HE Resource Centre for Healthcare Professionals

A close up shot of a green stethoscope on top of a doctor's notes

HE Resource Centre for Healthcare Professionals

Clinical Practice Guidelines

Hepatic Encephalopathy in Chronic Liver Disease:
2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver
Journal of Hepatology, Vol. 60, Issue 2, Pages 715-735, August 2014

Diagnostic Tools & Calculators

Clinical Hepatic Encephalopathy Staging Scale (CHESS)
By Dr. Christopher Rose (CRCHUM, University of Montreal) and Dr. Philip Wong (McGill University Health Centre), June 2016
Introductory letter available here.

Hepatic Encephalopathy Symptom Tracker and Monitoring Tool (for Patients & Caregivers)
By Dr. Christopher Rose (CRCHUM, University of Montreal) and Dr. Philip Wong (McGill University Health Centre), June 2016

Psychometric Hepatic Encephalopathy Score (PHES)
Minimal hepatic encephalopathy has significant impact on a liver patient’s daily living and health related quality of life and a majority of clinicians agree that it should be diagnosed and treated. The Psychometric Hepatic Encephalopathy Score (PHES) is the sum score achieved from the five sub-tests of the PSE (Portosystemic Encephalopathy)-Syndrome-Test. These paper-pencil tests assess attention, visuospatial perception, visuospatial construction, psychomotor speed and motor accuracy. The PHES has been standardized in many countries; however please note that the appropriate controls for PHES have not yet been standardized in Canada. Healthcare professionals interested in learning more about the PHES (© Hannover Medical School) can contact Dr. Karin Weissenborn to discuss which materials are needed, how to use the test and how to access the test.


Educational Videos, Reports & Slides

Hepatic Encephalopathy: Explore the Neuropsychiatric Consequences of Cirrhosis
Prepared by: Dr. Christopher Rose, Dr. Hermant Shah, Dr. Puneeta Tandon and Dr. Philip Wong (June 2017)

A title that says Module 1 Introduction to cirrhosis and its complications

Click on the above image and save the Powerpoint Show to view the slides.

Module 1:
Chronic Liver Disease & Cirrhosis: An Introduction
Hepatic Encephalopathy: Overview
Hepatic Encephalopathy: Pathophysiology
Hepatic Encephalopathy: Clinical Classification
Covert Hepatic Encephalopathy: West Haven/Conn Score (0-1)
Covert Hepatic Encephalopathy: Testing

A title that says Module 2 Overt HE
Click on the above image and save the Powerpoint Show to view the slides.

Module 2:
Overt HE
Nonabsorbable Disaccharides: Lactulose
Dietary Modification: BCAA’s(Branched-Chain Amino Acids) Nutrition in cirrhosis

For a video version of the slides with voice-over narration, please click here.

Canadian Association for the Study of the Liver Hepatocellular Carcinoma Meeting: Consensus, Controversies and Future Directions

The slides and videos are now available online. Click here.


Nutrition GuideThe Nutrition in Cirrhosis Guide

This Guide covers general topics relevant to all patients with cirrhosis. Specific nutrition issues are also addressed that may be helpful at other times. The Guide is a tool for use throughout your cirrhosis journey. It also includes recipes that are suitable for all individuals and can be modified to accommodate food allergies, dietary restrictions, and preferences.

Click here to download a copy. To order a hard copy version, send your request to Publications Order.


Note: The information links on this page have been chosen based on their content, source and potential usefulness for our site visitors and are provided here as a public service with regard to liver-related issues. However, the Canadian Liver Foundation assumes no responsibility for any information on these sites and the inclusion of a link on this page does not constitute an endorsement of any sponsoring organization or individual by the Canadian Liver Foundation.

We want to hear from the medical community. Input from you helps us to identify professional education programs and resources which meet the needs of your patients and your community. If you would like information or education in a particular area (i.e.: paediatric, liver health/prevention, etc.) or type of liver disease (i.e.: fatty liver disease, hepatitis, liver cancer, etc.), please contact Nem Maksimovic by email or phone at 1 (800) 563-5483

Back to top