Increased nitrogen load

[rlanders85]

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UW says one cause for precipitating hepatic encephalopathy is excessive nitrogen load and gives GI bleeding and constipation as examples... can anyone explain how these 2 examples cause excessive nitrogen load?

 

[django7]

In terms of GI bleeding: the blood in the bowel is metabolized by gut flora resulting in more ammonia and other toxic metabolites. Hence the higher chance of encephalopahy in cirrhotics. Also remember the higher chances of encephalopathy after a portosystemic shunt
I'm not sure about constipation though

 

[jamiedrew]

Hi!

I just got this question on UWorld as well and was wondering the same thing, so the constipation cause I googled: apparently constipation causes slow transit time which allows high reabsorption of ammonia in the gut!

- Jamie