Risk Factors of Hepatic Encephalopathy in chronic liver disease

Objective: To find out the risk factors for developing Hepatic Encephalopathy in Chronic liver disease.Background: Hepatic encephalopathy is a neuropsychiatric disorder caused by liver damage. In its pathology, alterations in normal brain function are associated with an increase in blood ammonia, products of neurotoxic fatty acids, and other gut derived toxins, which gain access to the brain as a result of liver dysfunction. Study Design: Hospital based descriptive, cross sectional study.Duration: Oct 2011 to March 2012Patients and Methods: 150 patients chronic liver disease admitted with hepatic encephalopathy were included in this study. Patients suffering from viral or bacterial encephalitis, stroke, brain tumor, Wernicke's encephalopathy were excluded from the study.Results and Observations: There were 96 (64%) female and 54 (36%) were male patients. Mean age of the patients was 52.45 (±12.271) years. 80 (53.33%) patients were having constipation. Infection was found in 55 (36.66%) cases. Upper GI Bleed was present in 51 (34%) patients. 44 (29.33%) patients had moderate to severe electrolyte imbalance as the cause. Constipation alone was the cause in 11.33% of cases. More than one factor was found to be responsible in around 56% of patients while in 6.6% of cases none of these precipitating factors was isolated.Conclusion: Constipation is the commonest cause of hepatic encephalopathy followed by infection, upper GI bleed and electrolyte imbalance.