Probiotics may prevent complications of liver disease

A STUDY finds that probiotics are effective in preventing hepatic encephalopathy in patients with cirrhosis of the liver. Hepatic encephalopathy is a deterioration of brain function that is a complication of liver disease. The trials involved cirrhosis patients who showed risk factors for hepatic encephalopathy, but had yet to experience an obvious episode. When comparing treatment with probiotics versus placebo, the researchers at the Govind Ballabh Pant Hospital in New Delhi, India, where the trial was conducted, found that the incidence of hepatic encephalopathy was lower in patients treated with probiotics.

"This rigorous new research finds that probiotics modify the gut microbiota to prevent hepatic encephalopathy in patients with cirrhosis of the liver," said David W. Victor III, MD,

Probiotic supplementation was not associated with any side effects and none of the patients required discontinuation of therapy. These results suggest that probiotics are similar in effectiveness to the current standard of care, lactulose, in the prevention of hepatic encephalopathy, yet they appear to be much better tolerated. The effectiveness of lactulose, a nonabsorbable disaccharide, is limited by side effects (diarrhea, bloating and gas) and a narrow therapeutic window.

"By virtue of its size, study duration and design, as well as the thorough nature of the baseline and follow-up assessments, this study represents an important contribution to the hepatic encephalopathy literature," added Dr. Victor, a practicing hepatologist in the Methodist J.C. Walter Jr. Transplant Centre at Houston Methodist Hospital, Texas.