Uncovering the causes and prevention of hepatic encephalopathy

Author: Xie Wen, Chief Physician, Beijing Ditan Hospital, Capital Medical University

Reviewer: Wang Lixiang, Chief Physician, Third Medical Center, PLA General Hospital

The 10th Chairman of the Science Popularization Branch of the Chinese Medical Association

The liver, as one of the important organs of our body, is not only responsible for detoxification, but also participates in the regulation of many life activities. However, when the liver is severely damaged, a series of complications will follow, among which hepatic encephalopathy is the most serious and difficult one.

So, where does hepatic encephalopathy come from? And how can we prevent its recurrence in our daily lives?

1. What are the causes of hepatic encephalopathy?

The causes of hepatic encephalopathy are mostly related to severe damage to liver function, among which cirrhosis is the most common underlying condition, especially developed from viral hepatitis B and C. In addition, factors such as the increasing prevalence of fatty liver disease, autoimmune hepatitis and schistosomiasis can also lead to cirrhosis and then cause hepatic encephalopathy.

The key mechanism of hepatic encephalopathy is the decreased detoxification capacity of the liver, especially the imbalance in blood ammonia processing, including increased production or decreased metabolism, leading to ammonia poisoning.

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Specific triggering situations include:

1. Constipation: It prevents toxic substances such as ammonia from being excreted through feces, causing an increase in blood ammonia levels;

2. Use of diuretics: may cause electrolyte imbalance and indirectly promote hepatic encephalopathy;

3. Infection: If there is abdominal infection, fever accompanied by diarrhea can aggravate the condition;

4. Gastrointestinal bleeding: blood accumulates in the intestines, promoting abnormal blood ammonia production;

5. Other complications: Any complications related to cirrhosis may become a predisposing factor.

It is worth noting that the manifestations of hepatic encephalopathy are diverse. Mild cases may only show euphoria, that is, atypical high mood, which is also an early signal that requires vigilance.

2. How to prevent recurrence of hepatic encephalopathy?

Patients with HE need to pay special attention to their diet and exercise habits in daily life to maintain liver health and reduce the risk of recurrence.

In terms of diet, patients with hepatic encephalopathy need to follow the principle of balanced nutrition and ensure adequate intake of the six major nutrients. In particular, the intake of high-quality protein is essential for maintaining body function and promoting liver repair. It is recommended to choose high-quality protein that is easily digestible and absorbable, such as shrimp, chicken, fish, eggs, etc., and avoid high-fiber foods such as soy milk during acute attacks, which may cause intestinal discomfort.

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In addition, separate meals are an important part of the dietary management of patients with hepatic encephalopathy. Eating small and frequent meals, 5-6 meals a day, especially night snacks, can help maintain blood sugar stability and reduce the impact of hypoglycemia on the body. At the same time, food should be soft and easy to digest to avoid the potential damage of rough food to gastroesophageal varices.

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In terms of exercise, patients with hepatic encephalopathy should choose appropriate forms of exercise according to their condition and physical fitness level. In the stable stage of the disease, moderate physical activity or physical exercise is beneficial to improving physical function and mental health. However, too intense anaerobic exercise should be avoided to avoid increasing the burden on the liver. Walking is a form of aerobic exercise suitable for patients with hepatic encephalopathy. The speed and time can be adjusted according to their own situation so as not to feel overly tired.

In addition, patients with hepatic encephalopathy also need to pay attention to avoid some factors that may induce recurrence of the disease. For example, avoid intestinal problems such as constipation and gastrointestinal bleeding, and avoid electrolyte imbalance caused by excessive diuresis. Through long-term management and continuous treatment, patients with hepatic encephalopathy can effectively control the disease, reduce the risk of recurrence, and improve the quality of life.