title: Management of hepatic encephalopathy with oral zinc supplementation: a long-term treatment.
abstract: OBJECTIVE
  The effect of long-term oral zinc supplementation, in addition to standard therapy (protein-restricted diet and lactulose) on recurrent hepatic encephalopathy, was assessed in a double-blind study.
  
  
  METHODS
  Ninety cirrhotic patients with stable recurrent hepatic encephalopathy, after following a one month period of standard therapy, were randomized to receive oral zinc acetate supplementation (600 mg/day) in addition to standard therapy or to continue only standard therapy (a diet containing 0.8 g/kg/day of protein and 90 g/day of lactulose) for six months. Psychometric tests, NCT (number correction test) and PSE (portal-systemic encephalopathy) Index, were used to evaluate the degree of hepatic encephalopathy, both at the beginning and the end of each treatment period.
  
  
  RESULTS
  Oral zinc supplementation in addition to standard therapy was able to normalize serum zinc levels. The patients who never showed clinical signs of hepatic encephalopathy during the trial were 88.6% in zinc-group and 86% in only standard therapy group. Psychometric tests, NCT and PSE Index, were statistically better than basal values either in zinc-group or in only standard therapy group.
  
  
  CONCLUSIONS
  Final values of psychometric tests were better in zinc-group than only standard therapy group but the differences were not statistically significant.
authors.affiliation: Departement of Gastroenterology, U.S.L. 12, Pisa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Bresci
authors.forename: G
authors.initials: G
authors.lastname: Parisi
authors.forename: S
authors.initials: S
authors.lastname: Banti
mesh_terms: D000085:Acetates / Q000008:administration & dosage*; D019342:Acetic Acid; D000284:Administration, Oral; D004311:Double-Blind Method; D005260:Female; D006501:Hepatic Encephalopathy / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D013997:Time Factors; D015032:Zinc / Q000097:blood
chemical_list: D000085:Acetates; D015032:Zinc; D019342:Acetic Acid