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    Hepatic Encephalopathy, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Hepatic Encephalopathy, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Hepatic Encephalopathy, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Ebook105 pages2 hours

    Hepatic Encephalopathy, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

    By Kenneth Kee

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    About this ebook

    This book describes Hepatic Encephalopathy, Diagnosis and Treatment and Related Diseases
    Hepatic encephalopathy happens when the liver is not able to eliminate toxins from the blood.
    This is called loss of brain function following the continual liver disease.
    This disorder may occur suddenly or develop slowly over time.
    Hepatic encephalopathy, a disorder present in some patients with cirrhosis, may present with personality changes, intellectual impairment, and a reduced level of consciousness.
    The diversion of portal blood into the systemic circulation seems to be a factor for the syndrome.
    Hepatic encephalopathy is regarded as a group of neuropsychiatric abnormalities in patients with liver failure, after exclusion of other known brain disease.
    Hepatic encephalopathy can be subdivided into covert hepatic encephalopathy and overt hepatic encephalopathy.
    Covert hepatic encephalopathy is a sub-medical, less severe presentation of hepatic encephalopathy and needs psychometric testing for diagnosis.
    Overt hepatic encephalopathy has an important impact on a patient's quality of life, such as employment and driving ability and is linked with higher admissions to hospital and with death
    Causes
    An important function of the liver is to convert toxic substances in the body to harmless material.
    When the liver is injured, these toxins can accumulate in the bloodstream and impair the function of the nervous system.
    This disorder can happen suddenly and the patient may become ill very quickly.
    Frequent causes of chronic liver disease in the USA are:
    1.Chronic hepatitis B or hepatitis C infection
    2.Alcohol abuse
    3.Autoimmune hepatitis
    4.Bile duct disorders
    4.Some medicines
    5.Non-alcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH)
    Once the patient has liver damage, episodes of worsening brain function may be triggered by:
    1.Body is low on water or fluids
    2.Eating too much protein
    3.Low potassium or sodium levels
    4.Bleeding from the intestines, stomach, or esophagus
    5.Infections
    6.Kidney disorders
    7.Low oxygen levels in the body
    8.Shunt placement or complications
    9.Surgery
    10.Narcotic pain or sedative medicines
    Various hypotheses have been proposed to clarify the pathogenesis of hepatic encephalopathy in patients with liver cirrhosis.
    1.Changed brain energy
    2.Ammonia hypothesis
    3.GABA hypothesis
    Early symptoms may be mild and are:
    1.Breath with a musty or sweet odor
    2.Change in sleep patterns
    3.Changes in thinking
    4.Confusion that is mild
    5.Forgetfulness
    6.Mental fogginess
    7.Personality or mood changes
    8.Poor concentration
    9.Poor judgment
    10.Worsening of handwriting or loss of other small hand movements
    More severe symptoms may be:
    1.Abnormal movements or shaking of hands or arms
    2.Agitation, excitement, or seizures (occur rarely)
    3.Disorientation
    4.Drowsiness or confusion
    5.Strange behavior or severe personality changes
    6.Slurred speech
    7.Slowed or sluggish movement
    People with hepatic encephalopathy can become:
    1.Unconscious,
    2.Unresponsive, and
    3.Possibly enter a coma
    Diagnosis
    Signs of nervous system changes such as confusion, flapping of hands
    Signs of liver disease such as jaundice and ascites
    Abnormal liver function
    Arterial ammonia levels are raised
    MRI of brain and liver
    Treatment
    An assessment of the blood ammonia level may be useful in such patients.
    Precipitants of hepatic encephalopathy should be corrected (e.g., hypovolemia, metabolic disturbances, GI bleeding, infection, constipation).
    Lactulose
    Antibiotics such as neomycin and Rifaximin
    Protein restriction
    Flumazenil (benzodiazepine antagonist)
    L-ornithine L-aspartate
    Sodium benzoate

    TABLE OF CONTENT
    Introduction
    Chapter 1 Hepatic Encephalopathy

    LanguageEnglish
    PublisherKenneth Kee
    Release dateJan 29, 2018
    ISBN9781370466382
    Hepatic Encephalopathy, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Author

    Kenneth Kee

    Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

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      Book preview

      Hepatic Encephalopathy, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee

      Hepatic Encephalopathy,

      A

      Simple

      Guide

      To

      The Condition,

      Diagnosis,

      Treatment

      And

      Related Conditions

      By

      Dr Kenneth Kee

      M.B.,B.S. (Singapore)

      Ph.D (Healthcare Administration)

      Copyright Kenneth Kee 2018 Smashwords Edition

      Published by Kenneth Kee at Smashwords.com

      Dedication

      This book is dedicated

      To my wife Dorothy

      And my children

      Carolyn, Grace

      And Kelvin

      This book describes Hepatic Encephalopathy, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

      (What The patient Need to Treat Hepatic Encephalopathy)

      This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If the patient would like to share this book with another person, please purchase an additional copy for each reader.

      If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

      Thank you for respecting the hard work of this author.

      Introduction

      I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

      My purpose in writing these simple guides was for the health education of my patients.

      Health Education was also my dissertation for my Ph.D (Healthcare Administration).

      I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

      This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

      From which many free articles from the blog was taken and put together into 1000 eBooks.

      Some people have complained that the simple guides are too simple.

      For their information they are made simple in order to educate the patients.

      The later books go into more details of medical disorders.

      The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

      Since 2013, I have tried to improve my spelling and writing.

      As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

      Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

      I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

      I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

      I apologize if these repetitions are irritating to some readers.

      Chapter 1

      Hepatic Encephalopathy

      What is Hepatic encephalopathy?

      Hepatic encephalopathy happens when the liver is not able to eliminate toxins from the blood.

      This is called loss of brain function following the continual liver disease.

      This disorder may occur suddenly or develop slowly over time.

      Hepatic encephalopathy, a disorder present in some patients with cirrhosis, may present with personality changes, intellectual impairment, and a reduced level of consciousness.

      The diversion of portal blood into the systemic circulation seems to be a factor for the syndrome.

      Hepatic encephalopathy is regarded as a group of neuropsychiatric abnormalities in patients with liver failure, after exclusion of other known brain disease.

      Hepatic encephalopathy can be subdivided into covert hepatic encephalopathy and overt hepatic encephalopathy.

      Covert hepatic encephalopathy is a sub-medical, less severe presentation of hepatic encephalopathy and needs psychometric testing for diagnosis.

      Overt hepatic encephalopathy has an important impact on a patient's quality of life, such as employment and driving ability and is linked with higher admissions to hospital and with death.

      What are the causes of Hepatic encephalopathy?

      Causes

      An important function of the liver is to convert toxic substances in the body to harmless material.

      These substances may be produced by the body, such as ammonia.

      Or they may be chemicals that the patient takes in, such as medicines.

      When the liver is injured, these toxins can accumulate in the bloodstream and impair the function of the nervous system.

      The effect may be hepatic encephalopathy.

      This disorder can happen suddenly and the patient may become ill very quickly.

      Causes are:

      1. Hepatitis B infection (infrequent to occur this way)

      2. Blockage of blood supply to

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