English

Abstract

Background: Hepatic encephalopathy is one of the fatal complications of livercirrhosis in clinical setting. A number of drugs with varied response have been tried up till now.Objectives: To compare the efficacy of lactulsoe alone and in combination with rifaxamin incases with hepatic encephalopathy. Study Design: Randomized control trail. Setting: SheikhZayed Hospital (SZH) Rahim Yar Khan (RYK). Period: January 2015 to October 2015. Patientsand Methods: 120 cases of liver cirrhosis with encephalopathy were randomized into differentgrades according to West Haven’s criteria. These cases were then equally divided into group Aand B. Group A was treated with lactulose alone while group B was treated with lactulose plusrifaxamin with their standard doses. The cases were assessed for their improvement in symptomson West Haven’s scale and the cases with complete resolution of symptoms were labeled ascured. The mortality benefit was also noted. Results: The mean age was 43.24± 8.34 yearsand mean duration of symptoms was 3.45± 0.8 days. There was no significant difference interms of child pugh score in both groups with p= 0.69. There was also no significant differencein both groups in terms of grades of encephalopathy (p= 0.21). However there was significantbetter efficacy and decreased mortality in group B as compared to A with p values of 0.02 and0.03 respectively. Conclusion: Lactulose combined with rifaxamin has significant improvementin encephalopathy as well as in reducing mortality in comparison with lactulsoe alone