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1840891 tn?1431547793

Minimal hepatic encephalopathy

I'm curious as to how common it is for hepatologists to test cirrhotics for minimal HE. I've been cirrhotic (compensated) since 2004, I've had no overt HE but I have often noticed decreased brain function, by which I mean slower reaction time, slow or reduced reading comprehension, reduced capacity for problem-solving, less creative thinking, and loss of word recall. In short: brain fog. When these signs are worse I'm usually noticeably more fatigued and sleepy during the daytime. The only test my hepatologist has ever performed related to HE is the checking for hand tremor, which I never have. I'm reading the post here about probiotics and am seeing references to minimal HE and numerous tests for it and I'm wondering if my doctor is a little behind on this particular curve. Have those of you without overt HE been tested for minimal HE?
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Avatar universal
  This Thursday, we will all be praying for you, and visualizing those Doctors killing the helloutof that tumor!!  That tumor doesn't stand a chance...rawr!! Love you, Howie <3
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4670047 tn?1375730401
This is very interesting stuff. Thanks to all of you for posting this!!!
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317787 tn?1473358451
I will visualize with Cean

Cean I have never been tested for minimal HE or any HE
I only had my ammonia tested once a couple of years ago and it was 108
At that time I was reading one of HR's posts and he said that Lactulose can be used as a preventative as well as a pre or probiotic, can't remember which.  I asked my doctor for a prescription and have been on it ever since.

I am also taking probiotics as I had read Mike's article.  I have been taking acidoliphilus for many years though recently made an effort to find the best one for me.
I can try to send the post that HR wrote though it might actually be in two threads

My best, always....Dee
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446474 tn?1446347682
COMMUNITY LEADER
My treatment is Thursday the 27th at about 9 am at UCSF Medical in Interventional Radiology by the way. This will be the 3rd time they will treat this blasted tumor.

I found out Monday while talking to the doctor who will perform the procedure I will have general anesthesia for the first time since 2009 so they can pinpoint the tumor with the needle more accurately. Breathing causes the liver to move and my tumor is right next to my portal vein. Now that could get real bloody real fast. Portal vein carries all of the blood from the stomach, the intestines, the spleen, the gallbladder, and the pancreas flows to the liver. Yikes!

The last time I had general I decompensated. Oh well I hope the kill this tumor once and for all and gets me to transplant.

Hector
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1840891 tn?1431547793
Thanks Hector! I'll be with you tomorrow morning in my meditation, visualizing that tumor withering away and making room for healthy tissue. Best wishes and lots of love!
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446474 tn?1446347682
COMMUNITY LEADER
Minimal hepatic encephalopathy, Grade 0  has no symptoms (behavior or personality changes) so it is difficult to detect except by complex psycho-metric testing, Which personally I have never heard of being done on anyone of the hundreds of cirrhotics I have met. It is only through testing that it can be shown that Minimal (covert) HE impairs concentration and the ability to drive.

HE is clinically apparent only in Grades 1 to 4 of the West Haven Criteria.

No consensus on diagnostic criteria or tests have been standardized.

It is Grade 1 or 2 of overt HE that the patient or someone close my will normally notice behavior or personality changes.  Such as shortened attention span, minimal disorientation of time or place. Lethargy or apathy.

Most of the symptoms you mention can have other causes including aging. Almost a decade in a person's life in midlife can make quiet a bit of difference. I don't know of any 55 year old that can do what they did when 45 years old.

Not everyone with cirrhosis develops Minimal HE. It is estimated that about 60% do depending on the criteria for judgement.

The only test I have taken for HE beside ammonia levels is a connect the next ordered dot test which is timed. Serial dotting Test. But that test is for overt HE.

Best-
Hector
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