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Minimal hepatic encephalopathy (MHE) is subtle cognitive or psychomotor dysfunction in patients with cirrhosis whose mental status seems normal. This study from India examined the effect of lactulose on MHE.
Researchers identified 61 patients with cirrhosis who had no history of overt hepatic encephalopathy but were considered to have MHE, based on abnormalities on at least two neuropsychological tests (from a battery of 6 tests). These patients were randomized to receive 3 months of lactulose or no lactulose; treatment assignment was not blinded. The lactulose group experienced a significant decrease in the mean number of abnormal neuropsychological test results (from 2.74 at baseline to 0.75 at 3 months), but no change occurred in the untr…