Hello and welcome to HCM
all the findings in your husbands case- increase in levels of ammonia, high bilirubin, dementia, confusion after having food point towards the diagnosis of Hepatic Encephalopathy
This diagnosis is already made.
However, now there is no response to lactulose.
It is due to the progression of the disease process going on in the liver.
Now, the condition has progressed from simple fatty liver
to more serious state.
You need to get a liver biopsy
to know the exact picture.
In case of end stage liver disease
or liver failure
, liver transpant is the next step in management.
Thanks and take care
Dr Shailja P Wahal