What are the reasons why patients with cirrhosis are prone to hepatic encephalopathy?

Aug 20, 2025 Source: Cainiu Health

Dr. Gao Jun

Introduction

Under normal circumstances, patients with cirrhosis are prone to hepatic encephalopathy, which may be caused by severe liver dysfunction, formation of portosystemic shunts, induction by upper gastrointestinal bleeding, infections exacerbating metabolic disturbances, electrolyte imbalances affecting neurological function, and other related factors. If symptoms such as impaired consciousness occur, it is recommended to seek timely medical treatment at a正规 hospital. A detailed analysis is as follows:

Generally, patients with liver cirrhosis are prone to develop hepatic encephalopathy due to reasons such as severe liver dysfunction, formation of portosystemic shunts, upper gastrointestinal bleeding induction, worsening metabolic disturbances from infection, and electrolyte imbalances affecting nerve function. If symptoms such as impaired consciousness appear, prompt medical consultation and treatment at a regular hospital are recommended. Detailed explanations are as follows:

1. Severe Liver Dysfunction

Liver cirrhosis causes extensive liver cell necrosis, leading to reduced metabolic and detoxification functions of the liver. The body cannot effectively remove toxic substances such as ammonia, which accumulates in the blood and may trigger hepatic encephalopathy. Under medical guidance, medications such as lactulose oral solution, ornithine aspartate granules, and lactitol powder can be used to promote ammonia metabolism and excretion, improving liver function.

2. Formation of Portosystemic Shunts

In liver cirrhosis, portal vein pressure increases, forming portosystemic shunts. Toxic substances absorbed from the intestines bypass the liver and directly enter the systemic circulation, affecting central nervous system function. Patients should avoid consuming high-protein foods to reduce the production of toxic substances and adjust the shunting condition under medical supervision.

3. Upper Gastrointestinal Bleeding Induction

Patients with liver cirrhosis often have esophageal and gastric variceal bleeding. Blood decomposed in the intestines produces large amounts of ammonia, leading to a sudden increase in blood ammonia levels and triggering hepatic encephalopathy. Prompt hemostasis is necessary, and endoscopic band ligation or sclerotherapy may be performed to control bleeding when needed. Meanwhile, the above-mentioned ammonia-lowering medications should be used to stabilize the patient's condition.

4. Infection Worsening Metabolic Disturbances

Patients with liver cirrhosis have low immunity and are prone to spontaneous bacterial peritonitis, pulmonary infections, etc. Infections worsen systemic metabolic disturbances, increase the burden on the liver, and may trigger or exacerbate hepatic encephalopathy. Under medical guidance, medications such as cefoperazone sodium and sulbactam sodium for injection, levofloxacin for injection, and metronidazole for injection can be used to control infections and reduce liver damage.

5. Electrolyte Imbalance Affecting Nerve Function

Patients with liver cirrhosis often develop electrolyte disturbances such as hypokalemia and hyponatremia, which can affect nerve conduction function and trigger hepatic encephalopathy. Regular monitoring of electrolyte levels is necessary, with potassium and sodium supplementation based on test results to maintain electrolyte balance—for example, using oral potassium chloride sustained-release tablets or sodium chloride injections.

In daily life, attention should be paid to limiting high-protein diet intake; maintaining regular bowel movements and avoiding constipation; preventing infections and maintaining personal hygiene; and regularly reviewing liver function and blood ammonia levels to adjust treatment plans according to disease progression.

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What are the symptoms of hepatic coma?

Under normal circumstances, hepatic coma, also known as hepatic encephalopathy, is a central nervous system dysfunction syndrome based on metabolic disorders caused by severe liver disease. Its symptoms include disturbed consciousness, abnormal behavior, asterixis, speech disorders, and neurological signs. If coma deepens or vital signs become unstable, emergency intervention is required to reduce mortality.

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Can cirrhosis be detected by ultrasound?

In general, liver cirrhosis can be diagnosed through ultrasound examination, but whether a definitive diagnosis can be made depends on the specific circumstances. In daily life, individuals with high-risk factors for liver disease should undergo regular ultrasound examinations to monitor changes in liver morphology. If abnormalities are detected on ultrasound, timely medical consultation is necessary, and further tests should be completed according to the doctor's recommendations.

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Can taking antiviral medication lead to cirrhosis?

In general, whether taking antiviral medication will lead to liver cirrhosis depends on the medication regimen and control of the underlying disease. When antiviral drugs are taken properly and the primary condition is effectively controlled, cirrhosis usually does not develop. However, if the medication is used improperly or the underlying disease remains uncontrolled, progression to liver cirrhosis may occur. During antiviral treatment, patients must strictly follow their doctor's instructions.

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What is the relationship between impaired liver function and total bile acids?

In general, impaired liver function is closely related to total bile acid levels, which are among the sensitive indicators reflecting liver function. Clinically, total bile acids are often tested in combination with other liver function parameters, such as bilirubin and albumin, to assess the degree of liver damage, determine prognosis, and play an important role in the diagnosis and monitoring of liver cirrhosis and cholestatic liver disease.