What primarily causes Hepatic Encephalopathy?

Hepatic encephalopathy is primarily caused by elevated levels of ammonia in the bloodstream, which occur as a result of impaired liver function. In healthy individuals, the liver metabolizes ammonia, a byproduct of protein breakdown, converting it into urea that can be excreted in the urine. However, when the liver is compromised, such as in cases of cirrhosis or acute liver failure, it cannot efficiently remove ammonia from the blood.

The accumulation of ammonia may lead to neurotoxicity that alters neurotransmission and contributes to the symptoms associated with hepatic encephalopathy, such as confusion, altered behavior, stupor, and even coma. Therefore, controlling ammonia levels is crucial in managing patients with liver dysfunction. This understanding supports the rationale for addressing increased ammonia as a primary factor in the development of hepatic encephalopathy.