Pathology

Causes of Hepatic Encephalopathy



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The liver is a vital organ that plays a major role in important body functions. One of its major functions is removing alcohol and other toxic substances in the blood. When the liver loses its capacity to detoxify the blood, brain function deteriorates resulting in a condition known as hepatic encephalopathy.

To date, the exact cause of hepatic encephalopathy is not known. What is known is that this condition stems from liver dysfunction, which in turn, is due to disorders affecting this vital organ. These disorders include those that lower the liver’s functional capacity (i.e. cirrhosis or hepatitis); and conditions that hamper sufficient blood flow to the liver.

As a vital organ playing an important role in the metabolic process, the liver acts to break down toxic substances produced by the body or taken into the body (such as drugs and alcohol), convert them into harmless or acceptable forms, and eliminate the waste products from the body. However, in the presence of liver damage, these toxic wastes can not be eliminated from the body. As a result, these toxic substances accumulate in the blood circulation.

One of the dangerous substances that the liver normally renders harmless is ammonia. This compound is produced by the body when proteins are metabolized. Ammonia, together with other toxic substances may build up in the bloodstream when they are not efficiently eliminated by the damaged liver. Once these substances reach the brain, they can cause hepatic encephalopathy.

Although more commonly seen in patients suffering from chronic liver diseases, hepatic encephalopathy may also occur suddenly in people who suffer from acute liver damage even if they do not have prior liver problems.

Patients with liver disorders are at risk of experiencing hepatic encephalopathy. This condition is usually triggered by a number of factors.

Dehydration is a risk factor for hepatic encephalopathy in patients with liver disorders. It should be important that such patients are sufficiently hydrated to prevent this condition.

Excessive consumption of protein-rich foods results in increased production of ammonia, which can accumulate in the presence of liver damage. This build-up in turn, can trigger the development of hepatic encephalopathy.

Abnormalities in electrolyte balance (particularly potassium) can also act as a risk factor for hepatic encephalopathy when the liver is damaged. This electrolyte imbalance can be a result of vomiting, or therapies like paracentesis (removal of excessive peritoneal fluid from the abdominal cavity) or use of diuretics (“water pills”).

Other factors that can trigger the development of hepatic encephalopathy include: bleeding from the esophagus, stomach, or intestinal tract; infectious diseases; kidney problems; low levels of oxygen in the body; shunt placement or its complications; surgical procedures; as well as use of medications that act as suppressants of nervous system function (i.e. barbiturates and benzodiazepine tranquilizers).

Hepatic encephalopathy can be a complication of liver diseases, thus, proper diagnosis and treatment of any problem affecting the liver is important in preventing this condition. Liver problems can be prevented by avoiding excessive intake of alcohol and intravenous drug use.

The acute form of hepatic encephalopathy may be treated; while chronic forms usually worsen or keep coming back. Both forms may cause irreversible coma or even death. According to MedlinePlus, an estimated 80 percent of patients die if they experience a coma. Recovery from hepatic encephalopathy and the chances of the condition recurring differ from one patient to another.

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ARTICLE SOURCES AND CITATIONS
  • InfoBoxCallToAction ActionArrowhttp://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001347/
  • InfoBoxCallToAction ActionArrowhttp://www.nlm.nih.gov/medlineplus/ency/article/000302.htm