Hepatic Encephalopathy Treatment

Dr. Bhavin K DavraMBBS, MD - General Medicine, DNB- GastroenterologyGastroenterologist

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Hi, from the details provided by you, I understand that you have cirrhosis of liver with chronic hepatitis b infection as the cause. You do not seem to have developed complications of portal hypertension viz. Gi bleed (blood in vomitus or stools), ascites (collection of fluid/water in stomach) or hepatic encephalopathy (drowsiness, transient loss of consciousness) etc. You need to continue with anti-viral medications for hepatitis b and cardivas along with regular screening and follow up with blood tests (every 3 to 6 months), ultrasound of abdomen (every 6 months) and surveillance endoscopies. Liver transplant is usually needed once you start developing complications or liver cancer (hcc) and is decided by your gastroenterologist/ hepatologist based on several parameters and scores (meld score.) 

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Ajay Kumar SheshamaMBBSGeneral Physician

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There is signs and symptoms of liver failure so they are talking like mad men so they should have to take proper management and proper treatment because this is severe condition .it may leads to hepatic encephalopathy so its need urgent management. 

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Dr. Jyoti BiswasMBBS,MD(medicine)General Physician

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Hepatic encephalopathy is really a serious disease. You have to check blood ammonia, gaba etc etcc. Patient usually sleep at day and remains awake at nighttime. There are many many signs and symptoms which are typical. But I need to check those reports before starting any medicine. Hope you will understand need details evaluation and treatment you can chat with me clicking on" text consultation" option if you wish thanks. 

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Dr. Radhika SharmaMD - Tuberculosis & Respiratory Diseases / Pulmonary Medicine, MBBS Bachelor of Medicine and Bachelor of SurgeryPulmonologist

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lybrate-user, her ca-125 is on the higher side but i’m sure her treating physician must have ruled out everything including malignancy. For some patients, their liver enzymes can get deranged. The best thing is to stop the treatment until bilirubin comes back to normal. If she stable and you are very worried you can repeat her lft tomorrow a and send me the reports. 

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Dr. Siddharth JainLiver Transplant, Surgical Gastroenterology, Fellowship in Abdominal Multi Organ Transplant Surgery, MS - General Surgery, MBBS Bachelor of Medicine and Bachelor of SurgeryGastroenterologist

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Mr. lybrate-user, If you father is suffering from cirrhosis and is having ascites (fluid in abdomen). Then this means the liver disease is fairly advanced. This condition needs to be taken seriously. Also important to understand is that there is treatment available. Treatment will depend on: 1. How advanced the liver disease is? 2. Cause of liver failure. 1. To see how advanced the disease is, we usually asses it based on a severity scoring. To simply put it for you Cirrhosis can be Type A, B or C based on severity, A being less advanced and C is most advanced. 2. Common causes for liver disease are: excessive alcohol intake, viral hepatitis, NASH. I will suggest you to share your father's liver function and ultrasound reports with me. I will also need a detailed medical history of your father. So you can share his reports and prescriptions that you may have. This is my link: https://www.Lybrate.com/delhi/doctor/dr-siddhart-jain-gastroenterologist In fact my article will soon be posted on Lybrate regarding liver failure and cirrhosis, I am sending you the excerpts from the same. This will hopefully will be informative: Whats is Liver Cirrhosis? What is Portal hypertension (PHT)? Why PHT occurs in cirrhotic patients and why it can be a life threatening problem? “Cirrhosis” (can be equated to scarring of liver). For instance, when there is a cut, the body repairs the wound but leaves behind a scar. Similarly, when liver gets hurt and tries to repair itself, that too may leave a scar behind. With repeated insult to the liver a cycle of injury, repair and scar formation ensues. Gradually, normal liver cells are lost, liver becomes shrunken and hard from replaced scar tissue. Common causes of insult to liver are alcohol, viral hepatitis or steatohepatitis (fatty liver disease). “Portal Hypertension” (PHT): Liver cirrhosis leads to portal hypertension which is increased pressure in portal vein (a large vein draining blood from the stomach and intestines into the liver). Normally, portal vein is a low pressure system. When the liver becomes hard from scarring, back pressure in the portal vein increases. How can Portal Hypertension be life threatening? A lot of complications in cirrhosis occur because of PHT. Blood vessels in the gut coalesce to form the portal vein. As pressure in portal vein increases, back pressure in these vessels increases too. Once the pressure rises significantly, these vessels rupture and can cause severe bleeding. This will be seen as blood in vomiting or as black stools. This can be a life threatening complication of portal hypertension. PHT can decrease the level of platelets in the blood, which also increased the risk of bleeding. Ascites (fluid in the abdomen) forms because of portal hypertension. Ascites if gets infected (SBP) becomes a serious condition. Excessive ascites formation is also related to reduced blood flow to kidneys resulting in kidney failure. Liver filters/cleanses this blood before it goes to the heart. In failure, this does not happen and unfiltered blood circulates in the body, which if affects the brain (increased ammonia level in blood) can cause confusion, drowsiness or even coma (hepatic encephalopathy). 

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Dr. Kumar SambhavMBBSGeneral Physician

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Hi, you need to start eating healthy food, start doing exercise, try make your digestion good, stop eating spicy oily food, drink green tea daily twice, you need to follow this advice for 6 months you must do yoga and exercises to make your self healthy. 

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Dr. Nash KamdinMBBSGeneral Physician

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Dear lybrateuser, -It is better to avoid alcohol if you do not take, as after starting it becomes a habit & the intake also keeps increasing -it adds only empty calories to the diet which can increase weight along with the snacks which one has, also increases body & blood fat which is harmful for the body . 

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Dr. Lalit Kumar TripathyMBBSGeneral Physician

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Symptoms of jaundice 1. Fever, muscle/joint pain, weak ness 2. Loss of appetite, nausea, vomiting, diarrhoea, 3. Yellow coloration of urine and conjunctiva (white of eye) light coloured (pale) stool, 4. Itching sensation, pain abdomen enlarged, tender liver, 5. Serum bilirubin level is raised 6. Symptoms resolves within 2-3 week, 7. Very few develop acute liver failure/confusion/coma due to hepatic encephalopathy treatment 1. Take bland diet, avoid spicy, oily and fatty food like oil, ghee, butter, cream. He should have soft, easily digestible foods like suji, dhalia, porridge, curd rice. 2. Drink plenty of water, take resh fruit like orange, apple, pineapple, grape, papaya, mango. Fruit juice, sugar cane juice, coconut water. Have plenty of green leafy vegetables 3. Take adequate rest at least for 2 week 4. Take liv 52 2tablet twice daily after food 5. Monitor your lft for serum bilirubin 6. Consult gastroenterologist/hepatologist for advice and treatment. Prevention of jaundice jaundice due to hepatitis a virus is common and is due to fecal contamination of food and water. It can be prevented by 1. Avoiding contaminated food and water from out side sources like junk food etc 2 use purified drinking water and have warm home made food, 3. Avoid fly contamination of food 4, properlyl wash your hands with soap and water before taking food 5. Wash vegetable, fruit before consuming. 

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Dr. Lalit Kumar TripathyMBBSGeneral Physician

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Symptoms of jaundice 1. Fever, muscle/joint pain, weak ness 2. Loss of appetite, nausea, vomiting, diarrhoea, 3. Yellow coloration of urine and conjunctiva (white of eye) light coloured (pale) stool, 4. Itching sensation, pain abdomen enlarged, tender liver, 5. Serum bilirubin level is raised 6. Symptoms resolves within 2-3 week, 7. Very few develop acute liver failure/confusion/coma due to hepatic encephalopathy chronic hepatitis-may cause cirrhosis of liver with ascitis, swelling of legs, oesophageal varices, hepatic encephalopathy treatment 1. Take bland diet, avoid spicy, oily and fatty food like oil, ghee, butter, cream. He should have soft, easily digestible foods like suji, dhalia, porridge, curd rice. 2. Drink plenty of water, take resh fruit like orange, apple, pineapple, grape, papaya, mango. Fruit juice, sugar cane juice, coconut water. Have plenty of green leafy vegetables 3. Take adequate rest at least for 2 week 4. Take liv 52 2tablet twice daily after food 5. Monitor your lft for serum bilirubin 6. Consult gastroenterologist/hepatologist for advice and treatment. Prevention of jaundice jaundice due to hepatitis a virus is common and is due to fecal contamination of food and water. It can be prevented by 1. Avoiding contaminated food and water from out side sources like junk food etc 2 use purified drinking water and have warm home made food, 3. Avoid fly contamination of food 4, properlyl wash your hands with soap and water before taking food 5. Wash vegetable, fruit before consuming. 

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Dr. Lalit Kumar TripathyMBBSGeneral Physician

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1. Hepatitis is inflammation of liver, it could be because of viral and non viral origin 2. Viral hepatitis is due to hepatitis virus and are of 5 typestype (a, b, c, d, e 3. Hepatitis a, b, c are common. 4. A&e are due to faecal contamination of food, water. 4. Hepatitis b is due to contact with infected blood/blood product, sexual contact with infected person and from mother to child. Hepatitis c-contact with blood like sharing needle, unprotected sex, mother to foetus. 5. Hepatitis d is due tocontact with infected blood like sharing of needle but infection occurs when individual is also affected with hepatitis b symptoms of hepatitis a) fever, muscle/joint pain, weak ness b) loss of appetite, nausea, vomiting, diarrhoea, yellow coloration of urine and conjunctiva (white of eye) c) light coloured (pale) stool, itching sensation, d) pain abdomen enlarged, tender liver, serum bilirubin level is raised e). Symptoms resolves within 2-3 week, very few develop acute liver failure/confusion/coma due to hepatic encephalopathy treatment 1. Take bland diet, avoid spicy, oily and fatty food like oil, ghee, butter, cream. He should have soft, easily digestible foods like suji, dhalia, porridge, curd rice. 2. Drink plenty of water, take resh fruit like orange, apple, pineapple, grape, papaya, mango. Fruit juice, sugar cane juice, coconut water. Have plenty of green leafy vegetables 3. Take adequate rest at least for 2 week 4. Take liv 52 2tablet twice daily after food 5. Monitor your lft for serum bilirubin 6. Consult gastroenterologist/hepatologist for advice and treatment. Prevention of jaundice jaundice due to hepatitis a virus is common and is due to fecal contamination of food and water. It can be prevented by 1. Avoiding contaminated food and water from out side sources like junk food etc 2 use purified drinking water and have warm home made food, 3. Avoid fly contamination of food 4, properlyl wash your hands with soap and water before taking food 5. Wash vegetable, fruit before consuming. 

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