Screening for each potential HE symptom is critical1

Because cirrhosis is such a strong risk factor for overt HE, screening for HE is critical in patients with CLD/cirrhosis.2 Diagnosis requires the detection of signs suggestive of HE in a patient with severe liver insufficiency who does not have obvious alternative causes of brain dysfunction.3

You can help patients at risk of overt HE recurrence by screening today

  • As the burden of CLD/cirrhosis increases, so do hospital readmissions. HE is a common driver for such readmissions4
  • Classify HE using the West Haven criteria3
West Haven criteria chart

Part of a holistic approach to managing HE is considering available guidelines

AASLD recommends the following to identify patients at risk for HE and initiate care (GRADE II-2,A,1)3,*:

  • Identify and treat precipitating factors
  • Seek and treat alternative causes of altered mental status
  • Initiate care for patients with altered consciousness
  • Commence empirical HE treatment

*Per the GRADE System for Evidence: GRADE II-2=cohort or case-control analytic studies; A=evidence is “high quality,” and further research is very unlikely to change our confidence in the estimated effect; and 1=recommendation is “strong,” with factors influencing strength of recommendation including the quality of evidence, presumed patient-important outcomes, and costs.3

Connect to AASLD

AASLD/EASL 2014 Guideline Overview

Quickly review some of the recommendations for adult patients with OHE.

HE, hepatic encephalopathy

CLD, chronic liver disease

GI, gastrointestinal

AASLD, American Association for the Study of Liver Diseases

EASL, European Association for the Study of the Liver

OHE, overt hepatic encephalopathy


XIFAXAN® (rifaximin) 550 mg tablets are indicated for the reduction in risk of overt hepatic encephalopathy (HE) recurrence in adults and for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.

  • XIFAXAN is contraindicated in patients with a hypersensitivity to rifaximin, rifamycin antimicrobial agents, or any of the components in XIFAXAN. Hypersensitivity reactions have included exfoliative dermatitis, angioneurotic edema, and anaphylaxis.
  • Clostridium difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including XIFAXAN, and may range in severity from mild diarrhea to fatal colitis. If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued.