusion
  7. The ends of the bleeding vessels are tied and cut off (ligated) endoscopically, and this is known as sclerotherapy. Alternately, bands may be applied to the cut vessels to prevent further bleeding. This is known as banding.

If this first line does not work, then the next level of interventional therapy is initiated.

  • TIPS, which is a transjugular intrahepatic portosystemic shunt, which is a shunt that is placed into the liver to reduce pressure.
  • Distal splenorenal shunt (DRSR) is when a shunt or link is created between the splenic vein and the left kidney vein. This also helps control variceal pressure and bleeding.
  • Both these shunts are widely performed and require follow up once in 6 months to ensure they are performing well and without any blockages.

Other options:

  • In cases where a shunt is not possible, then devascularization is done. This involves removal of the bleeding varices.
  • The fluid in the abdomen may be removed surgically by paracentesis.
  • As a last option, a liver transplant surgery may also be considered.

So, while portal hypertension definitely is a serious medical condition, there are different levels of treatment. The important thing is to alert yourself once any symptoms set in. Early intervention always ensures minimal intervention and good prognosis.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2537 people found this helpful

Liver Cirrhosis - Ways That Can Help You Deal With It!

DNB (Surgical gastroenterology, MS( General Surgery), MBBS, Fellowship in Minimal Access Surgery, Diploma in Minimal Access Surgery, Fellow of International College of Robotic Surgeons
Surgical Gastroenterologist, Delhi
Liver Cirrhosis - Ways That Can Help You Deal With It!

Liver Cirrhosis is a medical condition that results in severe scarring (often permanent and irreversible) of the liver. While there can be a myriad of factors giving rise to cirrhosis (such as repeated liver injury or unhealthy diet), the most common triggers include Hepatitis B, Hepatitis C, Alcohol, NASH (non-alcoholics teatohepatitis ). In addition to interfering with the healthy functioning of the liver, cirrhosis also gives rise to many serious and life-threatening complications such as Blood vomiting, Jaundice, Ascites (a condition characterized by an increased build-up of fluids in the abdomen), Hepatic Encephalopathy, Edema, Splenomegaly. In some men, cirrhosis can even give rise to Breast enlargement and Testicular Atrophy. 

Preventive measures to manage Cirrhosis and the associated complications 
In the case of cirrhosis triggered by Hepatitis, medications are used to treat the viral infection thereby avoiding any further liver damage. 

  1. In people with cirrhosis resulting from alcohol abuse, the effectiveness of the treatment depends on how quickly a person can give up drinking (In some cases, the affected individual may have to undergo rehabilitation programmes to stop drinking). In addition to drinking, it is also beneficial to quit smoking as well. 
  2. For excess fluid retention on the body, in addition to the medications (such as diuretics and antibiotics), doctors often recommend a low-sodium or low-salt diet. The use of a TIPS (Transjugular Intrahepatic Portosystemic Shunt) can also contribute to slow down the fluid build-up in the body. 
  3. Medications may also be used to treat a host of serious complications (triggered by cirrhosis) such as Hepatic encephalopathy, weakness, itching, bruising, infections to provide some relief. 
  4. However, in case of severe or complete liver damage and failure (advanced cirrhosis), a liver transplant may be recommended. A liver transplant, as indicative of the name, involves replacing the damaged or diseased liver of the recipient with a healthy liver from the donor. 

Unfortunately, once the liver has been scarred, there is little that can be done to reverse the damage. However timely diagnosis and treatment in the form of liver transplant can ensure long-term survival in these life-threatening illness. Cirrhotics should be under regular follow-up to prevent development of complications and timely referral for transplant. A damaged , cirrhotic liver is a fertile ground for development of hepatocellular cancer(HCC). 

Routine imaging on follow-up is important to diagnose HCC at an early, curable stage. These patients require liver transplant at the earliest. Also regular upper GI endoscopy and variceal banding should be done to prevent development of life-threatening hematemesis ( Varieal bleeding ).

