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Hepatic Encephalopathy: Symptoms, Causes, Treatment, Cost, and Side Effects

Last Updated: Sep 20, 2022


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Toxins can be generated through various sources like food, alcohol, medicines, and others. They can also be internal toxins produced by muscles. Since the liver is the organ that is responsible for filtering out such toxins, chronic liver disease can affect the entire system. As these toxins reach the brain, they cause symptoms of Hepatic Encephalopathy.

There is still research going on on this disease and the treatment methods are not very specific. The diagnosis of hepatic encephalopathy is also not particularly centered around the disease and therefore, specific surgical methods are also not frequently available. Let's take a look at the various symptoms, causes, and treatments of hepatic encephalopathy.

What is Hepatic Encephalopathy?

The word hepatic means liver and encephalopathy means brain. As the name suggests, hepatic encephalopathy is a disease caused in the brain when there is a dysfunction in the liver. When there is a severe liver disease in your body, the toxins do not filter out properly. Sometimes, these toxins reach the brain through the blood and can cause cognitive impairment in the brain. This condition is known as hepatic encephalopathy.

What are the symptoms of Hepatic Encephalopathy?

About half of the people who suffer from liver cirrhosis also suffer from hepatic encephalopathy. The symptoms of hepatic encephalopathy are as follows:

  • Anxiety or irritability - One of the first symptoms of Hepatic encephalopathy is anxiety or irritability. You may feel anxious without knowing the reason. You might also have mood swings and other behavioral changes.
  • Sleeping problems - Insomnia can also be a common symptom of hepatic encephalopathy. Since this disease affects your brain, sleeping problems can be a common symptom.
  • Cognitive impairment - memory loss and confusion can also be very common symptoms of hepatic encephalopathy. If you are facing cognitive impairment for longer durations you should check in with your doctor.
  • Lack of muscle coordination - with chronic hepatic encephalopathy lack of muscle coordination can increase. This symptom is a visual sign of hepatic encephalopathy.
  • Asterixis - since this disease affects muscle coordination it may also lead to asterixis, that is, flappy hands tremor. The affected person loses sensation in their hands causing uncontrolled movements
  • Myoclonus - frequent muscle twitches or myoclonus is yet another symptom of hepatic encephalopathy. If you are facing this symptom more frequently then you should visit your doctor.

What causes Hepatic Encephalopathy?

Research work is still going on to find out the exact cause of hepatic encephalopathy. However, it is mainly called due to chronic liver disease in your body. As already mentioned, the liver is supposed to filter out all the toxins in your body. When this organ is diseased, the toxins do not get out of your bloodstream and can cause severe problems. One such problem is hepatic encephalopathy.

Some of the common causes of hepatic encephalopathy are as follows:

As the toxins reach your brain through your bloodstream proper functioning of the brain is affected. This leads to symptoms like cognitive impairment, muscle twitches, uncontrolled movements, sleep disorders, anxiety and irritability, memory loss and confusion, and a few other generic symptoms. However, it is a treatable disease and the symptoms are only temporary. If your liver disease is cured timely, then hepatic encephalopathy can also be treated on time.


How to prevent hepatic Encephalopathy?

Hepatic encephalopathy can be easily prevented if you follow the dos and don'ts that are mentioned below.

Dos and Don'ts


Do follow a nutritious diet - another important thing to do is follow a nutritious diet. Since your liver is where everything is stored therefore a nutritious diet can help maintain a healthy liver.

Do drink enough fluids - Last but not least drinking enough fluids can also help prevent hepatic encephalopathy. Fluids ease the mechanism of your digestive system and help your liver to maintain its proper functioning.


Don't consume alcohol - It is a proven fact that alcohol is very harmful to your liver. Frequent intake of alcohol can damage your liver functions. Therefore, alcohol should be avoided at all costs.

Don't take improper medications - medication can also harm your liver in many ways. This is why unnecessary medications should be strictly avoided. Take only those medicines which are officially prescribed by your doctor.

How Hepatic Encephalopathy is diagnosed?

