Open AccessHepatic encephalopathy therapy: An overview
Author(s) -
Oliviero Riggio,
Lorenzo Ridola,
Chiara Pasquale
Publication year - 2010
Publication title -
world journal of gastrointestinal pharmacology and therapeutics
Language(s) - English
Resource type - Journals
ISSN - 2150-5349
DOI - 10.4292/wjgpt.v1.i2.54
Subject(s) - medicine , intensive care medicine , hepatic encephalopathy , rifaximin , natural history , cirrhosis , randomized controlled trial , modalities , disease , clinical trial , complication , quality of life (healthcare) , antibiotics , social science , sociology , microbiology and biotechnology , biology , nursing
Type-C hepatic encephalopathy (HE) is a severe complication of cirrhosis, which seriously affects quality of life and is strongly related to patient survival. Treatment based on a classical pharmacological approach that is aimed at reducing the production of gut-derived toxins, such as ammonia, is still under debate. Currently, results obtained from clinical trials do not support any specific treatment for HE and our competence in testing old and new treatment modalities by randomized controlled trials with appropriate clinically relevant end-points urgently needs to be improved. On the other hand, patients who are at risk for HE are now identifiable, based on studies on the natural history of the disease. Today, very few studies that are specifically aimed at establishing whether HE may be prevented are available or in progress. Recent studies have looked at non absorbable disaccharides or antibiotics and other treatment modalities, such as the modulation of intestinal flora. In the treatment of severe stage HE, artificial liver supports have been tested with initial positive results but more studies are needed.