Liver problem hian thluak a nghawng dan: Hepatic Encephalopathy chungchang hi a awlsam zawngin sawi ila

I chhungkuaa mi tu emaw, i pa emaw, i pa emaw, i hriat mi emaw pawh ni se, mak tak maia thil ti thut mai hi i hmu ngai em? Hriatrengna hloh, tlem a buai, thil tenawm ber berte chunga thinrim, a nih loh leh nitin muthilh reng mai mai a ni em? Hengte hi kan upat deuh deuha thil thleng pangngai angin kan ngai fo thin. Mahse, a chang chuan hei hi an thin (liver) lama harsatna lian tham vang pawh a ni thei. Chu chu damdawi lam hawi chuan `Hepatic Encephalopathy` kan tih chu a ni. A hming hi hlauhawm tak angin lang mah se, awlsam takin sawi ila.

A awlsam zawngin, Hepatic Encephalopathy hi eng nge ni?

Hei hi hriatthiam a awl hle mai. A hmingah hian hmun hnih a awm a. “Hepatic” tih awmzia chu ‘liver nena inzawm’ tihna a ni. “Encephalopathy” tih awmzia chu ‘thluak hnathawh that lohna’ tihna a ni. Chuvangin an pahnih hi i dah khawm chuan thluak hi liver function tihchhiatnain a nghawng tihna a ni.

Kan taksaa ‘filter’ emaw ‘filter’ lian ber chu thin (liver) a ni tih han ngaihtuah teh. Liver hnathawh ber pakhat chu kan ei leh in kan ei zawh hnua thisen atanga toxins, ammonia ang chi te filter chhuah hi a ni. Tunah chuan han ngaihtuah teh, he filter hian hna a thawk tha lo a nih chuan eng nge thleng ang? Chu toxins (`Neurotoxins`) te chu filter a ni lo va, thisenah a lut nghal vek a ni. He thisen tha lo tak hian taksa pum puiah a fang kual a, a tawpah chuan thluak a thleng ta a ni. Thluak cell te hian heng toxins te hi an tuar thei lo. Chutah chuan thluak hian hna pangngai lo takin hna a thawk tan ta a ni. Chuvangin chu symptom zawng zawng chu a lo lang tan ta a ni.

Hetiang natna lan chhuah dan hi engte nge ni?

Mi tin hian natna lan chhuah dan a inang lo thei. Mi thenkhat chuan an tawng thut mai thei a, thenkhat erawh chuan zawi zawiin an nei thei thung. Ni engemaw zat chu a natna lan chhuah dan a reh thei a, mahse a lo lang leh thei bawk. Hengte hi i symptoms te chu a ni:

• Mood leh mize (personality) te
• Thiltih leh impulse control
• Hriatrengna, ngaihtuahna seng leh ngaihtuahna atan
• Hriatthiamna leh mut dan
• Coordination leh motor hnathawh dan

A nghawng thei a ni. Doctor-te chuan he natna hi heng natna lan chhuahna nasat dan azirin stage hrang hrangah an ṭhen a. Chu stage te chu eng nge ni tih i en ang u.

A lan chhuah dan stage hrang hrang (Grading System) 1.1.

Hei hi hriat theihna atana hman tlanglawn tak chu ``West Haven Criteria'' a ni.Hei hian stage 0 atanga 4 thleng a thliar hrang a ni.

Engvangin nge hetiang hi a lo awm? A chhan engte nge ni?

Kan sawi tawh ang khan a chhan ber chu liver-in toxins a filter theih loh vang a ni. Hei hi a thlen theih dan kawng hrang hrang a awm. Doctor-te chuan Hepatic Encephalopathy hi heng a chhan hrang hrangte a zirin chi thum-ah an ṭhen a.

Type A tih a ni

Hei hi liver failure (`Acute Liver Failure`) avanga lo awm a ni. Chumi awmzia chu a hmaa natna nei lo mi thin (liver) chu ni rei lote chhungin hna a thawk tawh lo thut tihna a ni. Hei hi a chhan chu:

• Viral natna (e.g. hepatitis A, B) 1.1.
• Damdawi thenkhat , a bik takin paracetamol ei tam lutuk hi a chhan lian ber a ni. Nangmah emaw i hriat mi emaw chuan he thil hi a overdose a nih chuan Colombo National Hospital-a National Poison Information Center-ah phone nghal la, damdawi inah hruai rawh.
• Poisoning, mushroom chi thenkhat ang bawkin.

Hei hi thil hmanhmawhthlak tak leh pawi tak a ni.

Type B tih a ni

Hei hi a buaithlak deuh a ni. A awlsam zawngin, thisen tihfai tur liver-a kal tur chu liver bypass-in taksa circulation-ah kawng dang (`portosystemic shunt`) hmangin a lut nghal a ni. Hei hian thisen chhunga toxin awmte chu filter lohvin thluaka a kal thei a ni.

Type C a ni

Hei hi a tam ber chi a ni. Hei hi hun rei tak chhunga thin natna (`Chronic Liver Disease`) avanga thin (liver) a chak loh zauh zauh hian a thleng thin. Hei hi a chhan ber chu cirrhosis a ni. Cirrhosis hi hun kal zelah thin a chhia a, a hliam a, a khauh a, a thawk tha thei lo. Hei hi a chhan chu:

• Hun rei tak chhunga zu in tam lutuk.
• Viral infection rei tak, hepatitis B leh C te.
• Fatty Liver Natna a awm.