The diagnosis of hepatic encephalopathy does not contain any particular tests. However, if you are facing any of the above-mentioned symptoms you can visit your doctor. After a few blood tests and ruling out other symptoms, your doctor May diagnose you with hepatic encephalopathy. Tests like magnetic resonance imaging (MRI), computed tomography (CT) scans, and electroencephalogram (EEG) can also help detect hepatic encephalopathy. The diagnosis of hepatic encephalopathy is broadly based on:

  • Patient's medical history
  • Thorough examination
  • Symptoms and blood tests

How Hepatic Encephalopathy is diagnosed?

The diagnosis of hepatic encephalopathy does not contain any particular tests. However, if you are facing any of the above-mentioned symptoms you can visit your doctor. After a few blood tests and ruling out other symptoms, your doctor May diagnose you with hepatic encephalopathy. Tests like magnetic resonance imaging (MRI), computed tomography (CT) scans, and electroencephalogram (EEG) can also help detect hepatic encephalopathy. The diagnosis of hepatic encephalopathy is broadly based on:

  • Patient's medical history
  • Thorough examination
  • Symptoms and blood tests

What tests are done for Hepatic Encephalopathy?

For checking hepatic encephalopathy your doctor may order a few blood profiling tests. They can also order MRI or CT scans and electroencephalograms for diagnosis of hepatic encephalopathy. Depending on the results they can order some more confirmatory tests to be perfectly sure.

How do you check for Hepatic Encephalopathy at home?

You can look for symptoms and signs of hepatic encephalopathy at home. There are no definite tests available for this disease. Therefore, tests like MRI or CT scans and encephalograms can detect hepatic encephalopathy better than any other tests.

Home Remedies for Hepatic Encephalopathy

Hepatic Encephalopathy is a treatable disease. With medications and proper care, you can easily be relieved of this disease. Here are some quick home remedies to present hepatic encephalopathy.

  • Avoid alcohol consumption altogether.
  • Have a healthy diet to keep your liver functioning.
  • Drink enough fluids and keep yourself hydrated.
  • Have electrolytes rich in potassium and magnesium.

Can Hepatic Encephalopathy go away on its own?

Since liver diseases and hepatic encephalopathy are correlated to each other, the symptoms of this disease can be reversed if the liver disease is treated properly. With proper care and medical assistance, hepatic encephalopathy can easily be treated. However, if the liver disease is too severe, there can be a recurrence of hepatic encephalopathy and it can turn into a chronic disease.

What to eat in Hepatic Encephalopathy?

Hepatic Encephalopathy can be treated with a properly nutritious diet. In recent studies, it has been found that proteins of animals and vegetables both can be beneficial in treating hepatic encephalopathy. Therefore, if you are suffering from hepatic encephalopathy, have a diet rich in these proteins. Eggs, fish, meat, pulses, vegetables, and fruits are some of the sources rich in animal and vegetable proteins. Also, the consumption of electrolytes rich in potassium and magnesium can help treat hepatic encephalopathy quicker.

What not to eat in Hepatic Encephalopathy?

Alcohol consumption should be strictly avoided when suffering from hepatic encephalopathy. It is also advised that white-flour foods like loaves of bread and other bakery items and sugary drinks like carbonated drinks should be avoided at all costs. Since your body is already recovering from the intoxication, these foods tend to increase the toxins even more. Therefore, they are not to be consumed when suffering from hepatic encephalopathy.

How Hepatic Encephalopathy is treated?

Treatment of hepatic encephalopathy widely depends on the severity of the symptoms. First and foremost, it is important to take proper medications while you are going through the hepatic encephalopathy treatment. The goal is to remove all the harmful toxins from your intestine. Therefore, medications consisting that can help in ammonia reduction are usually prescribed. Laxatives and antibiotics are also helpful in treating hepatic encephalopathy.

Should I go to urgent care for Hepatic Encephalopathy?

People who are suffering from hepatic encephalopathy should continue with the treatment plan that their doctors have prescribed. In most cases, urgent care is not needed. However, if your liver disease turns out to be chronic, then you must go to urgent care for Hepatic Encephalopathy. The severity of these symptoms can be dangerous for your health.

Which doctor to consult for Hepatic Encephalopathy?

There are a number of doctors you can consult for Hepatic Encephalopathy. A general physician is the first point of contact if you are having symptoms of hepatic encephalopathy. They can check up and send you to a hepatologist who will treat your liver and gallbladder diseases. You can also contact a nutritionist to get a proper diet plan. Sometimes a gastroenterologist can also help treat hepatic encephalopathy.

