Lactulose improves psychometric testing in cirrhotic patients with subclinical encephalopathy

Authors

  • Y. HORSMANS,

    1. Catholic University of Louvain, St-Luc University Hospital, Departments of Hepato-gastroenterology, and Pharmacotherapy, Brussels, Belgium
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  • P. M. SOLBREUX,

    1. Catholic University of Louvain, St-Luc University Hospital, Departments of Hepato-gastroenterology, and Pharmacotherapy, Brussels, Belgium
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  • C. DAENENS,

    1. Catholic University of Louvain, St-Luc University Hospital, Departments of Hepato-gastroenterology, and Pharmacotherapy, Brussels, Belgium
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  • J. P. DESAGER,

    1. Catholic University of Louvain, St-Luc University Hospital, Departments of Hepato-gastroenterology, and Pharmacotherapy, Brussels, Belgium
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  • A. P. GEUBEL

    1. Catholic University of Louvain, St-Luc University Hospital, Departments of Hepato-gastroenterology, and Pharmacotherapy, Brussels, Belgium
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Abstract

Background: Therapeutic trials suggest that lactulose is an effective treatment of acute and chronic encephalopathy in cirrhotic patients.

Aim and Methods: As it is likely that portal-systemic shunting and hepatocellular dysfunction are associated with some degree of neurological dysfunction, 14 patients with cirrhosis and documented portal-systemic shunting, but without detectable encephalopathy, were randomized to treatment with either lactulose 20 g t.d.s., or lactose 20 g t.d.s. as placebo, for a 15-day period. Monitoring included manually administered and computer-based psychometric testing, the results of which were correlated with a battery of biochemical and functional parameters.

Results: There was no correlation between biochemical or functional parameters and psychometric testing. There was a close correlation between the time required to complete the number connection test and both the number of errors and the duration of errors at sinusoid testing. Lactulose therapy resulted in a significant improvement, assessed by the number connection test and the race track test.

Conclusion: Our data suggest that lactulose therapy might improve subclinical hepatic encephalopathy in patients with cirrhosis and portal-systemic shunting.

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