Hepatic encephalopathy
- Find precipitant: infection, bleed, constipation
- Lactulose is first-line treatment
- titrate to ~2–3 soft stools/day
- Add rifaximin for recurrent episodes
- Avoid excessive sedatives
- Correct electrolytes/dehydration carefully
- Protein restriction is usually not routine
Use at a glance
- Find precipitant: infection, bleed, constipation
Treatment options
- Lactulose is first-line treatment
- titrate to ~2–3 soft stools/day
Practical pearls
- Add rifaximin for recurrent episodes
- Protein restriction is usually not routine
Safety / pitfalls
- Avoid excessive sedatives
- Correct electrolytes/dehydration carefully
Self-check
- What is first-line treatment for Hepatic encephalopathy?
Lactulose.
- What should generally be avoided in Hepatic encephalopathy?
excessive sedatives.
Drugs used for this (3)
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