He from cirossis

[Grizz11]

has anyone dealt with mental confusion and how did it go for recovery after taking lactose

[EmmaThom]

ive had 3 bouts of significant HE. The lactulous I was taking stopped being effective. I now take 4-8 sachets of Laxido and occasional sachets of Fibregel. I can't stress enough the importance of opening your bowels at least 2-3 times per day to prevent HE. My consultant has told me to go straight to a&e if I don't go to the toilet for 24 hours. Get an urgent GP appointment for a prescription of Laxido if required- I'm much more comfortable with that than lactulous it gave me terrible stomach aches and wind. Good luck and hope this helps 🙏

[EmmaThom in reply to EmmaThom]

fingot to mention I also take 550mg rifaximin 2 times per day - but this must be prescribed by a consultant. Repeat prescriptions will be provided by your local GP.

[Roy1955 in reply to EmmaThom]

Might be wise to check with an expert about replacing lactulose with an alternative laxative.

I am not certain but I think lactulose not only increases bowel movement but also has other therapeutic effect regarding HE such as binding with toxins so they poop out instead of being absorbed into the bloodstream.

Other laxatives might still make you "go" but not not do the same job regarding toxins.

[Richard-Allen]

Medications like Rifaximin and Lactulose are prescribed to help cut down the amount of ammonia being produced in the gut.

Ammonia is produced by healthy bacteria in the gut as food is broken down. This ammonia travels up to the liver where it is made safe (less toxic) and then passed onto the kidneys to be extracted from the body. It is the ammonia that gives urine its distinctive smell.

Because of the build-up of scar tissue on the liver as in Cirrhosis, as the ammonia can no longer get through to be processed, it can build up and leak out into the blood system. Here it travels up to the brain and can cause long-term brain damage.

Astrocytes are specialised glial cells in the brain. One of the primary roles of astrocytes is to protect neurons against excitotoxicity by taking up excess ammonia and glutamate and converting it into glutamine via the enzyme. But too much ammonia and the astrocytes can become enlarged and no longer function as well as they should. There is a condition called, “Alzheimer type ii astrocytes” (Not to be confused with Alzheimer’s) which is found in people with HE.

It has now been found that for some people this brain damage can become permanent. Earlier this year an article in the Journal of Hepatology entitled “Heretical thoughts into Hepatic Encephalopathy”, states:

“Many lines of investigation have confirmed that hepatic encephalopathy is irreversible in many patients and suggests the need for further studies focussing on mechanisms of neuronal injury and death to guide future drug development for these patients”.

The human body is a wonderful machine, and even though the brain may be damaged, it can often rewire itself so some people who have experienced HE episodes can make a near-full recovery.

Hope this is of some help.

Richard

[BritishLiverTrust4]

Dear Grizz11

If you would find it useful to talk things over, our nurse-led helpline is open Monday to Friday from 9am to 3pm on 0800 652 7330 (excluding bank holidays)

Best wishes

British Liver Trust

[Spooks58]

My husband was diagnosed with cirrhosis in June 2020 and admitted to hospital with jaundice, HE, oedema and ascites. He takes Lactulose daily but is still affected by HE daily to varying degrees. If anyone knows more about this I would appreciate it as he puts the confusion/forgetfulness down to being 64 but I'm sure there's more to it than that. How many other partners are aware of this?