Gut Liver.
2016 Jul;10(4):509-519. 10.5009/gnl15419.
Evaluation and Management of Hepatic Encephalopathy: Current Status and Future Directions
- Affiliations
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- 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.
- KMID: 2412037
- DOI: http://doi.org/10.5009/gnl15419
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.
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