Hepatitis C: An In-Depth Guide

Extreme confusion (hepatic encephalopathy)

Extreme confusion, along with sleepiness and/or an agitated mood, are symptoms of a condition called hepatic encephalopathy. Early signs include changes in sleeping patterns or the development of tremors. In the worst cases, it can lead to coma.


Hepatic encephalopathy may occur when the liver is unable to remove harmful waste products from the blood. It is a condition associated with cirrhosis and liver failure.


  • Rifaximin is an antibiotic that lowers the level of ammonia in the blood by getting rid of ammonia-producing bacteria in the colon. Research has shown this drug helps to stop hepatic encephalopathy from reoccurring, thus improving the quality of life of patients.
  • Lactulose and lactitol are commonly used to treat hepatic encephalopathy. They are thought to reduce waste through bowel movements. However, there is minimal to no documented evidence that lactulose is an effective therapy, especially when compared to the antibiotics rifaximin, neomycin, ribostamycin and vancomycin.


If your dietary protein intake is greater than what your liver is able to process, it can lead to a build-up of toxins that interfere with brain function. However, your body needs proteins, so restricting your daily protein intake should only be carried out under the direction of your doctor.