Hepatic encephalopathy in chronic liver disease; predisposing factors in a developing country

Authors

  • Fakhar Ali Qazi Arisar Resident, Department of Medicine, Section of Gastroenterology, Aga Khan University Hospital, Karachi, Sindh
  • Shameem Behram Khan Department of Medicine, Ward-5, Jinnah Post Graduate Medical Centre, Karachi, Sindh
  • Anam Umar Department of Medicine, Ward-5, Jinnah Post Graduate Medical Centre, Karachi, Sindh

DOI:

https://doi.org/10.3126/ajms.v6i2.11099

Keywords:

Hepatic encephalopathy, precipitating factors, cirrhosis of liver, causes, outcome

Abstract

Objective: To find out the risk factors for developing Hepatic Encephalopathy in patients suffering from Chronic liver disease.

Background: Hepatic encephalopathy (HE) is a neuropsychiatric disorder that is caused by liver damage.  In its pathology, alterations in normal brain function are associated with an increase in blood ammonia, benzodiazepine like substances, 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.

 Setting: Medical Unit 1, Ward- 5, Jinnah Post Graduate Medical Centre, Karachi.

Duration:  July 2013 to December 2013

Patients and Methods: About 150 patients admitted in medical unit 1 with a diagnosis of chronic liver disease in a state of 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.

DOI: http://dx.doi.org/10.3126/ajms.v6i2.11099

Asian Journal of Medical Sciences Vol.6(2) 2015 36-43

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Author Biography

Shameem Behram Khan, Department of Medicine, Ward-5, Jinnah Post Graduate Medical Centre, Karachi, Sindh

Resident, Internal Medicine

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Published

2014-09-16

How to Cite

Qazi Arisar, F. A., Khan, S. B., & Umar, A. (2014). Hepatic encephalopathy in chronic liver disease; predisposing factors in a developing country. Asian Journal of Medical Sciences, 6(2), 35–42. https://doi.org/10.3126/ajms.v6i2.11099

Issue

Vol. 6 No. 2 (2015)

Section

Original Articles

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