Rifaximin As an Alternative Treatment for Patients with Hepatic Encephalopathy

Liver cirrhosis is the final stage of progressive chronic liver pathologies. This is a histopathological alteration of the liver characterized by the loss of the hepatic parenchyma, thus generating the formation of fibrous septa and structurally abnormal regeneration nodules, resulting in a distortion of the normal hepatic architecture and an alteration of the anatomy of the hepatic vascularization and microcirculation. Currently for the treatment of liver cirrhosis and its complications, there are different drugs of which the main ones are lactulose, L-ornithine, L-aspartate (LOLA) and certain antibiotics, especially rifaximin. Methodology: a bibliographic search was carried out in databases, selecting original articles, case reports and bibliographic reviews from 2009 to 2021, using the documents that deal with rifaximin as an alternative treatment for hepatic encephalopathy, obtaining 21 articles for the preparation of this document. Results: In a 2015 meta-analysis, a significant comparison was made in the use of rifaximin and some other treatments for HD, where it was evidenced that rifaximin has a greater reduction in plasma ammonium levels (the cause of this complication), likewise, several studies have been conducted comparing rifaximin with placebo, other antibiotics and non- absorbable disaccharide laxatives. Conclusion: rifaximin is a dominant alternative in the treatment of acute episodes of hepatic encephalopathy and to prevent relapses.