To Determine the Outcome of Probiotics in Patients of Minimal Hepatic Encephalopathy with Liver Cirrhosis

Abstract

Background: Minimal hepatic encephalopathy (MHE) is the earliest form of hepatic encephalopathy and can affect up to 80% of cirrhotic patients. Although often not considered to be clinically relevant and, therefore, not diagnosed or treated, MHE has been shown to affect daily functioning, quality of life, driving and overall mortality. In addition to physician reporting and driving restrictions, medical treatment for MHE includes probiotics. Liver transplantation may not result in reversal of the cognitive deficits associated with MHE. Objective: The objective of this study was to determine the outcome of probiotics in patients of minimal hepatic encephalopathy with liver cirrhosis. Study Design: Descriptive, case series. Setting: Department of Medicine, PMC affiliated hospitals, Faisalabad. Period: Six months after approval of synopsis from 18/05/2016 to 18/11/2016. Methodology: After taking approval from hospital ethical committee, patients coming through OPD fulfilling the inclusion criteria were enrolled and informed consent was taken. All the patients were given probiotics (one capsule of ECOTEC^TM, three times a day) for 3 months. Development of overt hepatic encephalopathy was assessed clinically within 3 months of treatment by using West Haven criteria as per operational definition. Follow up was done by taking patient’s contact number. Results: In our study, out of 120 cases, 55.83%(n=67) were between 20-50 years of age while 44.17%(n=53) were between 51-70 years of age, mean+sd was calculated as 47.21+12.78 years, 36.67%(n=44) were male and 63.33%(n=76) were females, mean duration of disease was calculated as 6.82+1.84 months, frequency of development of overt hepatic encephalopathy was recorded in 22.5%(n=27). Conclusion: We concluded that the outcome of probiotics is not poor in patients of minimal hepatic encephalopathy with liver cirrhosis.