Comparison of the efficacy of lactulose and lactobacillus rhamnosus GG in the treatment of minimal hepatic encephalopathy

Objective: Minimal hepatic encephalopathy (MHE); mental and neurological examination is normal, diagnosed by different tests, and it is evident just before hepatic encephalopathy (HE). MHE; may negatively affect the quality of life of the patients, the driving performance of the vehicle, and may progress to HE. The purpose of our study to determine the prevalence of MHE with the critical flicker frequency (CFF) test, to identify the risk factors for MHE, and to compare the efficacy of lactulose and lactobacillus rhamnosus GG (LbGG) in the treatment of MHE. Materials and Methods: 154 cirrhotic patients diagnosed with clinical, laboratory, scanning methods and / or liver biopsy who were admitted the Gastroenterology polyclinic and who did not have obvious HE were included in the study. The applied CFF test <39 Hz was diagnosed as MHE, and the study population was divided into 3 groups as lactulose, LbGG and no treatment. The control CFF test was performed at the first month of the disease treatment. Results: MHE was not detected in 70(45,5%) of one hundred fifty four patients. In 84 (54,5%), MHE was detected 31 (36,9%) of the patients with MHE received lactulose, 31 (36,9%) received LbGG and 22 (26,2%) did not receive treatment. In the CFF test 1 month after treatment, it was found that 8 (25,8%) in the lactulose group, 10 (32,3%) in the LbGG group and 5 (22,7%) in the non-drug group were recovered. CFF levels were found to be statistically significantly higher in the rug-using groups compared to the drug-free group (p=0,011, p=0,007, p=804). There was a correlation between MHE and presence of acid, INR height, albumin-sodium low, Child-pugh phase, and MELD score. It was not determined that the treatments had any superiority to each other. Conclusion: The CFF test has an important place in the definition of MHE. Parameters indicative of the progression of chronic liver disease such as hepatocellulardysfunction, low Na and Child-Pugh stages and MELD elevation may be risk factors for development of MHE. It may be beneficial to treat patients with MHE with lactulose or LbGG, as well as to slow the development of HE. KeyWords: Minimal hepatic encephalopathy, critical flicker frequency, lactulose, LbGG