Rationale | Controlled studies | |
vs lactulose | vs placebo | |
Ammonia hypothesis | ||
Decrease in ammoniagenic substrates | ||
Enemas with lactulose | + | |
Restriction of dietary protein intake | ? | |
Inhibition of ammonia production | ||
Antibiotics | ||
Neomycin, paromomycin, metronidazole | = | ND |
Rifaximin | = | + |
Vancomycin | =/+ | ND |
Disaccharides | ||
Lactulose | ? | |
Lactitol | = | ND |
Lactose in lactase deficiency | + | |
Modification of colonic flora | ||
Lactobacillus SF 68 | = | ND |
Correction of hypokalemia | ND | ND |
Metabolic ammonia removal | ||
Ornithine-aspartate | + | |
Benzoate | = | ND |
False neurotransmitter hypothesis | ||
Branched chain amino acid supplementation | ||
Modified amino acid solutions (FO80 type) | = | ± |
"COMA" solutions | ND | ND |
Dietary BCAA supplementation | + | |
Increased dopamine | ||
L-DOPA, bromocriptine | - | |
GABA hypothesis | ||
Flumazenil | + | |
Other | ||
Zinc | ± |
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