In this open label trial, 235 patients with a history of hepatic encephalopathy were randomized to placebo, lactulose tid, or probiotics tid. Within 12 months of follow up, hepatic encephalopathy developed in 38 placebo patients, 22 probiotic patients, and 18 lactulose patients. Although a small trial, this suggests that probiotics may be added to the options for secondary prevention of hepatic encephalopathy (abstract)
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