PEG solution therapy in treating acute hepatic encephalopathy

Scientists from Baylor University Medical Center pointed out, the common drugs used to clean the patient’s intestines before a colonoscopy will be the standard treatment for patients with acute hepatic encephalopathy(HE) in the future. HE has affected half the liver cirrhosis patients for a neurological disorder. Related research was published in the international journal JAMA Internal Medicine.

Dr. Robert Rahimi said that in this study, we compared the current HE therapy-lactulose therapy with polyethylene glycol 3350 electrolyte solution(PEG)therapy. It is an oral medicine used for intestinal cleansing of patients before colonoscopy. Since the 1960s, lactulose therapy has been recognized as the standard therapy for the treatment of patients’ diseases.

The researchers divided 50 patients suffering from acute hepatic encephalopathy into two groups, 25 people in each group. One group received standard lactulose therapy and the other group received new PEG solution therapy. The results showed that compared with patients undergoing lactulose therapy (52%), a patient’s symptoms in the PEG group were significantly improved (92%). And there were no case reports of side effects in patients in the PEG group; besides, the hospitalization period of patients receiving PEG therapy was shorter than that in the lactulose group.

Researcher Rahimi said that the average treatment period for hospitalization for acute hepatic encephalopathy is 5 days, and PEG solution therapy can significantly relieve symptoms in a day. Thus significantly reducing the length of hospital stay and the financial burden of patients. The incidence of acute hepatic encephalopathy in patients with liver cirrhosis is as high as 45%, and patients often need to be admitted to the hospital for treatment.

The lactulose in the current lactulose therapy is a laxative, which has been used in the treatment of hepatic encephalopathy for nearly 50 years. For many years, hepatologists speculated that lactulose might alleviate the symptoms of hepatic encephalopathy by preventing ammonia from getting into the bloodstream by converting ammonia into ammonium. In this study, the researchers pointed out that PEG solution therapy may become the standard therapy for acute hepatic encephalopathy in the past few years. However, more research is still needed to clarify the safety and effectiveness of PEG solution therapy.


Lactulose vs Polyethylene Glycol 3350-Electrolyte Solution for Treatment of Overt Hepatic Encephalopathy The HELP Randomized Clinical Trial