Hepatic Encephalopathy

October 27, 2021 | By | Fibroscan, Hepatic Encephalopathy | Blog, Clinical research, Clinical trials, HE

Hepatic encephalopathy (HE) can develop when your liver can no longer remove toxic substances from your blood. The toxins build up and can travel through your body until they eventually reach your brain. This causes mental and physical symptoms of HE.

Why Does HE Develop?

Hepatic encephalopathy is a nervous system disorder brought on by severe liver disease. When the liver doesn’t work properly, toxins build up in the blood.  HE is a complication of cirrhosis– a severe form of liver disease. Common types of chronic liver disease can lead to liver scarring or even liver failure. These include:

  • Alcohol-related liver disease
  • Nonalcoholic fatty liver disease (NAFLD), or too much fat in liver cells
  • Inflammation of the liver (such as hepatitis A, B, or C)
  • Liver cancer

Living with untreated liver disease for a long time can lead to cirrhosis. Cirrhosis occurs when scar tissue replaces healthy liver tissue. As cirrhosis becomes worse, the liver has less healthy tissue. A healthy liver is essential in helping your body process food and nutrients into energy, removing harmful toxins. Over time, the liver becomes so damaged, it can no longer remove toxins from the blood. HE symptoms are broken down into four grades of severity:

  • Grade 1:
    • Lack of awareness
    • Euphoria or anxiety
    • Shortened attention span
    • Difficulty with addition or subtraction
    • Altered sleep patterns
  • Grade 2:
    • Lack of energy or interest
    • Confused sense of date and time
    • Obvious personality change
    • Inappropriate behavior
    • Uncoordinated movements
    • Tremor or flapping of the wrists
  • Grade 3:
    • Sleepiness or stupor
    • Responds to stimuli
    • Confused sense of place, where one is
    • Extreme disorientation
  • Grade 4:
    • Complete unresponsiveness (hepatic coma)


Treatments can rid the body of toxins and reverse this temporary condition. These are aimed at lowering the level of ammonia and other toxins in your blood. These toxins initially arise in your gastrointestinal or GI system. Hence, therapies are focused on your gut to eliminate or reduce the production of toxins.

Arizona Liver Health conducts free fibroscans that can detect liver diseases, such as NAFLD and NASH. A fibroscan done early enough can help you avoid complications from untreated liver disease such as HE. Once results are ready, our medical staff will help you determine if additional steps are needed. If your results indicate abnormal liver function, our team will discuss enrolling studies for the liver that may be an option. Schedule your FREE fibroscan today! Request an appointment here or call us at (480) 470-4000.