Hepatic Encephalopathy (HE) 

Understanding Hepatic Encephalopathy (HE)

Hepatic encephalopathy (HE) is caused by liver disease.  HE changes the way the brain works. When the liver is affected by disease for long periods of time, the liver forms scar tissue that replaces healthy liver tissue.  When the scar tissue takes over it is call cirrhosis.  Cirrhosis does not allow the liver clean the blood of the toxins.  Those toxins affect the brain and cause HE.  

Hepatic Encephalopathy Symptoms

HE can cause any of these problems:

• Confusion

• Mood changes (excited, nervous, acting strangely)

• Sleep changes (sleepy in the day, awake at night)

• Memory loss

• Speech not clear

• Writing not clear

• Being clumsy or slow in walking or with other body movements

HE symptoms can also worsen because of other medical problems such as bleeding from the stomach, intestines, or colon; infection, constipation, dehydration, surgery, or certain medications (such as narcotics or anti-anxiety meds). 

Managing Hepatic Encephalopathy

If you have any HE symptoms with liver disease, your doctor may prescribe medications to help: 

• Lactulose works by clearing toxins through the bowel.

• Xifaxan (rifaxamin) – pronounced “Zy-fax-in” can be ordered to treat symptoms not controlled by lactulose, and kills bacteria that make toxins.

• The doctor may also stop a medication that is thought to be causing HE (such as narcotics or anti-anxiety meds).

You can improve symptoms of HE by:

• Taking lactulose as prescribed in order to have 3 or 4 bowel movements daily, and your bowels are moving regularly.

• Taking other medications (if ordered by your doctor) such as Xifaxan.

• Checking with your doctor or nurse before starting any new medications.

• Not taking any kind of drugs or alcohol.

• Seek early medical help for any infections or bleeding.

If you feel that you have any symptoms of HE that are listed above you should contact your doctor’s office or seek early medical help.