What Triggers or Can Cause HE to Get Worse?

An episode of HE may be triggered by any of the following things:

  • Infections
  • Constipation
  • Dehydration: This happens when you don’t get enough water or other fluids.
  • Bleeding from your intestines, stomach or esophagus (the tube that connects your mouth to your stomach). This is referred to as gastrointestinal, or GI, bleeding.
  • Medications that affect your nervous system, such as sleeping pills, antidepressants or tranquilizers.
  • Kidney problems
  • An alcohol binge
  • Surgery
  • Having a portosystemic shunt: This is a tube that’s placed in your liver, sometimes called a TIPS, or a surgical procedure to reroute blood flow and relieve high blood pressure in the veins in and around your liver, a condition called portal hypertension.