### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I HAVE HEPATIC ENC (CANT SPELL) I HAVE HAD CIRH CANT SPELL THAT EITHER FOR 2 YEARS.  I HAVE ALL THE SYMPTOMS OF HEPATIC ENC EXCEPT FOR GOING IN A COMA.  I TRY TO TAKE GENERALAC EVERY DAY (1/4 CUP) EVERY DAY. I SKIP SOME DAYS IF I HAVE TO GO TO THE DR OR DENTIST.  WILL THIS CONDITION GET WORSE OR WILL IT STABLIZE.  I WAS AN HONOR STUDENT IN SCHOOL, WORKED FOR THE LAST 15 YEARS IN BANKING BUT HAD TO TAKE DISABILITY, UNABLE TO WORK  BECAUSE OF HEPATIC ENC.  I HAVE AN ENDOSCOPE ONE A YEAR AND ASCITES ARE VERY SMALL.  THE DR HAS ASKED ME IF I WANT TO CONSIDER A LIVER TRANSPLANT IN THE FUTURE....NOT SOON BUT GET ON THE LONG LIST.  I DONT THINK I WANT TO BUT MY KIDS ARE UPSET WITH ME. I KNOW YOU DONT HAVE A CRYSTAL BALL BUT WHAT IS A NORMAL PROGRESSION OF THIS DISEASE?

### output:

Hello there!  Thank you for asking, Hepatic encephalopathy is due to increase ammonia levels as they are not detoxified by liver anymore as they are cirrhotic. SO This Adds to the group f chronic liver disease. I am sorry to tell you but this disease progresses and there is no cure but management only. So if you want to increase your life span. Take regular medications, they are life long. Here is what you need to avoid excess proteinAvoid and treat early the infections, and constipation, Avoid opiates, benzodiazepines, antidepressants, and antipsychotic agents. Keep tracing your potassium levels. Don't let them fall. If any problem persists or worsens see the gastroenterologists. You need a lot of care and monitoring, RegardsS Khan