Effect of rifaximin, probiotics, and l-ornithine l-aspartate on minimal hepatic encephalopathy: a randomized controlled trial

Minimal hepatic encephalopathy (MHE) implies subtle impairment of cognitive functions in the absence of features of overt encephalopathy. We aimed to determine the prevalence of MHE in patients with liver cirrhosis and to find out the effect of rifaximin, probiotics, and l-ornithine l-aspartate (LOL...

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Bibliographic Details
Published in:Saudi journal of gastroenterology 2014-07, Vol.20 (4), p.225-232
Main Authors: Sharma, Kapil, Pant, Sanjay, Misra, Sriprakash, Dwivedi, Manisha, Misra, Alok, Narang, Sushil, Tewari, Reshu, Bhadoria, Ajeet S
Format: Article
Language:English
Subjects:
Adult
Aspartate
Complications and side effects
Development and progression
Dipeptides - therapeutic use
Dosage and administration
Drug therapy
Female
Gastrointestinal Agents - therapeutic use
Hepatic encephalopathy
Hepatic Encephalopathy - drug therapy
Hepatic Encephalopathy - epidemiology
Humans
L-ornithine l-aspartate
Liver cirrhosis
Liver Cirrhosis - epidemiology
Male
Middle Aged
minimal hepatic encephalopathy
Original
Patient outcomes
Probiotics
Probiotics - therapeutic use
Rifamycins - therapeutic use
rifaximin
Risk factors
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Summary:Minimal hepatic encephalopathy (MHE) implies subtle impairment of cognitive functions in the absence of features of overt encephalopathy. We aimed to determine the prevalence of MHE in patients with liver cirrhosis and to find out the effect of rifaximin, probiotics, and l-ornithine l-aspartate (LOLA) individually in reversal of MHE by comparing it with placebo group. This study was carried out in two phases. Phase I included the recruitment of 250 apparently healthy controls and extraction of normative data utilizing three neuropsychometric tests (NPTs) and critical flicker frequency (CFF) test. Phase II consisted of screening and recruitment of patients of MHE followed by drugs trial. A total of 317 cirrhotics were screened; 111 were excluded and the remaining 206 cirrhotics were screened for MHE using NPTs and/or CFF test. Of these, 124 patients with MHE were randomized to receive LOLA (n = 31), rifaximin (n = 31), probiotics (n = 32), for 2 months and were compared with patients who were given placebo (n = 30). Out of 206 cirrhotics, 124 (60.19%) had MHE. Among these 124 MHE patients, 87 (70.16%) patients had CFF
ISSN:1319-3767
1998-4049
DOI:10.4103/1319-3767.136975