Gastroenterology -Therapeutics & Hepatology

Hepatic Encephalopathy: Modern Management Strategies

Hepatic encephalopathy (HE), a neuropsychiatric disorder caused by liver dysfunction, requires modern management strategies to improve patient outcomes and quality of life. Current approaches focus on both acute management and long-term prevention. In acute settings, treatments aim to reduce ammonia levels, a key contributor to HE. Lactulose, a non-absorbable disaccharide, remains a cornerstone therapy, working by reducing ammonia production and enhancing its elimination. Additionally, rifaximin, a non-absorbable antibiotic, is increasingly used to decrease gut bacteria that produce ammonia. Long-term management includes dietary modifications, such as reducing protein intake to minimize ammonia production, and addressing underlying liver disease through medications and lifestyle changes. Innovative approaches are exploring novel therapies, such as ammonia scavengers and liver-directed therapies, to better manage HE. Moreover, advancements in biomarkers and diagnostic tools are improving early detection and monitoring of the condition. These modern strategies are advancing the care of HE, aiming for more effective symptom control and enhanced patient well-being.