Authors: Helen Vidot 1,2,* , Erin Cvejic 3 , Liam J. Finegan 4 , E. Arthur Shores 5 , David G. Bowen 2,6,7 , Simone I. Strasser 6,7, Geoffrey W. McCaughan 2,6,7, Sharon Carey 1 , Margaret Allman-Farinelli 8 and Nicholas A. Shackel 9.
Published: Nutrients. 2019.
The study was conducted in vivo, involving human participants.
Design: A blinded placebo-controlled study.
Treatment: 8 weeks of synbiotics, BCAAs, or a combination of BCAAs and Synbiotics.
Where and when: Australia.
Sample size: Sixty-one participants were enrolled and 49 returned for at least 1 follow-up review were included in the intention to treat analysis.
Sample criteria: Adult patients with hepatic cirrhosis and a history of HE who attended a liver clinic were invited to participate. People with coeliac disease or a history of gluten sensitivity were excluded from the study due to the composition of the synbiotics. Potential participants were excluded if they were currently using a probiotic or if they were taking rifaximin, an antibiotic now widely used in the management of HE or if random blood glucose levels were ≥15mMol/L.
Analysed material: Results were analysed using linear mixed effects regression analyses.
Results
Despite evidence of a placebo effect, there was significant improvement in TMT B and ICT weighted lures in participants who received combined synbiotics/BCAAs treatment compared to placebo at study completion. Cognitive improvement occurred without a significant change in ammonia levels. (s. 1).
There was statistical evidence that the changes over time differed across intervention groups. Compared with the placebo group, the combined synbiotic and BCAA group showed significantly greater improvements at 8 weeks relative to the baseline placebo group. (s. 9).
Indicative results
The study is to its own knowledge the first to report the effects of combined oral supplementation with synbiotics and BCAAs in subjects with decompensated cirrhosis and MHE. The results demonstrate a positive treatment effect with the combined synbiotics and BCAAs. (s 15).
A larger study is recommended to investigate the effects of intervention with synbiotics and BCAAs on both covert and overt HE, these results suggest that oral supplementation with a combination of synbiotics and BCAAs may be an effective additional treatment for individuals with HE. (s 15).
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