Severity of Cirrhosis can be estimated by two scoring tools easily available on the smartphones. Child Turcotte pugh(CTP)’s scoring system , Child’s Stage and MELD scoring system . CTP score of >7 , Child B or MELD > 15 are candidates for liver transplant. Patient with decompensation(Hepatocellular cancer , Upper GI Bleed, Encephalotpathy, Refractory ascites, Hepato-renal syndrome, Hepatopulmonary syndrome) are candidates for liver transplant. 

Some other healthy modifications to control cirrhosis include

  1. Choose your foods with care. Avoids foods that are high in sodium or are salty. Processed, canned, smoked, Barbecued foods, baked beans, ham, salami, bacon, caffeinated beverages, are best left avoided.
  2. Increase your intake of fresh fruits, vegetables, foods rich in proteins. Having a large meal may be difficult in the case of cirrhosis. Instead, have small meals at regular time intervals. 
  3. Some of the medicines such as Aspirin, NSAIDs (Advil, Aleve), Tylenol, can aggravate the liver damage. Thus, never have these medicines without consulting a physician. 
  4. It is also necessary to get vaccinated against some of the viral infections including Hepatitis (A and B), influenza, pneumonia.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3626 people found this helpful

A Guide to Living Healthy: Preventing Cirrhosis of the Liver!

MBBS, DNB ( General Surgery ), MNAMS - General Surgery
Gastroenterologist, Pune
A Guide to Living Healthy: Preventing Cirrhosis of the Liver!

Cirrhosis of liver is slow and gradual replacement of normal healthy liver tissue with scar tissue which results in poor liver function and blockage of flow of blood through liver which comes from intestines. As more scar tissue replaces normal healthy liver, liver begins to fail.

What causes cirrhosis?

  1. Alcohol: Amount of alcohol which can cause liver damage varies from person to person, however those who consume alcohol for long in significant amount are more prone to develop liver damage.
  2. Hepatitis B or hepatitis C: Caused by hepatitis B and C viruses, respectively, which are acquired by contact with contaminated blood (like needlestick injury, blood transfusion, injection drug abuser), sexual contact with infected person and from mother to child during childbirth.
  3. Non-alcoholic fatty liver disease (NAFLD): Caused by presence of extra fat in liver (after excluding significant alcohol intake) which causes inflammation and scarring leading to cirrhosis. Usually seen in patients who are overweight or obese, having diabetes, high fat in blood, high blood pressure or metabolic syndrome.
  4. Drugs causing liver injury.
  5. Others: Autoimmune hepatitis (body`s own immunity acting against liver), Wilson disease (build up of copper in body), hemochromatosis (excess of iron in body), certain bile duct disorders, etc.

What are the symptoms of cirrhosis?

  1. Early disease can present with nonspecific symptoms like weakness, fatigue (loss of energy), decrease wish to take food, vomiting or nausea, weight loss, etc.
  2. Advanced disease can present with fluid accumulation in legs (edema) or abdomen (ascites), facial puffiness, yellowish discoloration of eyes or urine (jaundice), redness of palm (palmer erythema), decrease urine output, small red lesions on skin, easy bleeding following trauma, blood coming out of mouth/anus/other body site, black colored feaces, mental confusion, flapping tremors of hand, etc. In men it can cause impotence, breast enlargement and shrinking of testis.

What are the complication of cirrhosis?

Portal hypertension: It is a common complication of cirrhosis which is due to increased pressure in portal vein. Portal vein is main blood vessel which carries blood to liver from stomach, intestines, spleen, gallbladder and pancreas. Because of scar formation in liver the normal flow of blood from these organs to liver is hampered. As a result of blockage of blood flow to liver there are few complications which can arise like accumulation of fluid in abdomen (ascites) and legs (edema), formation of enlarged veins (varices) in food pipe (esophagus), stomach, etc., enlargement of spleen (splenomegaly), mental confusion/altered behavior/altered sensorium (hepatic encephalopathy), respiratory discomfort (hepatic hydrothorax or hepato-pulmonary syndrome) or decrease urine output/rise in creatinine (hepato-renal syndrome).

