Pasupulati, A
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Numerous studies have evaluated lactulose in the treatment of minimal HE, overt HE, and as a secondary prophylactic measure in patients with cirrhosis, confirming its efficacy and safety.3033 Clinical trials have shown that lactitol is better-tolerated and is just as efficacious as lactulose for the treatment of HE.34,35 No significant difference has been found with respect to improving HE grade in the comparison of nonabsorbable antibiotics (rifaximin) versus nonabsorbable disaccharides (lactitol and/or lactulose).23,25,27 Probiotics are mixtures of beneficial bacteria that are believed to aid in the treatment of HE by modulating the microbiome
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