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Minimal hepatic encephalopathy (MHE) is characterized by cognitive deficits that adversely affect patients' health-related quality of life (HRQOL). Its diagnosis is difficult and relies on neuropsychometric and neurophysiological methods. Efficacy of rifaximin, a minimally absorbed antibiotic that targets the gastrointestinal tract, has benefited patients with overt hepatic encephalopathy (OHE; JW Gastroenterol Mar 24 2010). Now, two teams of investigators have evaluated the efficacy of rifaximin in improving cognitive performance and HRQOL in cirrhotic patients with MHE.
In both randomized, double-blind, placebo-controlled trials, cirrhotic patients without OHE were screened for MHE (defined as >2 standard deviations beyond an abnormal resu…