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For decades, lactulose, a non-absorbable disaccharide, has been considered to be the standard-of-care, first-line therapy for acute (overt) hepatic encephalopathy. Hepatic encephalopathy (HE), a complication of decompensated liver cirrhosis, represents a spectrum of clinical manifestations ranging from mild neuropsychiatric changes to coma and is a common indication for hospital admission.

Is It Time to Rethink Lactulose for the Treatment of Acute Hepatic Encephalopathy?