Comparison of probiotics to lactulose for minimal hepatic encephalopathy in patients with cirrhosis: a meta-analysis of randomized controlled trials

This meta-analysis found no evidence that probiotics are superior or inferior to lactulose in terms of MHE reversal, prevention of OHE, and reduction of serum ammonia levels. Probiotics were associated with fewer AEs, suggesting a potential safety advantage. Further large-scale, high-quality RCTs are warranted to confirm these findings.