  1. Increase risk of infection because of immune system dysfunction.
  2. Development of liver cancer (Hepatocellular carcinoma)
  3. Easy brusibility or bleeding following light trauma.
  4. Gall bladder stone formation
  5. Metabolic bone disease

What are the stages of cirrhosis?

  1. Compensated cirrhosis: Liver damage is damaged but no abdominal swelling (ascites), blood in vomiting or black/red color feaces (variceal bleed), altered behavior/sensorium (hepatic encephalopathy), respiratory discomfort (hepatic hydrothorax or hepato-pulmonary syndrome) or decrease urine output/rise in creatinine (hepato-renal syndrome).
  2. Decompensated cirrhosis: Presence of abdominal swelling (ascites), blood in vomiting or black/red color feaces (variceal bleed), altered behavior/sensorium (hepatic encephalopathy), respiratory discomfort (hepatic hydrothorax or hepato-pulmonary syndrome) or decrease urine output/rise in creatinine (hepato-renal syndrome).

How cirrhosis is diagnosed?

  1. Your doctor will take good history and do proper physical examination. If there is suspicion of cirrhosis then he will subject you to some blood test, ultrasound abdomen, fibroscan/elastography, upper GI endoscopy and if needed CT scan or MRI of abdomen or liver biopsy.

  2. Ultrasound of abdomen in cirrhosis may shows coarse liver echotexture, nodular liver surface, dilated portal vein or collateral, enlarged spleen or abdominal fluid (ascites).

How to prevent cirrhosis?

Best way to avoid development of cirrhosis from predisposing stage of liver illness is to recognize and treat early. Few advices to keep liver healthy are:

  1. Dietary modification: Eat healthy balanced diet. Avoid high calorie food or drinks, saturated fat, sugar and refined carbohydrates. Keep yourself hydrated.
  2. Lifestyle modification: Maintain healthy body weight. Avoid being overweight or obese. Aerobic exercise (like brisk walk 30-45min/day atleast 5days/week) regularly helps to lower liver fat.
  3. Avoid: Avoid use of contaminated needles, sharing of items of personal hygiene (like shaving razors, toothbrush, nail clippers, etc), use of illicit drugs, self medication with over the counter drugs or using drugs beyond doctor`s advice.
    1. Practice safe protected sex
    2. Alcohol
  4. Motivate others: to stop drinking and follow hand hygiene and doctor`s advice.
  5. Hand hygiene: Wash hand with soap and water regularly before eating, after going to toilet and after touching dirty objects.
  6. Vaccination: For hepatitis A or hepatitis B, if you are not vaccinated or not already infected or unsafe antibody titre. Transmission rate of hepatitis B from mother to child at birth can be reduced with vaccination and immunization of newborn starting within 12 hours of birth as well as by using antiviral drugs (if indicated).

Prevent others from getting infected from you if you harbor virus causing liver damage.

How to treat cirrhosis?

Treatment of cirrhosis is based on cause of cirrhosis and complication of cirrhosis. Main aim of treatment in early stage of cirrhosis is to slow the progression of cirrhosis and prevent complications development

  1. Stop alcohol, antiviral drugs for hepatitis b or hepatitis C, proper sugar level if diabetes, steroid or other medications for autoimmune hepatitis, medications to reduce copper from body in patients with Wilson`s disease, etc.
  2. Drugs to lower portal pressure (beta-blocker or nitrates), drugs to remove fluid from body (diuretics), drugs to lower ammonia level for encephalopathy (lactulose and others), drugs to improve kidney function (albumin, terlipressin and others).
  3. Opt for liver ransplant, If cirrhosis is life threatening or treatment of cirrhosis complication is ineffective.
  4. Low salt high protein diet
  5. Stop alcohol intake even if you have other cause of cirrhosis.
  6. Stop smoking
  7. Avoid over the counter drugs (especially pain killers)
  8. Vaccinate if not done already or infected

In case you have a concern or query you can always consult an expert & get answers to your questions!