Which is the best medicine for Hepatic Encephalopathy?

The best medicines for treating hepatic encephalopathy are antibiotics, laxatives, and ammonia reduction drugs.

  • Antibiotics - the main motive of hepatic encephalopathy medicines is to reduce the toxins produced by the body. The good bacteria in the intestine also produce such toxins. Therefore, antibiotics are given to control bacterial toxins.
  • Laxatives - Lactulose oral solution is also a good way to treat hepatic encephalopathy. It draws the toxins of your body into the colon and also results in frequent bowel movements. This results in the filtration of toxins from your body.
  • Ammonia reduction medicines - the central therapeutic strategy to treat Hepatic Encephalopathy is the reduction of plasma ammonia. This is why some ammonia-reduction medicines are often prescribed to patients.

What are the surgical treatments for Hepatic Encephalopathy?

Surgical methods to treat Hepatic Encephalopathy are rarely performed. Since it is related to liver disease, more focus and attention is given to treating the liver. If there is a progression of chronic hepatic encephalopathy, shunt ligation and colonic procedures are the main surgical approaches that can be performed. A liver transplant is also one of the approaches to treating chronic liver disease.

What is the procedure of Hepatic Encephalopathy surgery?

Shunt ligation is the most used technique to treat hepatic encephalopathy surgically. In this procedure, ligature or an ameroid constrictor is placed around the shunt vessel of the liver. This results in the redirection of the blood back through the liver. This is done to filter out the toxins that are otherwise not properly filtered by the liver. Some other colonic procedures are also performed. However, they are not very prevalent methods because research is still being conducted on such procedures.

What is the price of Hepatic Encephalopathy treatments in India?

For a consultation with your doctor, the charges involved are Rs. 1,000 to Rs. 1,500. The treatment procedure can range from Rs. 20,000 to Rs. 50,000. The final price of hepatic encephalopathy treatments depends on the severity of the disease, surgical methods, and your doctor's approach.

How long does it take to recover from Hepatic Encephalopathy?

As soon as the liver disease is treated completely, the patient can then recover from Hepatic Encephalopathy. It usually takes almost a month to recover from hepatic encephalopathy. With constant care and medication, the recovery time may be reduced. The recovery time can also increase depending on the severity of hepatic encephalopathy. However, for complete recovery, it is important to treat liver disease first.

Are the results of the Hepatic Encephalopathy treatment permanent?

If you have a chronic liver disease that is left untreated, you may have recurring Hepatic Encephalopathy from time to time. The treatment of hepatic encephalopathy alone is not permanent. If your liver disease is progressing then hepatic encephalopathy may come and go. Therefore to fully recover from hepatic encephalopathy, it is important to treat liver disease first.

What are the post-treatment guidelines for Hepatic Encephalopathy treatments?

Supportive care is the first thing that should be kept in mind after the treatment of hepatic encephalopathy. This includes following a proper diet, avoiding alcohol abuse, and taking proper medications. It should also be noted that hepatic disease should be completely cured to treat hepatic encephalopathy. Therefore, consult your doctor from time to time post-Hepatic Encephalopathy treatments.

What are the side effects of Hepatic Encephalopathy treatments?

There are no such side effects of hepatic encephalopathy treatment. However, medicinal complications may occur for people who have allergies to certain medicines. Before finalizing the prescription with your doctor, do mention if you have any such medicinal allergies. Chronic liver disease may result in a liver transplant. Such liver transplants may have side effects like bile duct complications, infections, bleeding, blood clots, seizures, and other related symptoms.

Hepatic Encephalopathy - Outlook / Prognosis

Hepatic Encephalopathy can be considered a major symptom of progressing liver disease. As the toxins do not filter out of your system properly, leaving this untreated may result in severe problems such as liver failure and other neurological problems. Therefore, if you are facing any of the symptoms of hepatic encephalopathy, do consult a doctor immediately. You can also book an appointment with the consultants here at Pristyn Care.

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Written ByDrx Hina FirdousPhD (Pharmacology) Pursuing, M.Pharma (Pharmacology), B.Pharma - Certificate in Nutrition and Child CarePharmacology
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Reviewed ByDr. Bhupindera Jaswant SinghMD - Consultant PhysicianGeneral Physician
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