Pharmacologic Management of Hepatic Encephalopathy
Hepatic encephalopathy is a common cause of morbidity and mortality among patients with decompensated liver cirrhosis. In this article, we review the history, mechanism, and evidence for first-line pharmacologic therapies for hepatic encephalopathy including nonabsorbable disaccharides, antibiotics, and electrolyte management. We also review newer, second-line therapies including polyethylene glycol, albumin, branched-chain amino acids, probiotics and fecal microbiota transplant, zinc, and l-ornithine-l-aspartate. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - January 31, 2024 Category: Gastroenterology Authors: Ali Khalessi, Nikolaos T. Pyrsopoulos Source Type: research
Preventing Readmissions for Hepatic Encephalopathy
Hepatic encephalopathy is a strong predictor of hospital readmissions in patients with advanced liver disease. The frequent recurrence of hepatic encephalopathy and subsequent readmissions may lead to nonreversible organ dysfunction, resulting in a significant decrease of patient quality of life and increase of health care burden costs for patients and facilities. Many of these readmissions for hepatic encephalopathy are preventable. Multidisciplinary patient-centered care throughout the continuum is essential in the management of hepatic encephalopathy. Understanding the patient ’s daily functions and limitations in the...
Source: Clinics in Liver Disease - January 30, 2024 Category: Gastroenterology Authors: Salima S. Makhani, Susan Lee, David Bernstein Source Type: research
Hepatic Encephalopathy —A Guide to Laboratory Testing
Hepatic encephalopathy (HE) remains both a clinical diagnosis and one of exclusion. Laboratory testing is largely focused on identifying precipitating factors. Ammonia levels in the blood can be helpful for the diagnosis of HE but are not required for confirmation. More recent literature is lending support to the prognostic capabilities of ammonia in cirrhosis, both in predicting future HE events and in determining outcomes in hospitalized patients. Accurate ammonia testing requires strict protocols to avoid common pitfalls in the measurement of this labile analyte. Future studies investigating the utility of other laborat...
Source: Clinics in Liver Disease - January 30, 2024 Category: Gastroenterology Authors: Frances Lee, R. Todd Frederick Source Type: research
Autoimmune Liver Diseases: Autoimmune Hepatitis PBC and PSC
CLINICS IN LIVER DISEASE (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 8, 2023 Category: Gastroenterology Authors: David Bernstein Source Type: research
Copyright
Elsevier (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 8, 2023 Category: Gastroenterology Source Type: research
Contributors
NORMAN GITLIN, MD, FRCP (London), FRCPE (EDINBURGH), FAASLD, FACP, FACG (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 8, 2023 Category: Gastroenterology Source Type: research
Contents
David Bernstein (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 8, 2023 Category: Gastroenterology Source Type: research
Forthcoming Issues
Hepatic Encephalopathy (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 8, 2023 Category: Gastroenterology Source Type: research
Advances in Viral Hepatitis B and D: Moving Toward the Goals of Elimination
CLINICS IN LIVER DISEASE (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - September 30, 2023 Category: Gastroenterology Authors: Robert G. Gish Source Type: research
Copyright
Elsevier (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - September 30, 2023 Category: Gastroenterology Source Type: research
Contributors
NORMAN GITLIN, MD, FRCP (LONDON), FRCPE (EDINBURGH), FAASLD, FACP, FACG (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - September 30, 2023 Category: Gastroenterology Source Type: research
Contents
Robert G. Gish (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - September 30, 2023 Category: Gastroenterology Source Type: research
Forthcoming Issues
Autoimmune Liver Diseases: Autoimmune Hepatitis PBC And PSC (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - September 30, 2023 Category: Gastroenterology Source Type: research
Cholangiocarcinoma Surveillance Recommendations in Patients with Primary Sclerosing Cholangitis
Cholangiocarcinoma (CCA) is a deadly complication observed in the setting of primary sclerosing cholangitis (PSC). When symptoms develop and CCA is diagnosed, it is usually at an advanced stage. Median survival is less than 12 months. Early identification of CCA leads to improved outcomes. Although diagnostic tests have excellent specificity, they are plagued by low sensitivity. No surveillance strategies have been widely agreed upon, but most societies recommend measurement of serum carbohydrate antigen 19-9 and MRCP e very 6 to 12 months in patients with PSC. Advances in understanding of the genetic factors that lead ...
Source: Clinics in Liver Disease - August 28, 2023 Category: Gastroenterology Authors: Daniel Saca, Steven L. Flamm Source Type: research
Treatment of Primary Biliary Cholangitis including Transplantation
Ursodeoxycholic acid (UDCA) is the first-line treatment of primary biliary cholangitis (PBC). Long-term UDCA use significantly reduces progression to cirrhosis. UDCA improves liver enzymes and transplant-free survival rates. Despite the association between PBC and hyperlipidemia, treatment is indicated under specific circumstances with statins and fibrates being safe options. Osteoporosis, which is frequently seen, is usually managed based on data from postmenopausal women. Sicca syndrome is treated similarly to its standalone condition with the use of hydroxypropyl methylcellulose eye drops and anticholinergic drugs. (Sou...
Source: Clinics in Liver Disease - August 26, 2023 Category: Gastroenterology Authors: Yasameen Muzahim, Ali Wakil, Mehak Bassi, Nikolaos Pyrsopoulos Source Type: research
