Title:Hepatic Encephalopathy: Cause and Possible Management with Botanicals
Volume: 8
Issue: 3
Author(s): Suyash Tripathi and Yamini B. Tripathi
Affiliation:
Keywords:
Ayurveda, botanicals, food supplement, hepatic encephalopathy, herbal formulations, liver cirrhosis, probiotics.
Abstract: Hepatic encephalopathy is a brain functional disorder, characterized by neuropsychiatric abnormalities with
liver failure. High blood ammonia, causing glutamate neurotoxicity is the basic cause, finally leading to low-grade
cerebral edema. Its manifestation is more likely in patients of sepsis, oxidative stress, generalized inflammation, gut
mal-functioning, amoebiaesis, viral hepatitis, nervous imbalance, etc. Thus, the therapeutic goals primarily include the
maintenance of proper blood supply and prevention of hypoxic condition in liver, along with management of factors
responsible for high blood ammonia, oxidative stress, inflammation, and high GI- serotonin. The drugs in clinical practice
include lactulose, sodium benzoate, flumazenil and rifaximin, supplementation of zinc, branched chain amino acids
(BCAA), l-ornithine-l aspartate, antioxidants and iNOS inhibitors. However, herbal formulations would be of great importance
as it shows multi-targeted action because it possesses a natural cocktail of secondary metabolites. It can collectively
act as an antioxidant, anti-inflammatory, prebiotic, hepatoprotective and neuron-protective agents. We have briefly
outlined some of these plants and also recent patents useful in the management of hepatic encephalopathy.
