Primary Prophylaxis of Hepatic Encephalopathy in Patients With Cirrhosis
Primary Prophylaxis of Hepatic Encephalopathy in Patients With Cirrhosis
To assess the effects of lactulose for the prevention of first episode of altered sensorium
 (hepatic encephalopathy, primary prophylaxis) in patients with cirrhosis.
Development of hepatic encephalopathy in a patient with cirrhosis is associated with poor
 survival rate of 10-70% at one year depending upon hepatic and renal functions. Treating
 patients to prevent development of first episode of hepatic encephalopathy is classified as
 primary prophylaxis of hepatic encephalopathy and preventing recurrence of hepatic
 encephalopathy in patients who had previous episode of hepatic encephalopathy is secondary
 prophylaxis of hepatic encephalopathy
Inclusion Criteria:

 -  cirrhotic patients(18-70yrs) who never had encephalopathy

 Exclusion Criteria:

 -  history of taking lactulose in the past 6 weeks

 -  alcohol intake during the past 6 weeks

 -  hepatocellular carcinoma

 -  previous TIPS or shunt surgery

 -  significant co morbid illness such as heart, respiratory, or renal failure

 -  neurologic diseases such as alzheimer's disease, parkinson's disease and nonhepatic
 metabolic encephalopathies.

 -  patients on psychoactive drugs such as antidepressants or sedatives

 -  who restarted alcohol during follow up