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Efficacy of lactulose in the prophylaxis of hepatic encephalopathy in cirrhotic patients presenting gastrointestinal bleeding.
Rev Assoc Med Bras (1992). 2016 May-Jun; 62(3):243-7.RA

Abstract

INTRODUCTION

Hepatic encephalopathy (HE) is a bad prognostic factor in patients with liver cirrhosis and its incidence is associated with several triggering factors being the most prevalent gastrointestinal bleeding. Lactulose, despite its questionable efficacy in the literature, is considered a first line treatment in patients with HE.

OBJECTIVE

To evaluate the effectiveness of lactulose in preventing HE in cirrhotic patients with gastrointestinal bleeding.

METHOD

A systematic review of the literature using the Medline scientific database. Only randomized controlled clinical trials evaluating the efficacy of lactulose for HE prophylaxis in cirrhotic patients with gastrointestinal bleeding were included.

RESULTS

The incidence of HE in the intervention group was 7%, while the control group was 26% (p=0.01). There was no significant difference in the incidence of mortality in the group treated with lactulose compared to the group that was not treated (p=0.48).

CONCLUSION

Administering lactulose to cirrhotic patients with upper gastrointestinal bleeding reduces the incidence of hepatic encephalopathy.

Authors+Show Affiliations

Hospital Ana Costa, Hospital Ana Costa, General Surgery, Santos SP , Brazil, Medical degree from Faculdade de Ciências Médicas de Santos. Resident Physician in General Surgery at Hospital Ana Costa, Santos, SP, Brazil.Faculdade de Ciências Médicas de Santos, Faculdade de Ciências Médicas de Santos, Santos SP , Brazil, Medical degree from Faculdade de Ciências Médicas de Santos, Santos, SP, Brazil.Associação Médica Brasileira, São Paulo SP , Brazil, PhD from Universidade de São Paulo. Coordinator of the Diretrizes Project, Associação Médica Brasileira and the Conselho Federal de Medicina, São Paulo, SP, Brazil.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

27310548

Citation

Aires, Felipe Toyama, et al. "Efficacy of Lactulose in the Prophylaxis of Hepatic Encephalopathy in Cirrhotic Patients Presenting Gastrointestinal Bleeding." Revista Da Associacao Medica Brasileira (1992), vol. 62, no. 3, 2016, pp. 243-7.
Aires FT, Ramos PT, Bernardo WM. Efficacy of lactulose in the prophylaxis of hepatic encephalopathy in cirrhotic patients presenting gastrointestinal bleeding. Rev Assoc Med Bras (1992). 2016;62(3):243-7.
Aires, F. T., Ramos, P. T., & Bernardo, W. M. (2016). Efficacy of lactulose in the prophylaxis of hepatic encephalopathy in cirrhotic patients presenting gastrointestinal bleeding. Revista Da Associacao Medica Brasileira (1992), 62(3), 243-7. https://doi.org/10.1590/1806-9282.62.03.243
Aires FT, Ramos PT, Bernardo WM. Efficacy of Lactulose in the Prophylaxis of Hepatic Encephalopathy in Cirrhotic Patients Presenting Gastrointestinal Bleeding. Rev Assoc Med Bras (1992). 2016 May-Jun;62(3):243-7. PubMed PMID: 27310548.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of lactulose in the prophylaxis of hepatic encephalopathy in cirrhotic patients presenting gastrointestinal bleeding. AU - Aires,Felipe Toyama, AU - Ramos,Paola Teruya, AU - Bernardo,Wanderley Marques, PY - 2014/10/01/received PY - 2014/10/17/accepted PY - 2016/6/17/entrez PY - 2016/6/17/pubmed PY - 2017/1/5/medline SP - 243 EP - 7 JF - Revista da Associacao Medica Brasileira (1992) JO - Rev Assoc Med Bras (1992) VL - 62 IS - 3 N2 - INTRODUCTION: Hepatic encephalopathy (HE) is a bad prognostic factor in patients with liver cirrhosis and its incidence is associated with several triggering factors being the most prevalent gastrointestinal bleeding. Lactulose, despite its questionable efficacy in the literature, is considered a first line treatment in patients with HE. OBJECTIVE: To evaluate the effectiveness of lactulose in preventing HE in cirrhotic patients with gastrointestinal bleeding. METHOD: A systematic review of the literature using the Medline scientific database. Only randomized controlled clinical trials evaluating the efficacy of lactulose for HE prophylaxis in cirrhotic patients with gastrointestinal bleeding were included. RESULTS: The incidence of HE in the intervention group was 7%, while the control group was 26% (p=0.01). There was no significant difference in the incidence of mortality in the group treated with lactulose compared to the group that was not treated (p=0.48). CONCLUSION: Administering lactulose to cirrhotic patients with upper gastrointestinal bleeding reduces the incidence of hepatic encephalopathy. SN - 1806-9282 UR - https://www.unboundmedicine.com/medline/citation/27310548/Efficacy_of_lactulose_in_the_prophylaxis_of_hepatic_encephalopathy_in_cirrhotic_patients_presenting_gastrointestinal_bleeding_ L2 - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302016000300243&lng=en&nrm=iso&tlng=en DB - PRIME DP - Unbound Medicine ER -