Liver Cirrhosis and Hepatic Encephalopathy

A condition in which the portal vein, which carries blood from the digestive system to the liver, is blocked or constricted. This leads to a buildup of pressure in the portal vein, causing various symptoms like swelling in the legs and abdomen.

A syndrome that occurs when the liver fails to filter ammonia from the blood, leading to a buildup of ammonia in the blood and brain. This can cause a wide range of symptoms including confusion, drowsiness, and coma.

Ammonia is a toxic substance produced by the breakdown of protein in the gut. In healthy individuals, the liver converts ammonia to urea, which is then excreted in the urine. However, in liver failure, ammonia levels in the blood can rise, leading to hepatic encephalopathy.

The accumulation of ammonia in the brain can lead to a variety of neurological problems, including impaired energy metabolism, altered neurotransmitter function, and disruption of nerve cell membrane function.

The reticular activating system (RAS) is a network of neurons in the brainstem that plays a crucial role in maintaining consciousness, alertness, and wakefulness. When ammonia levels rise in the brain, it can disrupt the function of the RAS, leading to drowsiness, confusion, and coma.

A complex syndrome resulting from impaired liver function, leading to a range of symptoms like jaundice, bleeding, infection, renal dysfunction, and hepatic encephalopathy.

A reversible disturbance of the central nervous system that occurs due to severe liver disease, leading to altered mental status.

The process by which the body breaks down and uses food to produce energy, build and repair tissues, and regulate bodily functions.

The yellowing of the skin and whites of the eyes caused by an excessive buildup of bilirubin in the blood, a byproduct of the breakdown of red blood cells.

The process by which the body removes waste products from the blood and eliminates them through urine and feces.

The accumulation of ammonia in the blood, a toxic substance produced by the breakdown of protein.

A series of biochemical reactions that convert ammonia into urea, a less toxic compound that can be excreted by the kidneys.

The breakdown of proteins into simpler units called amino acids, which are then used for various functions in the body.

A condition that reduces the capacity of the liver to remove ammonia from the blood, contributing to the development of hepatic encephalopathy.

A chemical messenger in the brain that transmits signals between neurons. It plays a crucial role in various bodily functions, such as mood, attention, and movement.

A neurotransmitter involved in alertness, focus, and energy levels. It's also important for the 'fight-or-flight' response.

A neurotransmitter involved in pleasure, reward, motivation, and movement. It's associated with feelings of happiness and well-being.

A neurotransmitter involved in mood, sleep, and appetite. It's also important for regulating emotional responses.

A group of amino acids essential for bodily functions, including protein synthesis and energy production.

Amino acids used in the synthesis of neurotransmitters and other important molecules. They're found in proteins and play a role in brain function.

The ratio of branched-chain amino acids to aromatic amino acids. It's a useful indicator of liver function.

A neurotransmitter involved in mood, sleep, and appetite. It's also important for regulating emotional responses. It's produced from the amino acid tryptophan.

A neurotransmitter that plays a role in reducing anxiety, inhibiting neuronal activity, and regulating sleep. It's produced from the amino acid glutamate.

Urea is a waste product produced by the breakdown of protein in the body and eliminated through urine. It's especially important for eliminating ammonia, a toxic byproduct of protein metabolism.

The urea cycle is a series of biochemical reactions taking place in the liver, where ammonia is converted to urea. This process effectively removes ammonia from the body, preventing toxic buildup.

Hepatic encephalopathy (HE) occurs when the liver fails to properly filter toxins from the blood, leading to their buildup in the brain. This buildup can cause neurological issues like drowsiness, confusion, and even coma.

Gastrointestinal bleeding, electrolyte imbalance, and infections can all worsen HE by increasing toxin levels in the bloodstream. These trigger events need to be addressed to manage HE effectively.

Ammonia, a toxic byproduct of protein breakdown, accumulates in the blood when the liver is unable to convert it to urea. This buildup contributes to HE and its neurological complications.

Managing HE involves addressing the precipitating factors, reducing ammonia levels, correcting amino acid imbalances, and providing neurotransmitter support. Ultimately, liver transplantation may be needed in severe cases.

A high protein diet can worsen HE by increasing the production of ammonia, which the failing liver cannot handle. Limiting protein intake may be part of management strategies.

The treatment of HE aims to remove toxic ammonia from the blood and support the brain function. This often involves medications, dietary adjustments, and careful monitoring of liver function.