1 Harleen Kaur Chela, MD, and S. Hasan Naqvi, MD, are in the Department of Medicine, Division of Hospital Medicine, University of Missouri - Columbia. Nishchayjit Basra, DO, is in the Department of Medicine, Internal Medicine Residency Program, University of Missouri - Columbia, Columbia, Mo.
Hepatic encephalopathy is a well-recognized complication of decompensated cirrhosis. It is a reversible state of neurocognitive decline, the etiology of which is multifactorial. Diagnosis is predominantly clinical and usually a diagnosis of exclusion. The identification of precipitating factors and their correction is an essential part of the management along with medical therapies such as lactulose and rifaxmin.