Liver Failure Symptoms; What Happens When Liver Shuts Down?

Hepatic encephalopathy

Hepatic encephalopathy is a neuropsychiatric syndrome caused by three Mechanisms:

1. Bacteria produce toxic substances by their action on the intestinal proteins. Bacteria produce ammonia that interferes with Kreb’s cycle and affects the brain.
2. Disturbance of amino acids: decreased production of normal neurotransmitters and increased formation of false neurotransmitters.
3. Hypokalemia and alkalosis increase the permeability of the blood-brain barrier to some toxins. Also, they decrease glucose entry to cerebral cells leading to coma.

Precipitating factors of hepatic encephalopathy are:

• Gastrointestinal bleeding
• High protein intake
• Old blood transfusion
• Aspiration of ascites
• Diuretics
• Spontaneous bacterial peritonitis
• Drugs e, g. morphine

Here is the clinical presentation of this patient:

• Inverted sleep rhythm
• Slow and monotonous speech
• Apathy
• Flapping tremors
• Disorientation for persons, place, or time
• Changed behavior
• Later on, an irritable coma will occur

Treatment of hepatic encephalopathy:

• Hospitalization in the intensive care unit.
• The endoscope will localize the site of bleeding.
• Restriction of protein in the diet
• Drink more fruit juices rich in potassium
• Enema every 4 hours to wash the colon
• Antibiotics prevent the action of intestinal bacteria on proteins (neomycin, metronidazole, or Riaximine).
• Lactulose clears the colon and promotes the conversion of luminal ammonia (NH3) to ammonium (NH4).
• Drugs as Bromocriptine and L-dopa
• Benzodiazepine antagonists as L-ornithine L-aspartate
• Liver transplantation

Finally, you should be aware of liver failure symptoms if you have a previous liver problem. If you feel any of the symptoms mentioned in this article, you should seek early medical care because liver failure is a critical illness.

“The earlier the diagnosis, the better the prognosis”