Probiotic Yogurt for the Treatment of Minimal Hepatic Encephalopathy

[Guest guest]

http://www.ingentaconnect.com/content/bsc/ajg/2008/00000103/00000007/art00021;jsessionid=mg1swfpq5drt.victoria

Probiotic Yogurt for the Treatment of Minimal Hepatic Encephalopathy

Authors: Bajaj, Jasmohan S.1; Saeian, Kia1; Christensen, M.1; Hafeezullah, Muhammad1; Varma, Rajiv R.1; Franco, 1; Pleuss, Joan A.2; Krakower, Glenn2; Hoffmann, G.3; Binion, G.1

Source: The American Journal of Gastroenterology, Volume 103, Number 7, July 2008 , pp. 1707-1715(9)

Publisher: Blackwell Publishing

Abstract:

OBJECTIVES: Minimal hepatic encephalopathy (MHE), the preclinical stage of overt hepatic encephalopathy (OHE), is a significant condition affecting up to 60% of cirrhotics. All MHE therapies modify gut microflora, but consensus regarding MHE treatment and long-term adherence studies is lacking. The aim was to determine the effect of probiotic supplementation in the form of a food item, probiotic yogurt, on MHE reversal and adherence. METHODS: Nonalcoholic MHE cirrhotics (defined by a standard psychometric battery ) were randomized with unblinded allocation to receive probiotic yogurt (with proven culture stability) or no treatment (no Rx) for 60 days in a 2:1 ratio. Quality of life (short form [sF]-36), adherence, venous ammonia, model of end-stage liver disease (MELD) scores, and inflammatory markers (tumor necrosis factor [TNF]-α, interleukin [iL]-6) were also measured. Outcomes were MHE reversal using blinded scoring, OHE development, and adherence. RESULTS: Twenty-five patients (17 yogurt, 8 no Rx; 84% Child class A) were enrolled. A significantly higher percentage of yogurt patients reversed MHE compared to no Rx patients (71%vs 0%, P= 0.003, intention-to-treat). Yogurt patients demonstrated a significant improvement in number connection test-A (NCT-A), block design test (BDT), and digit symbol test (DST) compared to baseline/no Rx group. Twenty-five percent of no Rx versus 0% of yogurt patients developed OHE during the trial. Eighty-eight percent of yogurt patients were adherent. No adverse effects or change in covariates were observed. All patients who completed the yogurt arm were agreeable to continue yogurt for 6 months if needed. CONCLUSIONS: This trial demonstrated a significant rate of MHE reversal and excellent adherence in cirrhotics after probiotic yogurt supplementation with potential for long-term adherence. (Am J Gastroenterol 2008;103:1707-1715)

Document Type: Research article

DOI: 10.1111/j.1572-0241.2008.01861.x

Affiliations: 1: Division of Gastroenterology and Hepatology 2: General Clinical Research Center 3: Department of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin

[Guest guest]

Well, there's another plus for probiotics. I wonder if I should up mine. I'm getting 250M CFU each of Bifidobacterium longum and Lactobacillus acidophilus. VSL-3 has 250 billion/packet.

While looking for the definition of CFU (colony forming units), I stumbled across this article:

http://gut.bmj.com/cgi/content/abstract/53/1/108

Once daily high dose probiotic therapy (VSL#3) for maintaining remission in recurrent or refractory pouchitis

T Mimura1, F Rizzello2, U Helwig2, G Poggioli2, S Schreiber3, I C Talbot1, R J Nicholls1, P Gionchetti2, M Campieri2, M A Kamm1

Conclusion: The once daily high dose probiotic VSL#3 is effective in maintaining antibiotic introduced remission for at least a year in patients with recurrent or refractory pouchitis. This is associated with a high level of quality of life.

I suspect it's been mentioned here before (sorry.

Arne

57 - UC 1977 - PSC 2000

Alive and well in Minnesota

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http://www.ingentaconnect.com/content/bsc/ajg/2008/00000103/00000007/art00021;jsessionid=mg1swfpq5drt.victoria

....CONCLUSIONS: This trial demonstrated a significant rate of MHE reversal and excellent adherence in cirrhotics after probiotic yogurt supplementation with potential for long-term adherence...