I think it is common with liver problems and bile build up. We were told it varies with each person the effect it will have. For example, you could have it built up a great amount and no confusion or very little build up a lots of confusion. My dad ended up being hospitalized because he couldn’t remember who we were or his birthday etc. Of course he was feeling so poorly and his billiruben level had shot up too. The doctors hadn’t told us this could happen either. Personally, I believe doctors often treat symptoms that arise not knowing if the person will experience it at all. Which is a good thing to not add medication to the mix it if will not become an issue. It just did with my dad.