Abstract
Sirs, In his review Bajaj stated, ‘The administration of lactulose while the patient is admitted with HE is associated with improvement’.1 To support his statement, he cited Blanc et al. whose real conclusion of their article was, ‘Lactulose-neomycin combination should not be used in the treatment of acute hepatic encephalopathy’.2 A few lines before, Bajaj indicated that ‘the Cochrane review did not find any significant difference in outcomes in patients treated with and without lactulose’. After more than 30 years of use, lactulose should no longer be part of standard care for a patient with hepatic encephalopathy. Declaration of personal and funding interests: None.
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