Review outlines effective approaches to reduce recurrent hepatic encephalopathy

https://www.news-medical.net/news/20260731/Review-outlines-effective-approaches-to-reduce-recurrent-hepatic-encephalopathy.aspx Hepatic encephalopathy (HE) is a neurologic complication of advanced liver disease, causing impaired functioning, reduced quality of life (QOL), and increased hospitalisation and mortality. This review discusses HE burden, precipitating risk factors, and strategies to reduce overt HE (OHE) recurrence. Key precipitants include medications, constipation, dehydration, uncontrolled diabetes, electrolyte imbalances, GI bleeding, infection, and sarcopenia. Management involves education, nutritional support, pharmacotherapy, and nonpharmacologic interventions (shunt embolisation, transplantation). Guidelines recommend lactulose as secondary prophylaxis; rifaximin is added when further episodes occur. PEG and LOLA may have roles in certain patients. Investigational approaches include nitazoxanide, FMT, and AI‑based technologies.