Gastroenterology consultation

Acute hepatitis with encephalopathy on chronic liver disease and cirrhosis in patient with alcohol use disorder. Exacerbation likely due to prolonged constipation and accidental paracetamol overdose.

Immediate management:

• Manual faecal disimpaction and enema
• Rehydration and supportive measures (consider steroids)
• Oral lactulose
• N-acetylcysteine
•  Immediate alcohol abstinence and alcohol withdrawal management

Long-term management:

• Sobriety counselling and support
• Patient education
• Dietitian referral
• Social work referral

Other consultations

No other consultations indicated.