Benefit of probiotics in preventing hepatic encephalopathy among patients with liver cirrhosis: an evidence-based case report

Abstract

Background: Hepatic encephalopathy (HE) is a serious complication in patients with liver cirrhosis. Its pathogenesis involved the mechanism of HE including endotoxins, ammonia production and other neurotoxins by gut microflora. Probiotic exert potential benefit for gastrointestinal microflora. The use of probiotics may provide substantial benefit for the treatment of HE. Objective: This report aimed to evaluate the benefit of probiotics in preventing HE among liver cirrhosis patients. Methods: Literature searching with keywords of ‘liver cirrhosis’, ‘probiotics’, ‘hepatic encephalopathy’ along with its synonyms and related terms was implemented in Pubmed. Additional hand-search was implemented to obtain the relevant articles Result: Three meta-analyses showed that probiotics are effective to prevent HE development. All meta-analyses obtained similar results, in which the odds ratio (OR) obtained was ranging from 0.22 to 0.42. One randomized controlled trial (RCT) by Dhiman et al showed that probiotics treatment reduces the relative risk of overt HE by 33% compared to placebo. Conclusion: Probiotics administration exert potential to prevent the development of HE in the liver cirrhotic patients. The patient may benefit with the given of probiotics.