Hepatic Encephalopathy: Diagnostic Tools and Management Strategies.

Bryan D Badal, Jasmohan S Bajaj

Journal: The Medical clinics of North America 2023;107(3):517-531

PMID: 37001951

Full Text on Elsevier Science View on PubMed

Abstract

Hepatic encephalopathy (HE) is brain dysfunction secondary to liver insufficiency or portosystemic shunting. HE is a major burden on patients and caregivers, impairs quality of life and is associated with higher mortality. Overt HE is a clinical diagnosis while Covert HE, needs specialized diagnostic strategies. Mainstay of treatment of HE is nonabsorbable disaccharides such as lactulose as well as rifaximin; however, investigational therapies are discussed in this review. Better tools are needed to prognosticate which patients will go on to develop HE but microbiome and metabolomic-driven strategies are promising. Here we review methods to prevent the HE development and admissions.

Address: Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University and Central Virginia Veterans Healthcare System, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA.; Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University and Central Virginia Veterans Healthcare System, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA. Electronic address: [email protected].

DOI: 10.1016/j.mcna.2023.01.003

Link outs

Subscription / membership required

Full Text Sources:

MeSH Terms: Humans, Hepatic Encephalopathy, Quality of Life, Lactulose, Rifaximin, Drug Therapy, Combination