Hepatic encephalopathy he or portosystemic encephalopathy pse is a reversible syndrome of impaired brain function occurring in patients with advanced liver failure however he is not a single clinical entity it may reflect either a reversible metabolic encephalopathy brain atrophy brain edema or any combination of these conditions. Jb hepatic encephalopathy he is a neuropsychiatric abnormality in patients who have a liver disease such as cirrhosis or in those with portosystemic shunting he ranges from subclinical manifestations all the way to coma. Hepatic encephalopathy clinical gastroenterology ebook mullen kevin d prakash ravi k amazonca kindle store. Hepatic encephalopathy common precipitants of hepatic encephalopathy renal failure gastrointestinal bleeding infection constipation sedative drugs eg opiates benzodiazepines antidepressantsand antipsychotic drugs diuretics high protein intake presentation of hepatic encephalopathy can be graded 0 4 or simply defined as mild or severe grade 0 subclinical normal mental status but minimal . Hepatic encephalopathy fhfo simmons md howahd goidstein md and james d boyle md wadsworth hospital veterans administmtion center vm anfeles california and ucla center for the health sciences los anfeles california in a double blind clinical trial 11 patients with he received 80 g of lactulose 1 4 b galactosidofructose daily while 10 patients received 60 g of glucose