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World J Gastroenterol. Jun 14, 2021; 27(22): 3050-3063
Published online Jun 14, 2021. doi: 10.3748/wjg.v27.i22.3050
Current approach to treatment of minimal hepatic encephalopathy in patients with liver cirrhosis
Segundo Moran, Marlene López-Sánchez, María del Pilar Milke-García, Gustavo Rodríguez-Leal
Segundo Moran, Marlene López-Sánchez, Gustavo Rodríguez-Leal, Laboratory of Hepatology Research, Centro Médico Nacional, Siglo XXI, Mexican Institute of Social Security, Mexico City 06720, Mexico
María del Pilar Milke-García, Division of Nutrition, National Institute of Nutrition, Salvador Zubirán, Mexico City 14080, Mexico
Author contributions: Moran S and López-Sánchez M contributed to the conception and design; López-Sánchez M, Moran S, Milke-García MDP, and Rodríguez-Leal G contributed to the analyses and data interpretation; Moran S, López-Sánchez M, and Milke-García MDP drafted the article; Moran S, López-Sánchez M, Milke-García MDP, and Rodríguez-Leal G G contributed to critical revision of the article for important intellectual content; López-Sánchez M, Moran S, Milke-García MDP, and Rodríguez-Leal G contributed to the final version of the article.
Supported by the Mexican Institute of Social Security, No. FFIS/IMSS/PROT/G16/1589; and National Council for Science and Technology (CONACYT), No. SALUD-2014-C01-233823.
Conflict-of-interest statement: The authors have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Segundo Moran, PhD, Doctor, Laboratory of Hepatology Research, Centro Médico Nacional, Siglo XXI, Mexican Institute of Social Security, Cuauhtemoc 330, Mexico City 06720, Mexico. segundomoran@hotmail.com
Received: January 28, 2021
Peer-review started: January 29, 2021
First decision: February 24, 2021
Revised: April 1, 2021
Accepted: April 21, 2021
Article in press: April 21, 2021
Published online: June 14, 2021
Processing time: 130 Days and 10.9 Hours
Core Tip

Core Tip: Minimal hepatic encephalopathy (MHE) is a frequent complication in patients with liver cirrhosis. MHE affects the quality of life and increases the risk of falls and car accidents, worsening patients’ prognoses; however, there is no standard of care. Current alternatives for the management of MHE include measures to maintain the nutritional status while avoiding sarcopenia, manipulation of intestinal microbiota with non-absorbable disaccharides such as lactulose, antibiotics such as rifaximin, and administration of different probiotics. This review analyzes the results of clinical studies that evaluated the effects of different treatments for MHE.