Thilthleng Tichhuak thei

Thin natna khirh tak, cirrhosis ang chi nei chuan eng emaw chen chu nun pangngaiin a hmang thei a ni. Mahse, `Hepatic Encephalopathy` symptoms a lo lang nghal thei. Hei hi thilthleng pakhat, liver-a phurrit tuar theih loha siam avanga lo awm a ni. Chutiang thil thleng chu `Triggers` kan ti thin.

• Constipation: Constipation a awm chuan toxins te chu intestines ah rei zawk a awm a, chu chuan thisenah a lut tam zawk thin.
• Dehydration: Taksaah tui a tlem chuan kal (kidney) hnathawh pawh a chak lo a, toxins paih chhuahna a ti tlem lehzual a ni.
• Infection: Taksa a infection eng pawh (e.g. urinary tract infection, lung infection) hian thin (liver) ah harsatna nasa tak a siam thin.
• Digestive system atanga thisen chhuak: Thisen chhuak, pum ulcer atanga thisen chhuak a awm chuan, thisen chu intestine-a a digested chuan ammonia ang chi toxins tam tak a lo chhuak thin.
• Liver tana tha lo damdawi ei te, mutna damdawi thenkhat leh natna tidamtu damdawi ei te.
• Vawi khata zu in tam lutuk.

Engtin nge doctor hian hei hi a hriat chian?

Hetiang symptom neia i hmangaih tak doctor hnena i hruai hian a tih hmasak ber tur chu nang leh damlo hnenah symptoms chungchang zawt hmasa phawt ang che. Tichuan, taksa enfiahna an nei ang. Asterixis (tremors) a awm leh awm loh an enfiah ang.

Chu bakah, a chhan dik tak hriat nan test eng emaw zat tih theih a ni bawk:

• Thisen test: Hengte hian liver enzyme level, thisen ammonia level a teh thei a, liver hnathawh dan kimchang tak a pe thei bawk.
• Ultrasound scan: Liver leh a chhehvela thisen kalna kawngte dinhmun enfiah thin ang che.
• Brain scan (CT scan or MRI): Thluak a hring emaw, harsatna dang emaw a awm leh awm loh enfiah nan.
• EEG test: Thluak electrical activity a teh a, thil dik lo a awm leh awm loh a enfiah thin.

Hei hi eng enkawlna nge ni?

Enkawlna atana thil tum lian pathum a awm a, chungte chu:

1. Emergency situation enkawl dan: Symptoms tihpun nghaltu trigger (e.g., infection, constipation) zawng chhuak leh enkawl.

2. A chhan bulpui enkawl dan: Liver natna thlentu atanga enkawl dan tur ruahmanna siam.

3. Thisen a toxins level tihhniam: Hei hi a pawimawh ber a ni.

Thisen a toxins level tihhniam nan damdawi chi hnih pek thin a ni a, chungte chu:

• Lactulose: Hei hi damdawi tui tak a ni a, ei tur a ni. Pum tifai leh rang taka intestines atanga toxins te paih chhuakin hna a thawk a ni. Tin, intestine-a toxin siamtu bacteria te pawh a control bawk.
• Rifaximin: Hei hi antibiotic a ni. Intestines-a bacteria tha lo tak takte thatin hna a thawk a, toxin siam chhuah a ti tlem bawk.

Heng enkawlnate hian a natna lan chhuah dan chu a tam zawkin a thunun thei a ni. Mahse, a hnuaia liver natna hi enkawl a nih loh chuan a natna hi a lo awm leh thei a ni. Liver a fail vek tawh chuan liver transplant chauh hi a solution awmchhun a ni thei.

Hetiang dinhmun hi engtin nge kan nunpui ang?

Chronic liver disease leh Hepatic Encephalopathy nena nun hi thil harsa tak a ni. Amaherawhchu, inrelbawlna mumal tak nen chuan nun tha tak i hmang thei a ni.

• I doctor nen inzawmna nei reng rawh: A hun takah clinic-ah kal rawh. I damdawi ei tur chu a hun takah ei thin ang che. I natna lan chhuah danah danglamna i hmuh chuan doctor hnenah hriattir nghal rawh.
• Chhungte hnen a\angin \anpuina la rawh: Heng damlote hian thil \henkhat an theihnghilh theih avangin, damdawi pek leh doctor hnena hruai ang chi thil atan chuan chhungkaw member \anpuina hi a pawimawh hle.
• I ei leh in tur ngaihtuah rawh: Ei leh in inthlau tak ei rawh. Sa ei tur zat tur chungchangah doctor rawn la.
• Constipation venna atan:Nitin tui in tam, fiber tamna ei tur (thei, thlai) ei thin ang che. Damdawi `Lactulose` hi Doctor-in a pek ang chiah chiah ei tur a ni.
• Zu in hi bansan vek rawh: Tuk khat lek pawh in hi a tha lo.
• Driving pumpelh: Hetiang dinhmun hi i neih chuan lirthei khalh hi a hlauhawm hle a, a tlem berah pawh a hlauhawm hle a, i ngaihtuahna leh thutlukna siam theihna a tichhe thei a ni.

He dinhmun hian nangmah emaw, i hmangaih tak emaw a nghawng chuan, a tichhe thei hle. Mahse, enkawl dan dik leh chhungte hmangaihna leh enkawlna nen chuan he dinhmun hi i nung thei tih hre reng ang che.