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Am J Gastroenterol 2002;97(8):2016-2021

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Finally, HE episodes are described as nonprecipitated or precipitated, in relation to whether a triggering factor is found or not.1 Pathophysiology of encephalopathy Historically, the presence of elevated toxin levels in the cerebral parenchyma have been involved in the pathophysiology of HE, with ammonia (NH3) as the main agent