LACTULOSE IMPROVES PSYCHOMETRIC TESTING IN CIRRHOTIC-PATIENTS WITH SUBCLINICAL ENCEPHALOPATHY

Background: Therapeutic trials suggest that lactulose is an effective treatment of acute and chronic encephalopathy in cirrhotic patients. A im and Methods: As it is likely that portal-systemic shunting and hepa tocellular dysfunction are associated with some degree of neurological dysfunction, 14 patients with cirrhosis and documented portal-systemi c shunting, but without detectable encephalopathy, were randomized to treatment with either lactulose 20 g t.d.s., or lactose 20 g t.d.s. as placebo, for a 15-day period. Monitoring included manually administer ed and computer-based psychometric testing, the results of which were correlated with a battery of biochemical and functional parameters. Re sults: There was no correlation between biochemical or functional para meters and psychometric testing. There was a close correlation between the time required to complete the number connection test and both the number of errors and the duration of errors at sinusoid testing. Lact ulose therapy resulted in a significant improvement, assessed by the n umber connection test and the race track test, Conclusion: Our data su ggest that lactulose therapy might improve subclinical hepatic encepha lopathy in patients with cirrhosis and portal-systemic shunting.