title: Contemporary Understanding and Management of Overt and Covert Hepatic Encephalopathy.
abstract: Hepatic encephalopathy (HE) is a major complication of liver disease that leads to significant morbidity and mortality. Caring for hospitalized patients with HE is becoming more complex, and the economic burden of HE continues to rise. Defining and diagnosing HE, particularly covert HE (CHE), remain challenging. In this article, we review new tools and those currently under development for the diagnosis of CHE and the latest advances in the acute and long-term management of overt HE (OHE) and CHE. In particular, we review the latest data on the use of lactulose and rifaximin for treatment of OHE and summarize the data on adjunctive agents such as sodium benzoate and probiotics.
authors.affiliation: Dr NeSmith is a gastroenterology fellow and Dr Ahn is an associate professor of medicine and director of clinical hepatology at Oregon Health & Science University in Portland, Oregon. Dr Flamm is a professor of medicine and chief of the liver transplantation program at Northwestern University Feinberg School of Medicine in Chicago, Illinois.
authors.forename: Meghan
authors.initials: M
authors.lastname: NeSmith
authors.affiliation: Dr NeSmith is a gastroenterology fellow and Dr Ahn is an associate professor of medicine and director of clinical hepatology at Oregon Health & Science University in Portland, Oregon. Dr Flamm is a professor of medicine and chief of the liver transplantation program at Northwestern University Feinberg School of Medicine in Chicago, Illinois.
authors.forename: Joseph
authors.initials: J
authors.lastname: Ahn
authors.affiliation: Dr NeSmith is a gastroenterology fellow and Dr Ahn is an associate professor of medicine and director of clinical hepatology at Oregon Health & Science University in Portland, Oregon. Dr Flamm is a professor of medicine and chief of the liver transplantation program at Northwestern University Feinberg School of Medicine in Chicago, Illinois.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Flamm
keywords: Hepatic encephalopathy; covert hepatic encephalopathy; lactulose; overt hepatic encephalopathy; rifaximin