The goals of treatment include life support, elimination or treatment of precipitating factors, and removal or neutralization of ammonia and other toxins . Life support including support of breathing or circulation may be required, particularly if coma develops. Precipitating factors must be identified and treated. Gastrointestinal bleeding must be stopped. The intestines must be emptied of blood.
Blood breaks down into protein components that are converted to ammonia.
Reduced or no protein in diet is prescribed to reduce ammonia production. Vegetable protein may be tolerated better than animal protein. Lactulose prevents absorption of ammonia from the intestines and acts as a laxative to evacuate blood from the intestines. Neomycin may be given by mouth to reduce ammonia production by intestinal bacteria. Sedatives, tranquilizers, or any other medication that is metabolized or excreted by the liver should be avoided.