Effectiveness of Combination of Zinc and Lactulose Versus Lactulose Alone to Decrease Recurrence of Hepatic Encephalopathy in Patients With Hepatic CirrhosIS

Abstract

Objective: To determine the effectiveness of combination of Zinc and lactulose with lactulose
alone to decrease recurrence of hepatic encephalopathy in patients with hepatic cirrhosis.
Methods: This Randomized Controlled Trial was conducted in South Medical Ward , Mayo
Hospital, Lahore from 1st July, 2016 to 30th June, 2017. One hundred and two patients of both
sexes were selected using simple random sampling technique. Patients were divided into 2
groups. Group A received Zinc in addition to lactulose and other standard treatment for hepatic
encephalopathy whereas Group B received lactulose and standard treatment. Patients were then
followed up every 4 weeks for six months or early in case of development of any complication.
Results: Out of a total of 102 patients, 73(71.6%) were males and 29 (28.4%) were females.
Mean age of the patients was 51.43±6.63. Out of the 51 patients enrolled in Group A, 16 (15.7%)
developed recurrent hepatic encephalopathy whereas 37 (36.3%) of 51 patients in Group B
developed recurrence during the follow up period. Oral zinc supplementation was significantly
associated with reduction in recurrence of hepatic encephalopathy and showed statistical
significance (p< 0.0001).
Conclusions: Oral zinc supplementation in addition to standard therapy for hepatic
encephalopathy leads to a decrease in its recurrence when compared with standard therapy
alone.