RESUMO
La encefalopatía hepática (EH) es una complicación frecuente de la cirrosis, con un gran impacto social, que deteriora la calidad de vida del paciente y se considera un signo de enfermedad hepática avanzada y, por tanto, una indicación clínica para la evaluación de trasplante hepático. Los pacientes que han presentado episodios de EH tienen un elevado riesgo de recurrencia, por lo que una vez superado el episodio de EH se recomienda el control y la prevención de factores precipitantes (hemorragia digestiva, peritonitis bacteriana espontanea, uso de los diuréticos con precaución, evitar medicación depresora del sistema nervioso), la administración continuada de disacáridos no absorbibles, como lactitol o lactulosa, o de antibióticos poco o no absorbibles como rifaximina, y la valoración de la necesidad de un trasplante hepático, dado que la presencia de un episodio de EH conlleva un mal pronóstico en la cirrosis (AU)
Hepatic encephalopathy (HE) is a frequent complication of cirrhosis which, in addition to producing a great social impact, deteriorates the quality of life of patients and is considered a sign of advanced liver disease and therefore a clinical indication for liver transplant evaluation. Patients who have had episodes of HE have a high risk of recurrence. Thus, after the HE episode resolves, it is recommended: control and prevention of precipitating factors (gastrointestinal bleeding, spontaneous bacterial peritonitis, use of diuretics with caution, avoid nervous system depressant medications), continued administration of non-absorbable disaccharides such as lactulose or lactitol, few or non-absorbable antibiotics such as rifaximin and assess the need for a liver transplant as the presence of a HE episode carries a poor prognosis in cirrhosis (AU)
Assuntos
Humanos , Encefalopatia Hepática/prevenção & controle , Cirrose Hepática/complicações , Recidiva/prevenção & controle , Fatores de Risco , Transplante de Fígado , Dissacarídeos/uso terapêutico , Antibacterianos/uso terapêuticoRESUMO
Hepatic encephalopathy (HE) is a frequent complication of cirrhosis which, in addition to producing a great social impact, deteriorates the quality of life of patients and is considered a sign of advanced liver disease and therefore a clinical indication for liver transplant evaluation. Patients who have had episodes of HE have a high risk of recurrence. Thus, after the HE episode resolves, it is recommended: control and prevention of precipitating factors (gastrointestinal bleeding, spontaneous bacterial peritonitis, use of diuretics with caution, avoid nervous system depressant medications), continued administration of non-absorbable disaccharides such as lactulose or lactitol, few or non-absorbable antibiotics such as rifaximin and assess the need for a liver transplant as the presence of a HE episode carries a poor prognosis in cirrhosis.
