A randomized double blind placebo controlled trial of probiotics in minimal hepatic encephalopathy

Background and aim: Hepatic encephalopathy (HE) is a common and serious complication of liver disease. Minimal HE has major impact on all aspects of a patient's life. The aim of this study was to asses the efficacy of probiotics in minimal hepatic encephalopathy in patients with cirrhosis of the liver. Methods: Stable cirrhotics with minimal hepatic encephalopathy diagnosed by number connection test and evoked responses were recruited for the study. The patients were randomized to two groups and the drugs were administered in a double blind fashion. Improvement in number connection test score, evoked response time and arterial ammonia levels were noted. Results: 43 patients were recruited for the study; 21 in the probiotics group and 22 in the placebo group. There was no statistically significant change in the parameters like arterial ammonia, evoked responses and number connection test before and after treatment with probiotics when compared to placebo. Conclusion: Short term administration of probiotics did not produce any significant improvement in the various parameters assessed in patients with minimal hepatic encephalopathy when compared with placebo.