Encephalopathy

You've had liver disease for a while, but now you notice something different about the way you act and feel. Maybe you forget things or get confused when someone's talking to you. Your friends may tell you that your speech sounds slurred or that you say things that aren't appropriate.

And it isn’t only changes in behavior. You might feel sluggish or find that you can't move your hands well anymore. Or your breath doesn't smell like it should.

What's going on? Is there a link to the liver problems you've been dealing with for years?

It could be. You may have hepatic encephalopathy (HE), a brain disorder that can happen if you have advanced liver disease. It affects a lot of things, like your behavior, mood, speech, sleep, or the way you move.

Sometimes the symptoms are so mild that it's hard for anyone to notice. But whether you have obvious signs or just a few subtle changes, it's important to see your doctor. The right treatment can keep your condition under control, but if you don't take care of yourself, you'll get worse and worse.

Causes
Your liver has several big jobs to do. One key task is to clean your blood by getting rid of harmful chemicals that your body makes.

Hepatic encephalopathy starts when your liver gets damaged from a disease you've had a long time, like hepatitis, Reye's syndrome, or cirrhosis. It doesn't work right anymore, and toxins get into your bloodstream and travel to your brain. They build up there and cause the mental and physical symptoms of HE.

Several things can trigger an episode or make your condition worse. For example, you could be at risk for problems if you have a tube called a shunt placed in your liver. You might have this done to help reroute your blood flow to treat cirrhosis or another long-term disease. There's a chance that this procedure will allow toxins to bypass your liver and move to your brain.

Other things can set off hepatic encephalopathy, too. It might happen because you:

Have an infection
Get constipated
Don't get enough to drink
Bleed from your intestines, stomach, or esophagus
Take medicine that affects your nervous system, like sleeping *****
Have kidney problems
Go on an alcohol binge