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Updates on the pathophysiology and therapeutic targets for hepatic encephalopathy

Alsahhar, Jamil S.; Rahimi, Robert S.

Current Opinion in Gastroenterology: May 2019 - Volume 35 - Issue 3 - p 145–154
doi: 10.1097/MOG.0000000000000527
LIVER: Edited by Don C. Rockey

Purpose of review Hepatic encephalopathy is one of the most debilitating clinical manifestations of cirrhosis and associated with increased morbidity and mortality. Treatment modalities available include the nonabsorbable disaccharides (lactulose) and the nonabsorbable antibiotics (rifaximin).

Recent findings Newer therapeutic targets under evaluation include ammonia scavengers (ornithine phenylacetate) and modulation of gut microbiota (fecal microbiota transplantation).

Summary This review will focus on the pathophysiology of hepatic encephalopathy along with an update on therapeutic targets under investigation.

Division of Hepatology, Baylor University Medical Center, Dallas, USA

Correspondence to Robert S. Rahimi, MD, Division of Hepatology, Baylor University Medical Center, 3410 Worth St. Suite #860, Dallas, TX 75246, USA. Tel: +1 214 820 8500; e-mail:

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