What I Would Like to Tell People About Hepatic Encephalopathy 

Some of the truths surrounding hepatic encephalopathy are not easy to live with. The side effects are scary to the patient. They are also bewildering to the family and friends. When I was diagnosed with end-stage liver disease after my liver failed, we were clueless. Here is what I would like to tell people about hepatic encephalopathy.

What is hepatic encephalopathy (HE)?

Hepatic Encephalopathy or HE comes on when we can’t process the food we are eating. Proteins are the hardest thing for us to digest.

What happens is that ammonia builds up in our bloodstream. Our liver doesn’t filter it, so it keeps circulating round and round through our heart, body, and brain.

How does diet work with HE?

We need protein to live, so eating plant-based proteins becomes very important for us.

We can take our body weight and divide by 2 to get a guide of how much protein our body needs to repair cells, and help us stay alive.

Do other conditions effect HE?

If we have portal vein hypertension or varices, hepatic encephalopathy can get worse after internal bleeding. Our blood is protein-rich, and if our esophagus or stomach keeps digesting it, we get extra brain foggy.

Taking a beta blocker can help reduce portal vein hypertension. Getting regular endoscopy checkups can help our doctor to find, and place bands on any areas of bleeding. This reduces hepatic encephalopathy a lot.

What medications can help?

If our hepatic encephalopathy is really bad, we can take certain medications, such as rifaximin, to help clear up our brain fog. It is prescribed by the doctor and the symptoms of HE usually clear up within a few days. Rifaximin can be expensive, and there are some drug programs available through pharmaceutical companies, charity, pharmacies, and grants.

Another medication that helps is a liquid called Lactulose. It works by binding with ammonia in our bloodstream. It keeps our bowels moving 3 to 4 times a day. This is also a prescription.

Most doctors allow the dosage of Lactulose to be increased. It may be prescribed with a specific dose, and then also be used “as needed” for symptoms.

What can people with HE do?

It may be hard to work for those of us with severe HE. Our inability to think can make it unsafe for us to operate machinery. Decision making may require longer periods of time. Talk to your medical provider and family members about what jobs you can do.

I recently looked through a box of pictures and remembered how sick I was. I do not even recall the events that happened. It was painful to see myself and wonder what it was like being there. With end-stage cirrhosis from the hepatitis C, hepatic encephalopathy can create a lot of problems for us. If you have questions, please post them on the forum. Look for more another blog from me about this topic soon.