Hepatic Encephalopathy

[SteveHepC]

I had a terrible, 15 or 20 minute episode yesterday. I was loading wood into the house when I went into a complete state of confusion. I don't remember stopping moving the wood, covering up the pile. My wife said I came into the house and asked her where I hang my back brace. I've been hanging it in the same place for 5 years. I was in a fog for quite awhile, and came out of it just as quickly. Genotype 2b - partial responder 4 years ago.

I read the following quote from an old article. Does anyone know if this still applies?
"Lactulose may be given to prevent intestinal bacteria from creating ammonia, and as a laxative to evacuate blood from the intestines. Neomycin may also be used to reduce ammonia production by intestinal bacteria. Rifaximin, a new antibiotic, is also effective in hepatic encephalopathy."

[Bill1954]

As far as I know, Lactulose is still the first line of defense for encephalopathy; I believe it’s quite harmless as well, being essentially a synthetic sugar. I believe the biggest side effects are gas and diarrhea. I’d definitely want a doctor to rule out other causes such as TIA, stroke, etc. just in case.

Sorry to hear of your experience. What is your stage of liver disease? I understand that encephalopathy is practically unheard of in compensated disease.

Maybe someone with more experience with this will stop by with more info for you.

Good luck—

Bill

[SteveHepC]

Thanks. I did find a Nov 5th Mike Simon Post that explains things in more detail.

I don't know my stage of fibrosis, as I cannot have a biopsy due to blood thinners. MRI's, CT Scans, Ultra Sound show no enlargement, No Acities. My Viral Load has remained steady at 2,300,000, all other enzymes are normal.

That episode scared me, so I will make an appointment and check everything out.

Steve

[Deb_c430]

That would also frighten me, Mike is a good person to ask,   best idea is yours go find out.

Bill also

Best of luck to you,    

Deb

[skersj]

This possibly could have been a TIA - sort of a mini stroke and not encephalopathy at all.  Glad you are getting it checked out. Please write back and let us know how your are doing. My prayers are with you.

[eureka254]

My hope is that you get checked out ASAP -- as far as concern for encephalopathy, your doc should be able to order a quick blood test to check for ammonia levels.  

Also, perhaps you could discuss the possibility of transjugular liver biopsy with your health providers -- my husband was on blood thinners and he was able to undergo the transjugular biopsy by stopping meds for just 5 days before the procedure, and it all went smoothly -- perhaps it might be a possible option for you.  (Ultrasound and CT Scan are poor diagnostic tools, imho, when it comes to assessing liver disease progression -- my husband has Stage 4 that went undetected by imaging: no apparent cirrhosis, ascities, etc.)  

Good luck and best wishes,
~eureka