3278 people found this helpful

Morning Sickness - Why Dextrose Therapy Should Not be Used?

Diploma In Advanced Gynaecological Endoscopic Surgery, ATSM (Urogynaecology), MRCOG, DRCOG, DGO, MBBS
Gynaecologist, Noida
Morning Sickness - Why Dextrose Therapy Should Not be Used?

Although, morning sickness is a common phenomenon in pregnant women, severe symptoms along with loss of weight and electrolyte disturbance may indicate hyperemesis gravidarum. This condition cannot be prevented from occurring. However, you can use several steps to manage the condition, but if you are thinking of dextrose for treating hyperemesis gravidarum, you should avoid using the remedy.

Causes behind it

Hyperemesis gravidarum commonly occurs when there is a rise in your hormone levels during pregnancy. The affected hormone is hCG or human chorionic gonadotropin. It is produced during pregnancy from the placenta and in early pregnancy stages, it is produced at a rapid rate. This hormone triggers severe nausea.

The symptoms of hyperemesis gravidarum are as follows:

  1. Intense nausea and vomiting
  2. Aversion towards food
  3. Loss of appetite and weight loss
  4. A reduced urge for urination
  5. Possible dehydration
  6. Headaches and confusion
  7. Extreme tiredness or fatigue that can cause fainting
  8. Jaundice
  9. Increased heart rate
  10. Losing skin elasticity

Treatment
There are different modes of treatment for hyperemesis gravidarum. Dextrose is one of the methods which should be abstained from unless the need is urgent.

  1. Intravenous fluids or IV is used for restoring the hydration of vitamins, nutrients, and electrolytes.
  2. Tube feeding is another treatment method.
  3. Nasogastric treatment incorporates nutrient restoration through a tube, which goes into the stomach via your nose.
  4. Percutaneous endoscopic gastrostomy is also applied where a tube passing through the abdomen goes into the stomach.
  5. Several medications are used for treatment.

Dextrose and Hyperemesis gravidarum

Dextrose is a simple sugar made from corn. Chemically, it is identical to glucose or blood sugar. It is used for several medical purposes. It is dissolved in many solutions which are given intravenously, combined with other medicines. Solutions which contain dextrose should not be given to patients suffering from hyperemesis gravidarum. This is because dextrose increases your body’s need for thiamine. Hence, the chances of precipitating Wernicke encephalopathy gets higher in women who already suffer from thiamine deficiency.

However, dextrose infusion can be used when the patient is very hypoglycemic and oral toleration becomes difficult. In such cases, the dextrose needs to be supplemented with thiamine. IV thiamine may be used before the dextrose infusion. Dextrose is a carbohydrate and solutions which contain dextrose  provide calories. They are often given in combination with fat and amino acids.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3356 people found this helpful

Popular Questions & Answers

My father had hepatic encephalopathy which is cryptogenic in nature. Can we (me and my Maa ) have the same problem in future. Please reply.

PDDM, MHA, MBBS
General Physician, Nashik
This cannot be transmitted to you or your mother from your father as cryptogenic means the cause is unknown.

Please confirm me Can a patient of hepatic encephalopathy and chronic liver disease. both can happen.

MBBS
General Physician, Mumbai
Yes that is absolutely correct. Chronic liver disease causes build up of toxins in the Blood. When these toxins reach the brain it causes hepatic encephalopathy.

My father is suffering from Hepatitis Encephalopathy and jaundice since 2 weeks. He is also diabetic. What kind of diet do you suggest for this?

PDDM, MHA, MBBS
General Physician, Nashik
Eat a high-fiber diet. Get insoluble and soluble fiber. Limit foods that are high in fat. Choose lean meats. Incorporate probiotics into your diet. Eat on schedule. Stay hydrated.

