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What Is Hepatic Encephalopathy?
Hepatic encephalopathy refers to the changes in the brain that occur in patients
with advanced acute or chronic liver disease. If liver cells are damaged,
certain substances that are normally cleansed from the blood by the healthy
liver are not removed (ammonia mainly, and other toxins). A patient with chronic
hepatic encephalopathy may develop progressive loss of memory, disorientation,
untidiness, and muscular tremors, leading to a form of chronic dementia. The
ingestion of protein invariably aggravates these symptoms.
The treatment of hepatic encephalopathy involves, first, the removal of all
drugs that require detoxification in the liver and, second, the reduction of
the intake of protein. Restricting the amount of protein in the diet will generally
lower the levels of amino acids and ammonia in the bloodstream and brain. Most
physicians advise their patients with this condition to eat only about 40 grams
of protein a day, and will prescribe lactulose or neomycin to lower amino acid
production. Non-meat proteins, such as those found in vegetables and milk, are
preferred. Certain amino acids are used in treatment, since they are considered
less likely to cause mental impairment. A dietary supplement rich in these amino
acids is used at many liver treatment centers.
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