Hepatic encephalopathy (HE) is a brain dysfunction caused by liver insufficiency and/or portosystemic shunting.1 In patients with cirrhosis and decreased hepatic function, toxins from the gut can enter the bloodstream and reach the brain, where they affect neurotransmission.1-3 This can cause episodes of HE, which may present as alterations in consciousness, cognition, and behavior that range from minimal to severe.1-3
HE is a problem hiding in plain sight
Recognizing patients at risk. The risk of HE is higher in patients with cirrhosis/chronic liver disease and4:
- Portal hypertension
- Ascites
- Variceal bleeding
- Medications, such as opioids
The risk of HE recurrence is high1,5,6
Once overt HE occurs, patients have a high risk of recurrence1,5,6:
- Cumulative risk of an overt HE recurrence at 1 year: 40%
- 40% cumulative risk of another overt HE recurrence within 6 months, despite standard-of-care treatment
HE and overt HE can be a burden for patients and families
- Overt HE may cause irreversible damage1,7,8
- HE-related hospitalizations rose 325% from 2005 to 20149*
- Other costs: disability, lost productivity, stress on caregivers10