+1 Recommend
0 collections
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Comparative Effectiveness and Safety of Polyethylene Glycol Electrolyte Solution Versus Lactulose for Treatment of Hepatic Encephalopathy : A Systematic Review and Meta-analysis


      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.


          Supplemental Digital Content is available in the text.


          Hepatic encephalopathy (HE) is a complex neuropsychiatric syndrome associated with liver failure and/or portal systemic shunting. Polyethylene glycol (PEG) electrolyte solution is a commonly used for catharsis of gut, which has been demonstrated to relieve HE in a number of randomized controlled trials. The aim of this paper was to evaluate the comparative efficacy and safety of PEG with lactulose for current HE treatment.


          PEG electrolyte solution versus lactulose of HE was deeply studied by conducting a systematic search in electronic databases and other sources until December 31, 2020. The PRISMA statement recommended the use of meta-analysis with 95% confidence interval (CI), relative risk (RR), and weighted mean deviation (WMD) as the estimated effect size. A sensitivity analysis was performed comprehensively to present the risk of bias and the source of heterogeneity.


          A total of 434 patients were involved in 7 randomized studies. It is found that there was a significant advantage of PEG therapy in the increase of clinical efficacy (RR=1.46; 95% CI: 1.26-1.68; P=0.000; I 2=0.0%) and the decrease of hospital stay (WMD=−1.78; 95% CI: −2.72 to 0.85; P=0.000; I 2 =90.1%). There was no significant difference in the incidence of adverse events (RR=0.75; 95% CI: 0.48-1.19; P=0.222>0.05; I 2 =7.2%) and the level of serum ammonia (WMD=9.02; 95% CI: −14.39 to 32.43; P=0.45>0.05; I 2 =84.9%) after 24 hours between the 2 groups.


          The results prove that PEG has a beneficial effect on the treatment of HE. Compared with lactulose, PEG can lead to more rapid HE resolution during the first 24 hours and shorten the length of stay without increasing the rate of adverse effects.

          Related collections

          Most cited references28

          • Record: found
          • Abstract: found
          • Article: not found

          Alterations of the human gut microbiome in liver cirrhosis.

          Liver cirrhosis occurs as a consequence of many chronic liver diseases that are prevalent worldwide. Here we characterize the gut microbiome in liver cirrhosis by comparing 98 patients and 83 healthy control individuals. We build a reference gene set for the cohort containing 2.69 million genes, 36.1% of which are novel. Quantitative metagenomics reveals 75,245 genes that differ in abundance between the patients and healthy individuals (false discovery rate < 0.0001) and can be grouped into 66 clusters representing cognate bacterial species; 28 are enriched in patients and 38 in control individuals. Most (54%) of the patient-enriched, taxonomically assigned species are of buccal origin, suggesting an invasion of the gut from the mouth in liver cirrhosis. Biomarkers specific to liver cirrhosis at gene and function levels are revealed by a comparison with those for type 2 diabetes and inflammatory bowel disease. On the basis of only 15 biomarkers, a highly accurate patient discrimination index is created and validated on an independent cohort. Thus microbiota-targeted biomarkers may be a powerful tool for diagnosis of different diseases.
            • Record: found
            • Abstract: found
            • Article: not found

            Probiotic VSL#3 reduces liver disease severity and hospitalization in patients with cirrhosis: a randomized, controlled trial.

            Little is known about whether probiotics can affect outcomes of patients with cirrhosis and hepatic encephalopathy (HE). We assessed the efficacy of a probiotic preparation in preventing the recurrence of HE (primary outcome) and reducing the number of hospitalizations and severity of liver disease in patients with cirrhosis.
              • Record: found
              • Abstract: found
              • Article: not found

              Correlation between ammonia levels and the severity of hepatic encephalopathy

              The American Journal of Medicine, 114(3), 188-193

                Author and article information

                J Clin Gastroenterol
                J Clin Gastroenterol
                Journal of Clinical Gastroenterology
                Lippincott Williams & Wilkins
                January 2022
                4 November 2021
                : 56
                : 1
                : 41-48
                [* ]Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning
                []Department of Gastroenterology, Liuzhou Traditional Chinese Medical Hospital, Liuzhou, China
                Author notes
                Address correspondence to: Jiean Huang, PhD, Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, 166 Daxue East Road, Nannning 530007, Guangxi, China (e-mail: hjagxmu@ 123456163.com ).
                Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/

                Clinical Reviews
                Custom metadata

                polyethylene glycol electrolyte solution,peg,lactulose,he,meta-analysis


                Comment on this article