Comparing Probiotics Plus Lactulose with Lactulose Alone in Treatment of Overt Hepatic Encephalopathy: Probiotics Plus Lactulose with Lactulose in Treatment of Overt Hepatic Encephalopathy

Omer Hassaan Aftab Ahmad; Amat Amtul Hafeez; Aiman Asif; Ammarah Amjad; Mehwish Tayyab; Sidra Mumal; Mashhood Ali

doi:10.54393/pjhs.v6i6.2871

Authors

Omer Hassaan Aftab Ahmad Department of Gastroenterology and Hepatology, Omer Diagnostics and Specialists Clinics, Islamabad, Pakistan
Amat Amtul Hafeez Department of Pharmacology, Narowal Medical College, Narowal, Pakistan
Aiman Asif Muhammad Islam Medical and Dental College, Islamabad, Pakistan
Ammarah Amjad Department of Pharmacology, Hazrat Bari Imam Sarkar Medical and Dental College, Islamabad, Pakistan
Mehwish Tayyab Department of Pharmacology, Hazrat Bari Imam Sarkar Medical and Dental College, Islamabad, Pakistan
Sidra Mumal Department of Pharmacology, Islamic International Medical College, Riphah University, Rawalpindi, Pakistan
Mashhood Ali Pakistan Institute of Medical Sciences, Islamabad, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i6.2871

Keywords:

Ammonia, Hepatic Encephalopathy, Lactulose, Liver Cirrhosis

Abstract

A neuropsychiatric condition known as hepatic encephalopathy (HE) is brought on by liver malfunction, which accumulates poisons like ammonia and impairs brain activity. Objectives: To compare the viability of combining probiotics with lactulose versus utilizing lactulose alone within the treatment of obvious hepatic encephalopathy. Methods: This quasi-experimental study took place in the Gastroenterology and Hepatology Department at the Pakistan Institute of Medical Sciences in Islamabad from August 2019 to January 2020. A total of 160 patients diagnosed with overt HE were included and divided into two groups. Group A received a combination of probiotics and lactulose, while Group B received lactulose alone. Treatment outcomes were evaluated over six months based on improvement in HE symptoms, Model for End-Stage Liver Disease (MELD) scores, length of hospital stay, and potential precipitating factors. Results: The mean age of participants was 44.08 ± 11.31 years. Group A comprised 64 males (80%) and 16 females (20%), while Group B had 30 male (37.5%) and 50 female (62.5%). The MELD scores were comparable between groups (p=0.648). However, the mean hospital stay was significantly shorter in Group A (2.34 ± 0.56 days) than in Group B (2.42 ± 0.63 days; p<0.05), indicating enhanced recovery in the combination therapy group. Conclusions: The addition of probiotics to lactulose significantly improves clinical outcomes in patients with overt hepatic encephalopathy by reducing hospital stay and enhancing treatment efficacy.

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