Can HE be ‘mild’?

[RuthieD]

Hubby has cirrhosis but abstinence since last episode last year means he currently has no symptoms. He takes no meds and won’t attend any appointments. Lately, he has been suffering sleeplessness and occasional forgetfulness. He hasn’t mentioned being worried but has been taking over the counter sleeping tablets. Could these be bad for his liver? Is it possible to have mild HE and could this be causing the sleeplessness..? Anyone with experience of HE without being in the middle of a full-blown episode..?

[AyrshireK]

My hubby has a diagnosis of mild HE - he takes rifaximin and lactulose to try and stop it from becoming more severe. The British Liver Trust has a page all about Hepatic Encephalopathy that will tell you more. britishlivertrust.org.uk/in...

What are the different stages of hepatic encephalopathy?

Hepatic encephalopathy is divided into stages based on the severity of the symptoms. Common classification systems include the West Haven Criteria and the Glasgow Coma Scale.

The five stages of hepatic encephalopathy, according to the West Haven Criteria, are:

Stage 0. At this stage, symptoms are minimal.

Stage 1. Symptoms are mild. They may include a shortened attention span and changes to your sleep habits, such as hypersomnia or insomnia.

Stage 2. Symptoms are moderate. At this stage, you may feel disoriented or lethargic.

Stage 3. Symptoms are severe. You’ll be unable to perform basic tasks. You’ll also feel confused and experience personality changes.

Stage 4. This stage is characterized by coma.

Taking over the counter meds could be dangerous as all medicine needs to be processed through the liver and a damaged liver struggles with this.

It is ultra important that he goes to his appointments or else his condition is not being properly monitored (6 monthly scans and bloods are ultra important as a cirrhotic liver can develop other issues that need picking up quickly). Non compliance with medical regime can be a negative if transplant was ever to become necessary.

Katie

[Hidden in reply to AyrshireK]

Hi

You are like a walking encyclopedia!! Brilliant. I'm not sure whether I have mild HE with all the things I do /not do. I know I laugh about it but more often than not I'm just not with it. My eyes will roll to back of my head and I don't remember a thing, I have Nash with fibrosis, got fibroscan in February . Love and hugs Lynne xxxx

[RuthieD in reply to AyrshireK]

Thanks Katie. I’ve only ever experienced HE when he’s in a major alcoholic episode so wasn’t aware/sure it could be low-level. When he’s well, he refuses help/appointments/meds and I have a hard job even getting him to discuss it, so needed to do my own checking!!

[Hidden]

Hi RuthieD

Katie has given you some great information already on this thread.

HE can indeed be mild and can be treated, but it is very important that your husband is seen and assessed by his GP and hepatologist.

He should also discuss his use of 'over the counter' medications with his GP and also always tell the pharmacist at the chemist that he has cirrhosis and check any medications are safe for him to take.

As Katie says, if you have cirrhosis it is very important to be compliant with hospital appointments and get the help, advice and support he needs.

Warm wishes

Trust1