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Diagnosis and Management of Hepatic Encephalopathy pp 65–76Cite as

Treatment Options for Covert Hepatic Encephalopathy

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Abstract

Hepatic encephalopathy, even in its mildest form, can lead to significant deterioration in quality of life, lower overall survival, and add to caregiver burden. However, due to a paucity of symptoms, covert hepatic encephalopathy (CHE) is often ignored or neglected by physicians as well as patients. The lack of consensus among experts for both diagnosis as well as treatment of CHE adds to this problem. Treatment options for CHE include lactulose, rifaximin, ammonia scavengers, branched-chain amino acids, and probiotics. In this chapter we review the existing evidence on these agents and explain treatment decisions using a case-based approach.

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Abbreviations

AASLD:

American Association for the Study of Liver Diseases

BCAA:

Branched-chain amino acids

CFF:

Critical flicker frequency

CHE:

Covert hepatic encephalopathy

EASL:

European Association for the Study of the Liver

HE:

Hepatic encephalopathy

LOLA:

l-Ornithine l-aspartate

MELD:

Model for end-stage liver disease

MMSE:

Mini-mental state examination

OHE:

Overt hepatic encephalopathy

PHES:

Psychometric hepatic encephalopathy score

PSS:

Portosystemic shunt

SBP:

Spontaneous bacterial peritonitis

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Author information

Authors and Affiliations

  1. Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

    Sahaj Rathi M.D., D.M. & Radha K. Dhiman M.D.,D.M.,F.A.C.G.,F.A.A.S.L.D.

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  1. Sahaj Rathi M.D., D.M.
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  2. Radha K. Dhiman M.D.,D.M.,F.A.C.G.,F.A.A.S.L.D.
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Editors and Affiliations

  1. McGuire VA Medical Center, Virginia Commonwealth University, Richmond, Virginia, USA

    Jasmohan S. Bajaj

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Rathi, S., Dhiman, R.K. (2018). Treatment Options for Covert Hepatic Encephalopathy. In: Bajaj, J. (eds) Diagnosis and Management of Hepatic Encephalopathy. Springer, Cham. https://doi.org/10.1007/978-3-319-76798-7_5

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  • DOI: https://doi.org/10.1007/978-3-319-76798-7_5

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