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Treatment options for covert hepatic encephalopathy
Nisheet Waghray1, Abhijeet Waghray, Kevin Mullen
1Division of Gastroenterology, MetroHealth Medical Center/Case Western Reserve University, Cleveland, USA, nwaghray@metrohealth.org.
Current Treatment Options in Gastroenterology
|March 14, 2014
Summary
Treating covert hepatic encephalopathy (HE) may be cost-effective. Standard HE therapies can reverse neuropsychiatric issues and potentially delay overt HE, but more research is needed.
Area of Science:
- Neurology
- Gastroenterology
- Psychiatry
Background:
- Covert hepatic encephalopathy (HE) is a mild form of HE characterized by neuropsychiatric abnormalities.
- Historically underdiagnosed, advances in computerized psychometric testing have improved detection rates.
- Numerous consequences of covert HE are increasingly recognized.
Purpose of the Study:
- To evaluate the cost-effectiveness of reversing neuropsychiatric abnormalities in covert HE.
- To explore the potential of standard HE treatments to postpone the onset of overt HE.
Main Methods:
- Review of current understanding and treatment of covert HE.
- Emphasis on the role of computerized psychometric testing in diagnosis.
- Discussion of the reversibility of covert HE consequences with standard treatments.
Main Results:
- Most identified consequences of covert HE are reversible with standard HE treatment.
- Standard HE therapies show potential for delaying the progression to overt HE.
Conclusions:
- Further large-scale, placebo-controlled randomized trials are necessary to confirm the efficacy of standard HE therapies in postponing overt HE.
- The cost-effectiveness of treating covert HE warrants continued investigation.
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