Hepatic encephalopathy

If the liver is severely damaged due to cirrhosis, it can no longer effectively filter toxins from the blood, so they accumulate. These toxins remain in the blood, and eventually reach the brain and impair its function. This condition is called hepatic encephalopathy (HE).2 To assess the severity of HE, doctors classify it into different grades of severity, starting from grade 0. While the symptoms are still relatively mild in grade 1, a person affected by HE can deteriorate to the point of unconsciousness if the disease progresses to grade 4. In extreme cases, a sudden liver coma can occur, which can carry an increased risk of death.3

Variceal bleeding

Another potential consequence of cirrhosis is variceal bleeding: a sudden, life-threatening loss of blood from a torn, abnormally enlarged vein in the esophagus (also called “esophageal varices”). In this case, the focus is on stopping the bleeding as quickly as possible and restoring the volume of lost blood.4,5

What to do in a liver cirrhosis emergency

For any liver cirrhosis patient, variceal bleeding and loss of consciousness are medical emergencies that must be treated immediately. Please make sure you know where to access emergency medical care in your local area. If you find yourself in the position of needing urgent assistance, remain calm and call for help as soon as possible. Upon arrival at the hospital, the medical team can start treating the actual cause of variceal bleeding or loss of consciousness.5,6

Regular check-ups prevent complications

To prevent situations like this from happening in the first place, it is very important to have regular medical checkups to help avoid complications from cirrhosis. Listen to your body and look out for signs of potential problems. If you experience abdominal pain, lightheadedness or drowsiness, contact a doctor immediately. Blood in the stool is also a warning sign that should not be ignored.6

Verzweifelte Frau am Handy

The first few minutes are the most important


  1. Long B, Koyfman A. The emergency medicine evaluation and management of the patient with cirrhosis. Am J Emerg Med. 2018 Apr;36(4):689-698.
  2. Kahn, A and Sethi, S. Healthline. Hepatic Encephalopathy. Available at: https://www.healthline.com/health/hepatic-encephalopathy-2. Last accessed: October 2020
  3. Weissenborn K. Hepatic Encephalopathy: Definition, Clinical Grading and Diagnostic Principles. Drugs. 2019;79(Suppl 1):5-9.

May 2021. GL-HEP-XIF-2000184