I'm NOT a doctor so you had better verify anything you read with my name on it.... but another thing I have learned is that if your liver has problems it won't break down ammonia and it is NOT difficult or expensive to check ammonia in your blood or urine. That ammonia is what causing the brain fog and confusion in the afternoons. Google it and you will learn a lot.
Here is a documentary about
HE...hepatic encephalopathy. www.hesback.com
I hope you get some good info from this!
There are two medications commonly used for HE...lactulose and Xifaxan. Themister has had ammonia levels very high, with almost no HE symptoms. He also has had low ammonia levels with significant symptoms. Themister had TIPS (shunt ) to prevent more bleeds. HE was instant and is the most difficult part of liver disease at our house. Big Hugs
Wife of themister, a fine man living with ESLD. Transplant list-2013
“Out of suffering have emerged the strongest souls; the most massive characters are seared with scars.” Kahlil Gibran