title: Pathophysiology, diagnosis, and management of hepatic encephalopathy.
abstract: Hepatic encephalopathy (HE) is a common complication of cirrhosis of the liver. It is also extremely debilitating, with an untreated 3-year survival of only 23 %. While the exact pathophysiology of HE has yet to be elucidated, a number of contributing factors have been described. Abnormal levels and altered metabolism of ammonia play a central role. Recently, inflammation has also been identified as a contributor to HE. Improved understanding of the pathophysiology of HE is crucial, as current therapy centers on reduction of the body's ammonia load. Lactulose is the first-line therapy for HE, with some antibiotics recently showing promise for improved outcomes in patients with HE. The role of anti-inflammatory therapies has yet to be evaluated.
authors.affiliation: Department of Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Sheasgreen
authors.forename: Lucy
authors.initials: L
authors.lastname: Lu
authors.forename: Ameen
authors.initials: A
authors.lastname: Patel
mesh_terms: D000641:Ammonia / Q000378:metabolism*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D007792:Lactulose / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000150:complications*
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D007792:Lactulose; D000641:Ammonia