Synbiotic modulation of gut flora improves minimal hepatic encephalopathy in cirrhoti...( able fiber showed a reversal of MHE co...),Health

Both treatments appeared to have significantly altered the cirrhotic patients' gut flora. At the outset of the study, the cirrhotic patients with MHE were found to have significant fecal overgrowths of E. Coli and Staphylococcus. Treatment with the synbiotic preparation reduced these levels to those of the healthy controls, while counts of non-urease producing Lactobacillus were significantly increased. Treatment with fermentable fiber alone increased non-urease producing Bifidobacterium spp and significantly reduced overgrowths of E. Coli and Fusobacterium spp. Treatment with the placebo did not alter the counts of any of the gut flora assessed.

"Our study is the first to examine the impact of synbiotics and fermentable fiber alone on MHE and other aspects of hepatic function in patients with cirrhosis," the authors report. "We conclude that treatment with synbiotics or fermentable fiber alone is an alternative to use of non-absorbable disaccharides, such as lactulose, for the management of MHE in patients with cirrhosis. Significant reductions in viable counts of potentially pathogenic gut flora occur with both treatments."

In an accompanying editorial in the same issue of Hepatology, Drs. Steven F. Solga and Anna Mae Diehl of Johns Hopkins University discuss the "impressive and exciting improvements in HE with both synbiotic therapy and fiber alone." They note that it is even more exciting that altering the gut flora may improve not only HE but also liver disease.

The researchers "have made a major contribution to the application to gut flora therapy to humans with liver disease," they write. "We expect this research to stimulate further int
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Contact: David Greenberg
dgreenbe@wiley.com
201-748-6484
John Wiley & Sons, Inc.
13-May-2004