Rifaximin for Minimal Hepatic Encephalopathy?

Outcomes were favorable — but at a high cost.

Some patients with hepatic cirrhosis and no history of overt encephalopathy have mild cognitive impairment, known as minimal hepatic encephalopathy (MHE). In previous small studies, patients with MHE responded to therapy with lactulose and probiotics (JW Gen Med Mar 27 2007 and JW Gastroenterol Aug 8 2008). Now, in two randomized trials, researchers address the effect of the nonabsorbable antibiotic rifaximin in patients with cirrhosis and MHE (according to standardized psychometric tests) but no overt hepatic encephalopathy. Antibiotic therapy reduces intestinal bacterial production of ammonia, a contributor to encephalopathy.

In one study, 94 patients received rifaximin or placebo. After 8 weeks, cognitive function and health-related quali…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose