Sapporo Medical Journal

Abstract : Background: Hepatic encephalopathy HE is a neuropsychological disorder in patient with advanced liver disease. The ammonia has a critical role in HE pathogenesis. The aim: to evaluate efficacy and safety of sodium benzoate (SB) as a cheap adjunctive agent that can be used in addition to rifaximin or lactulose for the treatment of HE. Methods: This study included 90 patients of overt HE in 3 groups: Group A (30 patients received oral sodium benzoate capsule and lactulose), group B (30 patients received oral sodium benzoate capsules and rifaximin, and group C (30 patients (control group) received lactulose and rifaximin). Each group was subjected to clinical examination, and laboratory investigations. The three groups evaluated before and after treatment for clinical response using West Haven Criteria classification of HE, Clinical Hepatic Encephalopathy Staging Scale (CHESS) score and psychometric tests. Results: There was statistically significant difference in WHC grades of HE, CHESS score of HE, and psychometric tests before and after treatment in each group (P < 0.05). There was no statistically significant difference in the overall improvement between the three studied groups after the treatment regarding WHC grades, CHESS score and psychometric tests. No reported significant adverse events. Conclusion: Adding SB to either lactulose or rifaximin in the treatment of HE is clinically equivalent to lactulose and rifaximin combination. This finding highlights the therapeutic