A 10 year old child is diagnosed with global developmental delay static encephalopathy perinatal hypoxic insult sequelae child did not cry on birth.

MBBS
General Physician, Mumbai
Apart from taking symptomatic treatment make sure to give him tablet folvite 5mg once a day lifetime

I am 51 years old and suffering from chronic liver disease with portal hypertension (cryptogen cirrhosis/ non steatohepatitis) 12 years and T2DM since 1 years back and hepatic encephalopathy.

C.S.C, D.C.H, M.B.B.S
General Physician, Alappuzha
You need to keep sugar level in good control and avoid liver toxic substances like alcohol and take balanced diet and vitamins

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?
Play video
Cirrhosis of Liver
Hello, I am Dr. Somasekhar Rao, gastroenterologist and hepatologist at the Apollo Hospitals, Jubilee Hill, Hyderabad. I would like to talk about cirrhosis of liver and its complications and how to manage those things. Basically cirrhosis of liver is nothing but the liver get shrunken and it becomes nodular and hard so the functions of the liver comes down. The functions which are there are 600 vital functions that a liver does normally in a human being and all these functions are compromised in a patient with cirrhosis.

Most important cause for cirrhosis is always alcohol and next comes viruses called hepatitis B and hepatitis C. The evolving most increasing cause no is nonalcoholic fatty liver disease. Fatty liver disease which we see on ultrasound can cause cirrhosis. Any patient in early cirrhosis may not present with any symptoms. The initial symptoms of decompensations would be:-

There will be swelling in the fluid
Swollen feet
There will be distinction of abdomen because of accumulation of fluid in the abdominal cavity
Patients may have jaundice.
Sometimes they may present with a history of passing black color motion that means this patient is having bleeding in the gastrointestinal tract. It can be most common because of the swollen blood vessels called viruses in the esophagus.
So other presentations would be disorientation. Patient can have hepatic encephalopathy, the functions of the liver because the liver acts as a filter to many toxins. All these toxins enter into your brain and cause disorientation this is called hepatic encephalopathy.

So now we will talk about the treatment of cirrhosis. Whenever we see a patient with cirrhosis, most important thing is we will try and evaluate the cause of cirrhosis. See if the patient is a chronic alcoholic. We are taking a history of all college. The first thing is to cut down and stop intake of alcohol when the patient is in early cirrhosis. It can reverse the cirrhosis to normal liver. Most important and nutritional aspects along with some supportive medication but when a patient presents with complications already, then we will be treating only the complications. Once the cirrhosis sets in and he is in CTP. By the time. you see that the patient eventually progresses most of the time. We are trying to treat the complications of cirrhosis. Then a patient presents to us with bleeding then we will find out whether it is very variceal bleeding and there is a procedure called endoscopic variceal ligation to decrease the pressure of the varices blood pressure in the esophageal varices.

We have some medications which decrease the pressure. We treat these patients and we control the bleeding and a patient presents with fluid in the stomach abdominal cavity or fluid in the legs. These patients are treated with so called restricted diet. Also we give some tablets called diuretics which increase the urine output and decrease the fluid in the legs and in the abdominal cavity and a patient presents with hepatic encephalopathy. We treat hepatic encephalopathy by medications and we try to decrease the ammonia level which is released by cleansing the gut and all those things. So all these things are managing complications of cirrhosis. Very rarely we see a patient in early cirrhosis then we treat the host.

The cirrhosis can be reversible. It is very rare but eventually when we see a patient in complications, he would always be in a stage called CTPB where he will progress to CTBC. CTBC is the end stage of cirrhosis and at that point of time the patient is left only with option of liver transplant.

Liver transplantation is again transplantation. It can be a live donor transplantation or deceased donor transplantation. So Eventually when you see a patient in CTBC we have to plan for liver transplantation. In these patient he can wait maybe for 2 or 3 months meanwhile we will be managing for complications.

Having issues? Consult a doctor for medical advice