Health Information and Tools >  Cirrhosis – Hepatic encephalopathy
Facebook Tweet Email Share

Main Content

Hepatic encephalopathy.

That's the medical term for a build-up of toxins that affect the way your brain works.

This happens when there's scarring in the liver, called cirrhosis.

When you have encephalopathy, the built-up toxins can cause confusion and other symptoms.

If it's not treated, it can even cause a coma.

Let's look at where body toxins come from.

We all have bacteria in our bodies.

They help your body work properly.

But they also make toxins that the liver removes.

If you have cirrhosis, your liver has a hard time getting rid of those toxins, and you can develop encephalopathy.  

As well as confusion, toxin build-up can cause you to forget things and change your sleep pattern.

So you might feel sleepy during the day and wide awake at night.

It can affect your mood, so you might get upset or bothered more easily.

It can also give you the shakes or cause you to have problems with balance.

Encephalopathy can affect how quickly you react, so your healthcare team might tell you not to drive.

Your healthcare team will usually prescribe lactulose if you have encephalopathy.

This special laxative makes you have more bowel movements to help your body get rid of toxins.

You'll need to keep track of your bowel movements, and take enough lactulose so you have 2 or 3 soft ones each day.

Take this medicine until your healthcare team tells you to stop.

Rifaximin is another medicine that can help you manage encephalopathy.

It changes your gut bacteria so they make fewer toxins.  

Some things can make encephalopathy worse.

Like infections, not having enough fluid (called dehydration), and bleeding.

Some medicines can also make it worse, like pain killers and sleeping pills.

Share what you learn about encephalopathy with your family and friends.

They can help you watch for symptoms.

If they notice you're not thinking clearly, or are sleeping more than usual, they should contact your doctor or nurse right away.

But they should call 911 and get you to the emergency department if they have trouble waking you up, or notice you can't talk, walk, or follow directions.

We understand that you may have many thoughts and feelings after being diagnosed with cirrhosis.

Remember, your healthcare team is here to support you.

Please let them know if you have questions.

To learn more about cirrhosis, visit or​