Lactulose improves psychometric testing in cirrhotic patients with subclinical encephalopathy

• Published in: Alimentary pharmacology & therapeutics 1997-02, Vol.11 (1), p.165-170
• Main Authors: HORSMANS, Y., SOLBREUX, P. M., DAENENS, C., DESAGER, J. P., GEUBEL, A. P.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Female; Gastroenterology. Liver. Pancreas. Abdomen; Gastrointestinal Agents - therapeutic use; Hepatic Encephalopathy - drug therapy; Hepatic Encephalopathy - etiology; Humans; Lactulose - therapeutic use; Liver Cirrhosis - complications; Liver Cirrhosis - drug therapy; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Psychiatric Status Rating Scales
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1046/j.1365-2036.1997.118289000.x

Background: Therapeutic trials suggest that lactulose is an effective treatment of acute and chronic encephalopathy in cirrhotic patients. Aim and Methods: As it is likely that portal‐systemic shunting and hepatocellular dysfunction are associated with some degree of neurological dysfunction, 14 patients with cirrhosis and documented portal‐systemic shunting, but without detectable encephalopathy, were randomized to treatment with either lactulose 20 g t.d.s., or lactose 20 g t.d.s. as placebo, for a 15‐day period. Monitoring included manually administered and computer‐based psychometric testing, the results of which were correlated with a battery of biochemical and functional parameters. Results: There was no correlation between biochemical or functional parameters and psychometric testing. There was a close correlation between the time required to complete the number connection test and both the number of errors and the duration of errors at sinusoid testing. Lactulose therapy resulted in a significant improvement, assessed by the number connection test and the race track test. Conclusion: Our data suggest that lactulose therapy might improve subclinical hepatic encephalopathy in patients with cirrhosis and portal‐systemic shunting.