Skip to main content
Top
Published in: Metabolic Brain Disease 6/2016

Open Access 01-12-2016 | Original Article

Current state of knowledge of hepatic encephalopathy (part III): non-absorbable disaccharides

Published in: Metabolic Brain Disease | Issue 6/2016

Login to get access

Abstract

Nonabsorbable disaccharides have been the mainstay of treatment for hepatic encephalopathy since introduced into clinical practice in 1966. Their beneficial effects reflect their ability to reduce the intestinal production/absorption of ammonia. A recent Cochrane review confirmed the efficacy and safety of nonabsorbable disaccharides for the treatment and prevention of hepatic encephalopathy in patients with cirrhosis. The findings were robust and support the use of nonabsorbable disaccharides as a first line treatment for hepatic encephalopathy, in this patient population, and for its prevention.
Literature
go back to reference Als-Nielsen B, Gluud LL, Gluud C (2004) Non-absorbable disaccharides for hepatic encephalopathy: systematic review of randomised trials. BMJ 328(7447):1046–1052CrossRefPubMedPubMedCentral Als-Nielsen B, Gluud LL, Gluud C (2004) Non-absorbable disaccharides for hepatic encephalopathy: systematic review of randomised trials. BMJ 328(7447):1046–1052CrossRefPubMedPubMedCentral
go back to reference Bajaj JS, Sanyal AJ, Bell D, Gilles H, Heuman DM (2010) Predictors of the recurrence of hepatic encephalopathy in lactulose-treated patients. Aliment Pharmacol Ther 31(9):1012–1017PubMed Bajaj JS, Sanyal AJ, Bell D, Gilles H, Heuman DM (2010) Predictors of the recurrence of hepatic encephalopathy in lactulose-treated patients. Aliment Pharmacol Ther 31(9):1012–1017PubMed
go back to reference Bajaj JS, Gillevet PM, Patel NR, Ahluwalia V, Ridlon JM, Kettenmann B, Schubert CM, Sikaroodi M, Heuman DM, Crossey MM, Bell DE, Hylemon PB, Fatouros PP, Taylor-Robinson SD (2012) A longitudinal systems biology analysis of lactulose withdrawal in hepatic encephalopathy. Metab Brain Dis 27(2):205–215CrossRefPubMed Bajaj JS, Gillevet PM, Patel NR, Ahluwalia V, Ridlon JM, Kettenmann B, Schubert CM, Sikaroodi M, Heuman DM, Crossey MM, Bell DE, Hylemon PB, Fatouros PP, Taylor-Robinson SD (2012) A longitudinal systems biology analysis of lactulose withdrawal in hepatic encephalopathy. Metab Brain Dis 27(2):205–215CrossRefPubMed
go back to reference Gluud LL, Vilstrup H, Morgan MY (2016) Nonabsorbable disaccharides versus placebo/no intervention and lactulose versus lactitol for the prevention and treatment of hepatic encephalopathy in people with cirrhosis. Cochrane Database Syst Rev May 6(5):CD003044 Gluud LL, Vilstrup H, Morgan MY (2016) Nonabsorbable disaccharides versus placebo/no intervention and lactulose versus lactitol for the prevention and treatment of hepatic encephalopathy in people with cirrhosis. Cochrane Database Syst Rev May 6(5):CD003044
go back to reference Qin N, Yang F, Li A, Prifti E, Chen Y, Shao L, Guo J, Le Chatelier E, Yao J, Wu L, Zhou J, Ni S, Liu L, Pons N, Batto JM, Kennedy SP, Leonard P, Yuan C, Ding W, Chen Y, Hu X, Zheng B, Qian G, Xu W, Ehrlich SD, Zheng S, Li L (2014) Alterations of the human gut microbiome in liver cirrhosis. Nature 513(7516):59–64CrossRefPubMed Qin N, Yang F, Li A, Prifti E, Chen Y, Shao L, Guo J, Le Chatelier E, Yao J, Wu L, Zhou J, Ni S, Liu L, Pons N, Batto JM, Kennedy SP, Leonard P, Yuan C, Ding W, Chen Y, Hu X, Zheng B, Qian G, Xu W, Ehrlich SD, Zheng S, Li L (2014) Alterations of the human gut microbiome in liver cirrhosis. Nature 513(7516):59–64CrossRefPubMed
go back to reference Riggio O, Varriale M, Testore GP, Di Rosa R, Di Rosa E, Merli M, Romiti A, Candiani C, Capocaccia L (1990) Effect of lactitol and lactulose administration on the fecal flora in cirrhotic patients. J Clin Gastroenterol 12:433–436CrossRefPubMed Riggio O, Varriale M, Testore GP, Di Rosa R, Di Rosa E, Merli M, Romiti A, Candiani C, Capocaccia L (1990) Effect of lactitol and lactulose administration on the fecal flora in cirrhotic patients. J Clin Gastroenterol 12:433–436CrossRefPubMed
go back to reference van Leeuwen PA, van Berlo CL, Soeters PB (1988) New mode of action for lactulose. Lancet 1(8575–6):55–56CrossRefPubMed van Leeuwen PA, van Berlo CL, Soeters PB (1988) New mode of action for lactulose. Lancet 1(8575–6):55–56CrossRefPubMed
go back to reference Vilstrup H, Amodio P, Bajaj J, Cordoba J, Ferenci P, Mullen KD, Weissenborn K, Wong P (2014) Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the liver. Hepatology 60(2):715–735CrossRefPubMed Vilstrup H, Amodio P, Bajaj J, Cordoba J, Ferenci P, Mullen KD, Weissenborn K, Wong P (2014) Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the liver. Hepatology 60(2):715–735CrossRefPubMed
go back to reference Volk ML, Tocco RS, Bazick J, Rakoski MO, Lok AS (2012) Hospital readmissions among patients with decompensated cirrhosis. Am J Gastroenterol 107(2):247–252CrossRefPubMed Volk ML, Tocco RS, Bazick J, Rakoski MO, Lok AS (2012) Hospital readmissions among patients with decompensated cirrhosis. Am J Gastroenterol 107(2):247–252CrossRefPubMed
go back to reference Weber FL, Banwell JG, Fresard KM, Cummings JH (1987) Nitrogen in fecal bacterial fibre, and soluble fractions of patients with cirrhosis: effects of lactulose and lactulose plus neomycin. J Lab Clin Med 110(3):259–263PubMed Weber FL, Banwell JG, Fresard KM, Cummings JH (1987) Nitrogen in fecal bacterial fibre, and soluble fractions of patients with cirrhosis: effects of lactulose and lactulose plus neomycin. J Lab Clin Med 110(3):259–263PubMed
Metadata
Title
Current state of knowledge of hepatic encephalopathy (part III): non-absorbable disaccharides
Publication date
01-12-2016
Published in
Metabolic Brain Disease / Issue 6/2016
Print ISSN: 0885-7490
Electronic ISSN: 1573-7365
DOI
https://doi.org/10.1007/s11011-016-9910-2

Other articles of this Issue 6/2016

Metabolic Brain Disease 6/2016 Go to the issue