Contemporary understanding and management of overt and covert hepatic encephalopathy

Meghan NeSmith, Joseph Ahn, Steven L. Flamm

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Hepatic encephalopathy (HE) is a major complication of liver disease that leads to significant morbidity and mortality. Caring for hospitalized patients with HE is becoming more complex, and the economic burden of HE continues to rise. Defining and diagnosing HE, particularly covert HE (CHE), remain challenging. In this article, we review new tools and those currently under development for the diagnosis of CHE and the latest advances in the acute and long-term management of overt HE (OHE) and CHE. In particular, we review the latest data on the use of lactulose and rifaximin for treatment of OHE and summarize the data on adjunctive agents such as sodium benzoate and probiotics.

Original languageEnglish (US)
Pages (from-to)91-100
Number of pages10
JournalGastroenterology and Hepatology
Issue number2
StatePublished - Feb 2016
Externally publishedYes


  • Covert hepatic encephalopathy
  • Hepatic encephalopathy
  • Lactulose
  • Overt hepatic encephalopathy
  • Rifaximin

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology


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