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Gastroenterol Hepatol. 2008 Jun;20(6):506-11. doi:
10.1097/MEG.0b013e3282f3e6f5.   Author information    •
Departments of aGastroenterology bNeurology, G.B. Pant Hospital,
New Delhi, India.    Minimal hepatic encephalopathy (MHE) is
associated with poor quality of life and increased work
disability. Treatment with lactulose and probiotics has shown
some benefit. We compared lactulose with probiotics and a
combination of lactulose plus probiotics in the treatment of
MHE.   One hundred and ninety cirrhotic patients without overt
encephalopathy [Child's A grade 71 patients (37.4%), Child's B
grade 72 patients (37.9%), Child's C grade 47 patients (24.7%)]
were evaluated by psychometry (number connection tests A and B
or figure connection tests A and B) and P300 auditory event-
related potential (P300ERP). MHE was diagnosed by abnormal
psychometry and/or P300ERP. Patients were randomized to receive
lactulose [group A (n=35): dose 30-60 ml/day], probiotics [grou