Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

The Management of Hepatic Encephalopathy from Ward to Domiciliary Care: Current Evidence and Grey Areas

Daniele Bellafante
,
Stefania Gioia
ORCID logo ,
Jessica Faccioli
ORCID logo ,
Oliviero Riggio
ORCID logo ,
Lorenzo Ridola
ORCID logo ,
Silvia Nardelli
* ORCID logo
Version 1 : Received: 29 November 2023 / Approved: 30 November 2023 / Online: 30 November 2023 (04:17:20 CET)

A peer-reviewed article of this Preprint also exists.

Bellafante, D.; Gioia, S.; Faccioli, J.; Riggio, O.; Ridola, L.; Nardelli, S. The Management of Hepatic Encephalopathy from Ward to Domiciliary Care: Current Evidence and Gray Areas. J. Clin. Med. 2024, 13, 166. Bellafante, D.; Gioia, S.; Faccioli, J.; Riggio, O.; Ridola, L.; Nardelli, S. The Management of Hepatic Encephalopathy from Ward to Domiciliary Care: Current Evidence and Gray Areas. J. Clin. Med. 2024, 13, 166.

Abstract

Hepatic Encephalopaty (HE) is a common complications of advanced liver disease and acute liver failure. It is a condition that features both neurological and psychiatric symptoms, that affects mortality, morbidity and quality of patients and caregivers’ life. HE diagnosis is generally an exclusion diagnosis. Once the patient is admitted to hospital, clinical examination, blood tests and eventually neuroimaging should be performed in order to rule out other causes of acute brain dysfunction. Moreover, HE recognizes various precipitants that can potentially promote its onset, alone or in combination, that must be identified. Once the diagnostic process is complete, a correct treatment should be started. The anti-HE treatment is based on a combination of correction of precipitants and non-absorbable disaccharides and non-absorbable antibiotic, such as rifaximin. Once the patient is discharged from the hospital, specific anti-HE therapy should be maintained in order to prevent other HE episodes.

Keywords

overt hepatic encephalopathy; minimal hepatic encephalopathy; portosystemic shunts; ammonia; liver cirrhosis

Subject

Medicine and Pharmacology, Gastroenterology and Hepatology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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