Hepatic encephalopathy is a decline in the functioning of your brain due to the accumulation of toxins in the blood. It is a reversible disorder, if managed properly through diet, laxatives and antibiotics. However, hepatic encephalopathy is a serious medical condition that can lead to malnutrition and even death, and should be managed under the care of a knowledgeable doctor or dietitian.
Hepatic Encephalopathy
The liver functions to remove toxins from your blood; however, chronic liver disease can damage your liver so that it is unable to remove toxins from the bloodstream. These toxins accumulate in the blood and then travel to the brain. This can make you feel confused, lethargic, agitated and forgetful, as well as change your mood or personality, cause you to slur your speech, change your sleeping pattern and cause abnormal movements. Although this condition normally occurs in the setting of liver disease, it can occur if you are healthy as well. Toxins may build up in the blood from having too much protein in your diet, taking certain drugs, dehydration, intestinal bleeding, infection, drinking excessive alcohol and electrolyte imbalances.
Importance of Diet
Following a proper diet is necessary for those with liver failure to prevent the build-up of toxins in the blood as well as prevention of malnutrition. Malnutrition is common in those with liver failure and increases the risk of death and development of other medical conditions, notes registered dietician Joseph Krenitsky in a 2003 article published in "Practical Gastroenterology."
Proteins
Protein is normally broken down into ammonia by the body which is then removed by the liver. The accumulation of ammonia in the body can lead to hepatic encephalopathy. It was previously believed that liver disease patients should restrict the amount of protein in their diets to prevent this from occurring. However, this can lead to malnutrition. Today the general consensus is that protein restriction is not necessary. In a 2003 article published in the "Annals of Hepatology," doctors Javier Lizardi-Cervera, Paloma Almeda, Luis Guevara and Misael Uribe recommend that patients with hepatic encephalopathy moderately reduce protein intake for the first few days after recovery to 40g a day. The intake should be increased slowly until the patient is able to tolerate a high intake of 70 to 80g a day.
Vitamins
Many patients with liver disease secrete less bile than normal. Bile is needed by the body to absorb vitamin A, D, E and K, as well as digest fats. Registered dietician Joseph Krenitsky notes that 33 percent of people with chronic cholestasis are vitamin A deficient, and 20 to 50 percent of people with primary biliary cirrhosis are vitamin D deficient. Patients with cholestasis should take 25,000 to 50,000 international units, IU, of vitamin A a day, 12,000 to 50,000 IU of vitamin D a day and 10 to 25 IU of vitamin E per kg of body weight a day.
Prevention
Avoid drinking excessive alcohol and eating too much protein if you have liver disease. Also make sure to drink enough water because dehydration can precipitate hepatic encephalopathy.
Considerations
Hepatic encephalopathy is a serious medical condition that needs to be treated by your physician. If you think you have hepatic encephalopathy, do not attempt to treat it on your own, as this could result in serious complications such as swelling of the brain, heart failure, respiratory failure, kidney failure, coma and even death.
