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Managing Encephalopathy in the Outpatient Setting
In cirrhosis of liver, hepatic encephalopathy (HE) has an important impact on health-related quality of life. It is important to define whether HE is episodic, recurrent, or persistent; types A, B, or C; overt HE or covert HE; and spontaneous or precipitated. The overt HE is clinically evident and n...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Jaypee Brothers Medical Publishers
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5663774/ https://www.ncbi.nlm.nih.gov/pubmed/29201772 http://dx.doi.org/10.5005/jp-journals-10018-1211 |
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author | Gupta, Tarana Rathi, Sahaj K Dhiman, Radha |
author_facet | Gupta, Tarana Rathi, Sahaj K Dhiman, Radha |
author_sort | Gupta, Tarana |
collection | PubMed |
description | In cirrhosis of liver, hepatic encephalopathy (HE) has an important impact on health-related quality of life. It is important to define whether HE is episodic, recurrent, or persistent; types A, B, or C; overt HE or covert HE; and spontaneous or precipitated. The overt HE is clinically evident and needs hospitalization. Nonabsorbable disaccharides, rifaximin, and probiotics are proven to be useful in the treatment of overt HE. Covert HE includes both minimal HE and grade I HE. It is not apparent on routine clinical examination. Presence of poor work productivity, increased accidental injuries on complex machinery and driving, etc., raise the suspicion of cognitive dysfunction. Specialized neurocognitive testing like psychometric HE, computerized tests like critical flicker frequency tests, inhibitory control tests, Stroop encephalopathy tests, and electroencephalography are needed to diagnose overt HE. Various studies have shown lactulose and rifaximin to be useful in overt HE. However, presence of persistent and recurrent HE in cirrhosis is an indication for liver transplant. Lactulose is effective both in improving reversal of minimal HE and in reducing the risk of development of overt HE. How to cite this article: Gupta T, Rathi S, Dhiman RK. Managing Encephalopathy in the Outpatient Setting. Euroasian J Hepato-Gastroenterol 2017;7(1):48-54. |
format | Online Article Text |
id | pubmed-5663774 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Jaypee Brothers Medical Publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-56637742017-11-30 Managing Encephalopathy in the Outpatient Setting Gupta, Tarana Rathi, Sahaj K Dhiman, Radha Euroasian J Hepatogastroenterol Mini Review In cirrhosis of liver, hepatic encephalopathy (HE) has an important impact on health-related quality of life. It is important to define whether HE is episodic, recurrent, or persistent; types A, B, or C; overt HE or covert HE; and spontaneous or precipitated. The overt HE is clinically evident and needs hospitalization. Nonabsorbable disaccharides, rifaximin, and probiotics are proven to be useful in the treatment of overt HE. Covert HE includes both minimal HE and grade I HE. It is not apparent on routine clinical examination. Presence of poor work productivity, increased accidental injuries on complex machinery and driving, etc., raise the suspicion of cognitive dysfunction. Specialized neurocognitive testing like psychometric HE, computerized tests like critical flicker frequency tests, inhibitory control tests, Stroop encephalopathy tests, and electroencephalography are needed to diagnose overt HE. Various studies have shown lactulose and rifaximin to be useful in overt HE. However, presence of persistent and recurrent HE in cirrhosis is an indication for liver transplant. Lactulose is effective both in improving reversal of minimal HE and in reducing the risk of development of overt HE. How to cite this article: Gupta T, Rathi S, Dhiman RK. Managing Encephalopathy in the Outpatient Setting. Euroasian J Hepato-Gastroenterol 2017;7(1):48-54. Jaypee Brothers Medical Publishers 2017 2017-05-05 /pmc/articles/PMC5663774/ /pubmed/29201772 http://dx.doi.org/10.5005/jp-journals-10018-1211 Text en Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd. This work is licensed under a Creative Commons Attribution 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by/3.0/ |
spellingShingle | Mini Review Gupta, Tarana Rathi, Sahaj K Dhiman, Radha Managing Encephalopathy in the Outpatient Setting |
title | Managing Encephalopathy in the Outpatient Setting |
title_full | Managing Encephalopathy in the Outpatient Setting |
title_fullStr | Managing Encephalopathy in the Outpatient Setting |
title_full_unstemmed | Managing Encephalopathy in the Outpatient Setting |
title_short | Managing Encephalopathy in the Outpatient Setting |
title_sort | managing encephalopathy in the outpatient setting |
topic | Mini Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5663774/ https://www.ncbi.nlm.nih.gov/pubmed/29201772 http://dx.doi.org/10.5005/jp-journals-10018-1211 |
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