From the Research
Treatment for Hepatic Encephalopathy without Hyperammonemia
There are no research papers to assist in answering this question, as all the provided studies focus on the treatment of hepatic encephalopathy with hyperammonemia.
Available Treatments for Hepatic Encephalopathy with Hyperammonemia
- Lactulose, a nonabsorbable disaccharide, is considered the first-line therapeutic agent for treating hepatic encephalopathy 1
- Rifaximin, a semisynthetic, nonsystemic antibiotic, has been approved for the treatment of overt hepatic encephalopathy and has been found to be equal or superior to lactulose in some studies 1
- Probiotics that improve gut flora have also been administered to treat hepatic encephalopathy 2
- Ammonia scavengers such as AST-120, glycerol phenylbutyrate, sodium phenylacetate or sodium benzoate, and ornithine phenylacetate have been used to improve HE symptoms 3
- Bowel cleansing with polyethylene glycol 3350 appears to be a promising therapy, with a recent study demonstrating a more rapid improvement in overt HE than lactulose 3
Mechanisms of Action
- Inhibiting ammonia production and/or increasing ammonia removal are the primary strategies for treating hepatic encephalopathy 4
- Targeting the gut has been the primary focus for many years, with the goal of inhibiting the generation of ammonia 4
- Extrahepatic organs containing ammonia metabolic pathways have become new potential ammonia-lowering targets 4