Learn Glossary clinical condition

Hepatic Encephalopathy

Reversible neuropsychiatric syndrome in advanced liver disease caused by accumulation of gut-derived neurotoxins, especially ammonia.

Manifestations range from subtle cognitive changes to coma. Triggered by GI bleeding, infection, constipation, electrolyte disturbance, or high-protein meals in some patients. Treatment includes lactulose (decreases ammonia absorption), rifaximin, and BCAA-enriched supplements in selected patients. Older 'low-protein' diets are now considered harmful; standard protein intake (1.2 to 1.5 g/kg/day) is preferred to prevent muscle wasting.

How one textbook covers it

  • Krause and Mahan's Food and the Nutrition Care Process, 16th ed.Chapter 29

    Manifestations range from subtle cognitive changes to coma. Triggered by GI bleeding, infection, constipation, electrolyte disturbance, or high-protein meals in some patients. Treatment includes lactulose (decreases ammonia absorption), rifaximin, and BCAA-enriched supplements in selected patients. Older 'low-protein' diets are now considered harmful; standard protein intake (1.2 to 1.5 g/kg/day) is preferred to prevent muscle wasting.

Related terms

Ammonia, Branched-Chain Amino Acids, Cirrhosis