Abstract :
Objectives: Minimal hepatic encephalopathy (MHE) is a preclinical stage of overt hepatic encephalopathy (OHE). All MHE therapies modify gut microflora but consensus regarding MHE treatment is lacking. The aim of this study is to determine the effect of probiotic is reversing MHE in cirrhotic patients.
Patients and Methods: A total of 58 cirrhotic patients were enrolled (44 males, 14 females) aged 42-60, 87.7% in Child-Pugh class A. The diagnosis of MHE was based on the number connection test-A (NCT-A), line-tracing test (LTT) and critical flicker frequency analysis (CFF). Diagnostic criteria for MHE were met when abnormalities in at least two out of the three tests were present.
Results: MHE was diagnosed in 16 patients (27.6%). Non-detectable ascites and Child A were the only significant differences between the MHE positive and MHE negative groups (p <0.01). Of the 16 patients, only 10 were recruited in the study, and were randomized, 5 patients in the probiotic group and 5 in the non-treatment group. Probiotic (Infloran®) was prescribed for 8 weeks in the probiotic group. Psychometric test and CFF were performed in both groups after 4 and 8 weeks of treatment. MHE was reversed in none. No significant improvement in NCT was seen in both groups. Improvement of LTT was seen in 2 patients (40%) in the probiotic group and 3 (60%) in the non-treatment group. CFF <39 Hz was found in 4 patients (80%) before treatment and in none after treatment.
Conclusions: Probiotic treatment for 8 weeks was not associated with reversal of MHE nor with improvement in the psychometric test and CFF. |
file/Thai-Journal-of-gastroenterology-vol-11-no-3-1734376.pdf