Chronic liver disease (CLD) can lead to cirrhosis or end-stage liver disease. Patients with cirrhosis are at risk for HE, which requires routine screening and prompt management.1-3
Up to 80% of patients with cirrhosis will develop covert HE, and up to 40% will have an overt HE episode.4
Use the clinical resources below in your practice to help identify cirrhosis, screen for decompensation, and diagnose HE. There are also resources available for you to share with patients and their caregivers to educate them about cirrhosis and help them navigate an overt HE episode.
For Your Practice
FIB-4 Brochure
Learn more about FIB-4—a noninvasive tool you can use to stratify the risk of liver fibrosis, which is strongly linked to the development of cirrhosis and future decompensation complications, such as overt HE.5,6
HE Diagnostic Tips
Need help making a confident diagnosis of HE? This guide provides a detailed list of signs and symptoms of HE, including grading using the West Haven Criteria, and additional testing options that may be needed.
EMR Workflow Support
Use this tool to ensure your EMR system is helping you track and manage patients accurately, including their medication for HE.
For Your Patients
Patient Counseling Tool: I Have CLD/Cirrhosis
Provide this to your patients with CLD/cirrhosis to reinforce details about their liver disease, diet and lifestyle management, and what they should look out for that may signal progression and potential complications, like overt HE.
Patient Counseling Tool: I Have HE
Give this to your patients with HE to empower them to communicate with their friends and family about their condition, including its development, symptoms, and what to do during an overt HE episode.
Related Links
Visit the websites below for more clinical resources on CLD, HE, and their management, for your practice and your patients.
Educational content for your patients about HE Discover a treatment option 
EMR, electronic medical record; FIB-4, fibrosis-4 index; HCP, healthcare provider.
References
1. Garcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, et al, eds. Goldman-Cecil Medicine. 26th ed. Elsevier; 2016:990-998.e3. 2. Poordad FF. Presentation and complications associated with cirrhosis of the liver. Curr Med Res Opin. 2015;31(5):925-937. 3. Shawcross DL, Dunk AA, Jalan R, et al. How to diagnose and manage hepatic encephalopathy: a consensus statement on roles and responsibilities beyond the liver specialist. Eur J Gastroenterol Hepatol. 2016;28(2):146-152. 4. Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014;60(2):715-735. 5. Cusi K, Isaacs S, Barb D, et al. American Association of Clinical Endocrinology Clinical Practice Guideline for the diagnosis and management of nonalcoholic fatty liver disease in primary care and endocrinology clinical settings: co-sponsored by the American Association for the Study of Liver Diseases (AASLD). Endocr Pract. 2022;28(5):528-562. 6. Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797-1835.
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