Source Division of Gastroenterology, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
Employability, driving capacity, and many domains of health-related quality of life are reduced in patients with minimal hepatic encephalopathy (HE). Moreover, once minimal HE is identified, more than 50% of patients develop overt HE within 30 months. Now that minimal HE has been shown to be associated with consequences, more studies are needed to assess the cost effectiveness to treat it. This article discusses the issues regarding diagnosis and management of minimal HE, now called "Covert HE."