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Probiotics Prevent Deadly Complications of Liver Disease

Bethesda, MD (June 6, 2014) — Probiotics are effective in preventing hepatic encephalopathy in patients with cirrhosis of the liver, according to a new study1 in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastroenterological Association. Hepatic encephalopathy is a deterioration of brain function that is a serious complication of liver disease.

“This rigorous new research finds that probiotics modify the gut microbiota to prevent hepatic encephalopathy in patients with cirrhosis of the liver,” said David W. Victor III, MD, who contributed an editorial2 in Clinical Gastroenterology and Hepatology on this research. “These results offer a safe, well-tolerated and perhaps cheaper alternative to current treatments.”

Investigators from Govind Ballabh Pant Hospital, New Delhi, India, conducted a single-center, prospective, open-label, randomized trial with cirrhosis patients who showed risk factors for hepatic encephalopathy, but had yet to experience an obvious episode. When comparing treatment with probiotics versus placebo, the researchers found that the incidence of hepatic encephalopathy was lower in patients treated with probiotics.

Probiotic supplementation was not associated with any side effects and none of the patients required discontinuation of therapy. These results suggest that probiotics are similar in effectiveness to the current standard of care, lactulose, in the prevention of hepatic encephalopathy, yet they appear to be much better tolerated. The effectiveness of lactulose, a nonabsorbable disaccharide, is limited by side effects (diarrhea, bloating and gas) and a narrow therapeutic window.

“By virtue of its size, study duration and design, as well as the thorough nature of the baseline and follow-up assessments, this study represents an important contribution to the hepatic encephalopathy literature,” added Dr. Victor, a practicing hepatologist in the Methodist J.C. Walter Jr. Transplant Center at Houston Methodist Hospital, TX.

Up to 45 percent of patients with cirrhosis develop hepatic encephalopathy, a loss of brain function that occurs when the liver is unable to remove toxins from the blood. Prognosis is poor, with a 58 percent mortality rate at one year, and a 77 percent mortality rate at three years. Research into safer and more effective treatments is essential for these patients.

For more information on probiotics, read AGA’s patient brochure.

The microbial communities that reside in the human gut and their impact on human health and disease are one of the most exciting and promising areas of research today. The AGA Center for Gut Microbiome Research and Education is committed to advancing this research.

1Lunia, MK. Probiotics Prevent Hepatic Encephalopathy in Patients With Cirrhosis: A Randomized Controlled Trial. Clin Gastroenterol Hepatol 2014;12(6):1003–1008.e1
2Victor, DW. Hepatic Encephalopathy Involves Interactions Among the Microbiota, Gut, Brain. Clin Gastroenterol Hepatol 2014: 12(6): 1009-1011

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The American Gastroenterological Association is the trusted voice of the GI community. Founded in 1897, the AGA has grown to include 17,000 members from around the globe who are involved in all aspects of the science, practice and advancement of gastroenterology. The AGA Institute administers the practice, research and educational programs of the organization. www.gastro.org.
 

About Clinical Gastroenterology and Hepatology

The mission of Clinical Gastroenterology and Hepatology is to provide readers with a broad spectrum of themes in clinical gastroenterology and hepatology. This monthly peer-reviewed journal includes original articles as well as scholarly reviews, with the goal that all articles published will be immediately relevant to the practice of gastroenterology and hepatology. For more information, visit www.cghjournal.org.
 
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