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The Role of Noncompliance in Hepatic Encephalopathy
Noncompliance is a big issue here. Many of these patients have previous presentations of hepatic encephalopathy and are sent home on maintenance therapy, including refaxamine antibiotics. Of course, alcohol is typically a causative agent. If not narcotics and other sedating medicines that they're either using recreationally or unwittingly given by health practitioners. These patients are at high risk for bleeding either chronically or intermittently. They all have alcoholic gastritis. And then electrolyte disturbances we talked about hypokalemia, typically from vomiting again from the gastritis or the alcoholic ketoacidosis.