How is Chronic hepatic encephalopathy diagnosed?

[DrFishHeads]

My dad is in hospital with confusion (he's slowly gaining lucidness), where he is being treated for a UTI, and they have told him he has chronic hepatic encephalopathy, and this level of confusion is not reversible. I'm just wondering how this gets diagnosed?

He was in hospital over the new year, and he didn't receive any of his consultant prescribed lactulose for five days.

As far as I am aware, he has only received a CT scan of his head, which came up fine.

Any advice out there?

[Smegmer]

Hi. Sorry to hear of you Dad being this sick. Its his damaged Liver not cleaning his blood and this is allowing Ammonia into the brain, this is damaging his brain. The Lactulose helps get it out in the poop, but its not a magic fix. So the Ammonia levels are what you want to be asking them about. Ideally he needs to gain some Liver function back so he can clear the Ammonia and let his brain have a breather and recover. You don't say the cause of his Liver issues, may I ask what caused it ?

[DrFishHeads in reply to Smegmer]

Cirrhosis 😓

[Smegmer in reply to DrFishHeads]

Yeh, that was clear. I meant was it booze related ? If so, those that stop can get some health back.

[chrisw740]

Sorry to hear your dad's so unwell.

Not knowing how old your dad is, it's worth pointing out that UTIs are notorious (particularly in seniors) for causing severe confusion. The symptoms can mirror dementia-like symptoms, which of course are also similar to those of hepatic encephalopathy. So there's a possible double whammy here if his suspected H.E has recently gone untreated too.

An ammonia Blood Test, (NH3 Test) would be useful to see where his levels are at then perhaps rifaximin could be added to his lactulose mitigation in the hope of bringing those levels down further. Obviously this is just a thought and proper medical advice is the only advice that should be followed.

Really hope he continues to improve.

Best

Chris

[kensimmons in reply to chrisw740]

Chris is right, wait and see.

[BritishLiverTrust3 Administrator British Liver Trust]

Dear DrFishHeads,

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

[Maison2023]

so sorry to hear this , I didnt know this could hepatic encephalopathy could be permanent , I hope he improves