Liver problems may cause psychological issues: The hidden danger of liver encephalopathy.

Liver encephalopathy is a serious complication of liver diseases, characterized by brain function disorders resulting from liver failure or portal-systemic shunts.

The main causes of liver encephalopathy include advanced cirrhosis of the liver, chronic liver failure, and acute liver damage. These can lead to the accumulation of toxins in the bloodstream, especially ammonia. These toxins, which are normally metabolized by the liver, move to the brain in case of its dysfunction, causing a range of psychiatric and neurological symptoms.

Being a potential cause of delirium, liver encephalopathy should be taken seriously. Failure to do so could lead to a brain hernia and other severe complications.

Symptoms of Liver Encephalopathy

Liver encephalopathy is a syndrome of neuropsychiatric symptoms and occurs in two main forms: overt and minimal.

The symptoms of liver encephalopathy are diverse. In its overt form, they can include subtle personality changes, mood swings, disorientation, and in severe cases, even coma.

Patients struggling with minimal encephalopathy, on the other hand may experience difficulties with concentration, memory problems, altered sleep patterns, hand tremors, and speech disorders. This condition requires immediate medical intervention, as it can lead to serious complications, including permanent brain damage and death.

The course of liver encephalopathy can vary: it can be episodic, recurring (when subsequent episodes occur within 6 months), or chronic.

Risk Factors

The main risk factor for the development of liver encephalopathy is liver disease. The precipitating factors (conditions that can increase the risk of liver encephalopathy in patients with liver disease) include:

• Bleeding from the gastrointestinal tract,
• Renal failure,
• Infections (including spontaneous bacterial peritonitis and urinary tract infections),
• Decrease in blood volume, e.g. after bleeding,
• Electrolyte disturbances,
• Constipation,
• Hypoxia,
• Use of sedative drugs (e.g. benzodiazepines),
• Hypoglycemia,
• Thrombosis of liver veins or portal vein.

Treatment for Liver Encephalopathy

Liver encephalopathy, being a reversible condition, often subsides after effective treatment of the underlying liver disease.