Hepatic Encephalopathy

Hepatic encephalopathy is a decline in brain function that occurs as a result of severe liver disease. In this condition, your liver can’t adequately remove toxins from your blood. This causes a buildup of toxins in your bloodstream, which can lead to brain damage.

Hepatic encephalopathy can be acute (short-term) or chronic (long-term). In some cases, a person with hepatic encephalopathy may become unresponsive and slip into a coma.

Symptoms:

Symptoms of hepatic encephalopathy differ depending on the underlying cause of the liver damage.

Moderate Symptoms:

  • difficulty thinking
  • personality changes
  • poor concentration
  • problems with handwriting or loss of other small hand movements
  • confusion
  • forgetfulness
  • poor judgment
  • a musty or sweet breath odor

Severe Symptoms:

  • confusion
  • drowsiness or lethargy
  • anxiety
  • seizures
  • severe personality changes
  • fatigue
  • confused speech
  • shaky hands
  • slow movements

Causes:

The exact cause of hepatic encephalopathy is unknown. However, it’s usually triggered by a buildup of toxins in the bloodstream. This occurs when your liver fails to break down toxins properly.

Hepatic encephalopathy may be triggered by:

  • infections such as pneumonia
  • kidney problems
  • dehydration
  • hypoxia, or low oxygen levels
  • recent surgery or trauma
  • medications that suppress your immune system
  • eating too much protein
  • medications that suppress your central nervous system, such as barbiturates or benzodiazepine tranquilizers
  • electrolyte imbalance, especially a decrease in potassium after vomiting or taking diuretics

Role of Probiotics in treating Hepatic Encephalopathy:

Gut microflora leads to production of ammonia and endotoxins which play important role in the pathogenesis of hepatic encephalopathy (HE). There is relationship between HE and absorption of nitrogenous substances from the intestines.

Probiotics play a role in treatment of HE by causing alterations in gut flora by decreasing the counts of pathogen bacteria, intestinal mucosal acidification, decrease in production and absorption of ammonia, alterations in permeability of gut, decreased endotoxin levels and changes in production of short chain fatty acids.