Hello and hope you are doing well.
Cirrhosis of liver could have caused liver failure and consequent hepatic encephalopathy. The liver which is decompromised cannot metabolize the waste products hence there is an elevation of blood ammonia levels resulting in encephalopathy. Also, iincreased levels of ammonia may also be seen with gastrointestinal bleeding, where the blood cells are haemolysed in the intestines, releasing protein. The treatment is directed at the cause and in giving life support measures. Lactulose is given to prevent intestinal bacteria from creating ammonia, and as a laxative to remove blood from the intestines. Hepatic encephalopathy could further progress to coma.
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