Cirrhosis Complications: Encephalopathy

Cirrhosis Complications: Encephalopathy

Overview

When the liver has been damaged, it may not be able to filter poisons from the bloodstream, especially substances in the blood produced by bacteria in the large intestine. As a result, these substances (which include ammonia) may build up in the bloodstream and cause problems in your brain called encephalopathy. High ammonia levels are a sign of encephalopathy.

What are the symptoms?

Symptoms of encephalopathy may include:

  • Irritability.
  • Depression.
  • Changes in sleep patterns.
  • Twitching of muscles or jerking movements of hands.
  • Difficulty with word-finding.
  • Poor short-term memory.
  • Poor concentration.
  • Confusion and disorientation.
  • Coma.

What increases your risk?

Encephalopathy is most likely to occur in people who have high blood pressure in the portal vein system (portal hypertension). But it may also occur in people who have severe acute liver damage but do not have portal hypertension.

Certain procedures (such as shunting, which redirects the flow of blood or fluid through other areas of the body) that help lower portal hypertension and prevent variceal bleeding may actually increase your risk for encephalopathy.

Many things can contribute to encephalopathy. These may include the use of sedatives, opioids, or alcohol. Other things that may increase your risk include gastrointestinal bleeding, abnormal levels of electrolytes in the blood (especially low potassium levels), the amount of protein in the diet, infection such as peritonitis, dehydration, or constipation.

How is it treated?

Most cases of encephalopathy are treated using a medicine called lactulose. This drug helps prevent the buildup of substances in the large intestine that may lead to encephalopathy. Lactulose is effective at decreasing ammonia levels in the blood and improving encephalopathy.

If you have had many cases of encephalopathy, your doctor may give you another medicine called rifaximin. This medicine may be used with lactulose to help prevent encephalopathy.

Related Information

Credits

Current as of: February 10, 2021

Author: Healthwise Staff
Medical Review:
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
W. Thomas London MD - Hepatology

Disclaimer: The information contained in this website, and its associated websites, is provided as a benefit to the local community, and the Internet community in general; it does not constitute medical advice. We try to provide quality information, but we make no claims, promises or guarantees about the accuracy, completeness, or adequacy of the information contained in or linked to this website and its associated sites. As medical advice must be tailored to the specific circumstances of each patient and healthcare is constantly changing, nothing provided herein should be used as a substitute for the advice of a competent physician. Furthermore, in providing this service, Adventist HealthCare does not condone or support all of the content covered in this site. As an Adventist health care organization, Adventist HealthCare acts in accordance with the ethical and religious directives for Adventist health care services.

Find a Doctor

Find an Adventist HealthCare affiliated doctor by calling our FREE physician referral service at 800-642-0101 or by searching our online physician directory.

View Doctors

Set Your Location

Setting your location helps us to show you nearby providers and locations based on your healthcare needs.