Gut Liver.  2016 Jul;10(4):509-519. 10.5009/gnl15419.

Evaluation and Management of Hepatic Encephalopathy: Current Status and Future Directions

Affiliations
  • 1Department of Medicine, Olive View Medical Center, Sylmar, Los Angeles, CA, USA.
  • 2Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • 3Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA. SSaab@mednet.ucla.edu
  • 4Department of Surgery, University of California at Los Angeles, Los Angeles, CA, USA.

Abstract

Hepatic encephalopathy is a spectrum of neurocognitive manifestations often seen in patients with liver injury or rarely in patients with portosystemic shunting without liver injury. It can be divided into minimal (covert) hepatic encephalopathy and overt hepatic encephalopathy, depending on the severity. Patients with hepatic encephalopathy have compromised clinical outcomes, decreased quality of life, and increased healthcare utilization, often resulting in a heavy financial and personal burden on caregivers. The diagnosis remains largely clinical, with the exclusion of possible other causes for the altered mental status. Current treatment strategies include nonabsorbable disaccharides and antibiotics. This review will focus on the diagnosis, management and clinical impact of hepatic encephalopathy.

Keyword

Hepatic encephalopathy; Liver cirrhosis; Liver diseases; Minimal hepatic encephalopathy

MeSH Terms

Anti-Bacterial Agents/therapeutic use
Cost of Illness
Disaccharides/therapeutic use
Forecasting
*Hepatic Encephalopathy/complications/diagnosis/therapy
Humans
Patient Acceptance of Health Care
Anti-Bacterial Agents
Disaccharides
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