Recurrent Mental Status Changes in a Patient With Chronic Alcoholic Cirrhosis Taking Diuretics: A Case Report

Cirrhosis of the liver, characterized by fibrous tissue replacing normal cells, disrupts physiological function and blood circulation. A further consequence of this is hepatic encephalopathy (HE), a neuropsychiatric syndrome that can range in severity from mild cognitive disturbances to full coma. This case follows the course of a 63-year-old Caucasian female with chronic liver cirrhosis who presents with recurrent episodes of mental status changes. Although each episode was treated with first-line pharmacologic interventions of lactulose, her HE recurrence persisted. This case report underscores the significance of early diagnosis and management, emphasizing the role of alcohol cessation, pharmacotherapy, and lifestyle adjustments. It also aims to address the delicate balance of diuretic use, focusing on dosage adjustments to address electrolyte imbalances and minimize risks associated with HE. The findings highlight the complexity of managing alcoholic liver disease and offer insights into tailored approaches for optimizing patient outcomes.