title: Disaccharides in the treatment of hepatic encephalopathy.
abstract: Management of hepatic encephalopathy (HE) primarily involves avoidance of precipitating factors and administration of various ammonia-lowering therapies such as nonabsorbable disaccharides and antimicrobial agents like rifaximin. The nonabsorbable disaccharides which include lactulose and lactitol are considered the first-line therapy for the treatment of HE and minimal hepatic encephalopathy (MHE). Lactulose significantly improves cognitive function and health-related quality of life in patients with MHE. Lactitol is comparable to lactulose in the treatment of HE with fewer side effects. Lactulose has also shown to be effective in primary and secondary prophylaxis of HE. Disaccharides were found to be comparable to rifaximin in recent systemic reviews in the treatment of HE however conclusion was based on inclusion of some poor quality trials. Combination therapy of disaccharides either with rifaximin, L-ornithine L-aspartate,probiotics for the treatment of HE needs further validation in large studies.
authors: Department of Gastroenterology, G.B.Pant Hospital, Academic Block Room - 203, New Delhi, India.
authors: Praveen
authors: P
authors: Sharma
authors: Barjesh Chander
authors: BC
authors: Sharma
mesh_terms: D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use; D004187:Disaccharides / Q000378:metabolism / Q000627:therapeutic use*; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006501:Hepatic Encephalopathy / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D007408:Intestinal Absorption; D007792:Lactulose / Q000627:therapeutic use; D013402:Sugar Alcohols / Q000627:therapeutic use
chemical_list: D000890:Anti-Infective Agents; D004187:Disaccharides; D005765:Gastrointestinal Agents; D013402:Sugar Alcohols; D007792:Lactulose; C014635:lactitol