My husband is 7 years post transplant. He had numerous episodes with elevated ammonia levels and severe confusion before transplant. His ammonia levels continue to go up even after transplant. All on his blood tests, bioposy, ultrasound are shw normal lover functions. He has been hospitalized several times after transplant for confusion. His ammonia levels can be as little as 10 points above normal to 165. This makes it hard to do anything. He takes 9 Rifaximin a day and at first sign..if I catch it.. I give him lactulose. No one has been able to tell us WHY this keeps happening or what else we can do. He has at least 3 to 4 ...or more bowel movements a day. Any help will be appreciated.