Clinical

Probiotic yogurt may help reverse minimal hepatic encephalopathy

Last Updated: 2008-08-11 11:34:41 -0400 (Reuters Health)

NEW YORK (Reuters Health) - In cirrhotic patients, minimal hepatic encephalopathy may be ameliorated with probiotic yogurt supplementation, results of a study published in the July issue of the American Journal of Gastroenterology indicate.

"Minimal hepatic encephalopathy (MHE), the preclinical stage of overt hepatic encephalopathy (OHE), is a significant condition affecting up to 60% of cirrhotics," write Dr. Jasmohan S. Bajaj and colleagues from Medical College of Wisconsin, Milwaukee. "All MHE therapies modify gut microflora, but consensus regarding MHE treatment and long-term adherence studies is lacking."

In a prospective, randomized study, the researchers examined the effect of a probiotic yogurt on reversal of MHE and adherence in nonalcoholic cirrhotic patients. The subjects were randomly assigned to receive probiotic yogurt or no treatment for 60 days.

A total of 25 patients were enrolled in the study (17 yogurt, 8 no treatment). The researchers report that 12 yogurt patients (71%) and zero no-treatment patients (0%) reversed MHE (p = 0.0030, intention-to-treat).

Development of OHE was observed in 25% of patients in the no-treatment group and 0% of those in the yogurt group.

"The mechanism of probiotic action is believed to be related to substrate deprivation for potentially pathogenic bacteria and the provision of fermentation end products as a substrate for potentially beneficial ones," Dr. Bajaj and colleagues explain.

Overall, 88% of subjects in the yogurt group were adherent. No adverse effects were observed. All of the patients who completed the yogurt arm during the study were agreeable to continue yogurt if the study was extended for 6 more months.

Am J Gastroenterol 2008;103:1707-1715.