title: Effects of probiotic therapy on hepatic encephalopathy in patients with liver cirrhosis: an updated meta-analysis of six randomized controlled trials.
abstract: BACKGROUND
  Liver cirrhotic patients with hepatic encephalopathy have poor prognosis. Probiotics alter the intestinal microbiota and reduce the production of ammonia. We conducted a meta-analysis about the role of probiotics on liver cirrhotic patients with hepatic encephalopathy.
  
  
  METHODS
  We collected the relevant literatures up to February 21, 2014 from databases of PubMed, EMBASE and the Cochrane Central Register of Controlled Trials. A statistical analysis was conducted by RevMan 5.2 and STATA 12.0 software.
  
  
  RESULTS
  Six randomized controlled trials involving 496 liver cirrhotic patients were included. The results showed that probiotic therapy significantly reduced the development of overt hepatic encephalopathy (OR [95% CI]: 0.42 [0.26, 0.70], P=0.0007). However, probiotics did not affect mortality, levels of serum ammonia and constipation (mortality: OR [95% CI]: 0.73 [0.38, 1.41], P=0.35; serum ammonia: WMD [95% CI]: -3.67 [-15.71, 8.37], P=0.55; constipation: OR [95% CI]: 0.67 [0.29, 1.56], P=0.35).
  
  
  CONCLUSIONS
  Probiotics decrease overt hepatic encephalopathy in patients with liver cirrhosis.
authors.affiliation: Department of Surgery, Zhejiang University Hospital, Zhejiang University, Hangzhou 310027, China. zrb94276@zju.edu.cn.
authors.forename: Jun
authors.initials: J
authors.lastname: Xu
authors.forename: Rui
authors.initials: R
authors.lastname: Ma
authors.forename: Li-Feng
authors.initials: LF
authors.lastname: Chen
authors.forename: Li-Jun
authors.initials: LJ
authors.lastname: Zhao
authors.forename: Kan
authors.initials: K
authors.lastname: Chen
authors.forename: Ren-Bing
authors.initials: RB
authors.lastname: Zhang
mesh_terms: D006501:Hepatic Encephalopathy / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control*; D006801:Humans; D007422:Intestines / Q000382:microbiology*; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D016017:Odds Ratio; D019936:Probiotics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome