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Effect of probiotic treatment on cirrhotic patients with minimal hepatic encephalopathy: A meta-analysis

Qing Cao1, Cheng-Bo Yu1, Shi-Gui Yang1

  • 1State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

Hepatobiliary & Pancreatic Diseases International : HBPD INT
|February 12, 2018
PubMed
Abstract

Insights

Probiotics show promise in treating minimal hepatic encephalopathy (MHE) in liver cirrhosis patients. This meta-analysis found probiotics can reduce ammonia and endotoxin levels, improving MHE and preventing overt hepatic encephalopathy (HE).

Area of Science:

  • Gastroenterology and Hepatology
  • Microbiology
  • Clinical Nutrition

Background:

  • Minimal hepatic encephalopathy (MHE) is an early, reversible stage of hepatic encephalopathy (HE).
  • Existing research on probiotic treatment for MHE in cirrhotic patients yields inconsistent results.
  • This meta-analysis aims to clarify the efficacy of probiotics in managing MHE among patients with liver cirrhosis.

Purpose of the Study:

  • To systematically evaluate the effectiveness of probiotics in treating cirrhotic patients diagnosed with minimal hepatic encephalopathy (MHE).
  • To assess the impact of probiotics on key indicators such as serum ammonia, endotoxin levels, and MHE status.

Main Methods:

  • A comprehensive meta-analysis of randomized controlled trials (RCTs) was conducted.
  • Searches were performed across seven electronic databases for studies published up to July 2015.
  • The analysis included 14 RCTs involving 1132 patients, comparing probiotics against placebo/no treatment and lactulose.

Main Results:

  • Probiotics significantly improved MHE and reduced Number Connection Test (NCT) scores compared to placebo.
  • Probiotics also demonstrated a trend towards preventing overt HE progression compared to placebo.
  • While probiotics showed some benefits, lactulose appeared more effective in reducing NCT values in certain comparisons.

Conclusions:

  • Probiotics are effective in reducing serum ammonia and endotoxin levels in liver cirrhosis patients.
  • Probiotic supplementation can improve minimal hepatic encephalopathy (MHE) and prevent the progression to overt hepatic encephalopathy (HE).
  • Further research may be needed to directly compare the long-term efficacy of probiotics versus lactulose for MHE management.
Keywords:
LactuloseMinimal hepatic encephalopathyProbioticsRandomized controlled trials

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