High Protein Diet Versus Normal Protein Diet in Treating Patients With Minimal Hepatic Encephalopathy
High Protein Diet Versus Normal Protein Diet in Treating Patients With Minimal Hepatic Encephalopathy
A total of 80 patients diagnosed with liver cirrhosis and minimal hepatic encephalopathy will
 be recruited. They will be randomized to receive high protein diet ( n = 40) and a normal
 protein diet ( n = 40 ) during one month. Randomization will be conducted by an external
 monitor and will keep the secret codes until the end of the study. All patients will be
 provided with structured menus and two snacks a day as an amaranth protein supplement. The
 supplement will content the same amount of fiber but the protein content will vary depending
 on the group to which the patient is assigned.
The protein in the diet is a major source of ammonia in blood, which is considered one of the
 factors involved in the pathogenesis of hepatic encephalopathy. However ; it is also known
 than the restriction on the consumption of protein predisposes to depletion of muscle mass,
 and increase the risk to develop overt hepatic encephalopathy, due to the muscle role in the
 detoxification of ammonia in presence of liver failure. Currently, the type and amount of
 protein in the diet to treat minimal hepatic encephalopathy (MHE) is unknown. In this study,
 the investigators will administrated two types of protein content in patients with MHE: a
 high protein diet (1.5 g/kg/day) vs a normal protein diet (0.8 g/kg/day) during 1 month.
Inclusion Criteria:

 -  Diagnosis of cirrhosis of any etiology

 -  Men and women between 18 and 70 years.

 -  Right-holders of the Mexican Social Security Institute

 -  Patients who agree to participate in the study and signed the informed consent

 Exclusion Criteria:

 -  Recent history of alcohol abuse and/or drugs (less than 6 weeks).

 -  Illiterate

 -  Alcoholic cirrhosis

 -  History and/or diagnosis of overt hepatic encephalopathy

 -  Consumption of psychotropic medications (benzodiazepines, antiepileptics)

 -  Patients under treatment with lactulose, lacitol, rifaximin, neomycin, metronidazole
 and/or fiber supplements.

 -  History of chronic renal disease or heart failure

 -  Patients with gastrointestinal bleeding

 -  History of neurological or psychiatric disorders that affect the ability to develop
 neuropsychological tests

 -  Diagnosis of bacterial overgrowth

 -  Diagnosis of liver cancer

 -  Patients with ophthalmologic disorders