Bifidobacterium longum with Fructo-Oligosaccharide (FOS) Treatment in Minimal Hepatic Encephalopathy: A Randomized, Double-Blind, Placebo-Controlled Study
- 28 March 2007
- journal article
- research article
- Published by Springer Science and Business Media LLC in Digestive Diseases and Sciences
- Vol. 52 (11), 3259-3265
- https://doi.org/10.1007/s10620-006-9687-y
Abstract
Minimal hepatic encephalopathy (MHE) describes patients with chronic liver disease or cirrhosis who have no clinical symptoms of brain dysfunction but perform worse on psychometric tests compared with healthy subjects. The pathogenesis of hepatic encephalopathy is controversial although ammonia has been found to induce cerebral dysfunction. Increased intestinal ammonia production is due to bacterial urease activity and the production of other toxin methabolities, such as mercaptans, thioles. This study assesses the clinical efficacy of Bifidobacterium longum plus fructo-oligosaccharides (FOS) in the treatment of MHE. A total of 60 cirrhotic patients were randomly and equally divided into two groups receiving Bifidobacterium+FOS (17 males, 13 females; mean age, 46±11 years) or placebo (16 males, 14 females; mean age, 45±12 years), respectively. All patients underwent clinical and laboratory assessment psychometric tests and automated EEG analysis: neurophysiological assessment, liver function assessment, amd neuropsychological assessment. After 90 days of treatment, fasting NH4 serum levels were significantly decreased (P=0.003), performance on Trail Making Test-A was significantly decreased (P=0.000), performance on Trail Making Test-B was significantly decreased (P=0.000), performance on the symbol digit modalities test was significantly improved (PP=0.000), and performance on the MMSE test was significantly improved (P=0.000). We conclude that the improvement in biochemical and neuropsychological tests of the group treated with Bifidobacterium longum+FOS are interesting and merit further, close examination.Keywords
This publication has 25 references indexed in Scilit:
- Synbiotic modulation of gut flora: Effect on minimal hepatic encephalopathy in patients with cirrhosisHepatology, 2004
- Hepatic encephalopathy-definition, nomenclature, diagnosis, and quantification: Final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998Hepatology, 2002
- Hepatic encephalopathyThe American Journal of Gastroenterology, 2001
- Diagnosis of EncephalopathyDigestion, 1998
- Regulatory effects of bifidobacteria on the growth of other colonic bacteriaJournal of Applied Bacteriology, 1994
- Effects of the in vitro fermentation of oligofructose and inulin by bacteria growing in the human large intestineJournal of Applied Bacteriology, 1993
- Neurophysiological assessment of early hepatic encephalopathyElectroencephalography and Clinical Neurophysiology, 1990
- Trailmaking and number-connection tests in the assessment of mental state in portal systemic encephalopathyDigestive Diseases and Sciences, 1977
- “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinicianJournal of Psychiatric Research, 1975
- Transection of the oesophagus for bleeding oesophageal varicesBritish Journal of Surgery, 1973