Hepatic encephalopathy precipitating factors

O Portal hypertension is the precipitating factor for the complications of cirrhotic liver disease—ascites, spontaneous bacterial peritonitis (SBP), variceal bleeding, and hepatic encephalopathy. Lowering portal pressure can reduce the complications of cirrhosis and decrease morbidity and mortality. 

Treatment goals for hepatic encephalopathy include provision of supportive care, identification and removal of precipitating factors, reduction in the nitrogenous load from the gut and optimisation of long-term therapy. 

Strauss, E., Ferreira da Costa, M. The importance of bacterial infections as precipitating factors of chronic hepatic encephalopathy in cirrhosis. Hepato-Gastroenterol. 1998 45 900—904... 

Factors that may precipitate hepatic encephalopathy include ... 

Increased sensitivity to drugs is also encountered in liver disease. The use of anticoagulants increases the risk of bleeding due to the reduced absorption of vitamin K or decreased production of vitamin K-dependent clotting factors. There is an enhanced risk for respiratory depression and hepatic encephalopathy due to morphine or barbiturates in patients with severe liver disease. Vigorous use of diuretics can precipitate hepatic coma due to potassium loss in liver disease. There is an increased risk of hypoglycemia with... 

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