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Comment & Response |

Lactulose vs Polyethylene Glycol for Treatment of Hepatic Encephalopathy

Elliot B. Tapper, MD1
[+] Author Affiliations
1Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2015;175(5):867. doi:10.1001/jamainternmed.2015.0331.
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To the Editor Rahimi and colleagues1 should be congratulated on their trial. Hepatic encephalopathy is a costly, morbid condition, and they have advanced the current knowledge of its inpatient management.2 Timely resolution of altered sensorium is likely crucial for the prevention of nosocomial complications, containment of health care costs, and the return of patients with a debilitating condition to their functionality and a home discharge. Furthermore, these data seem to suggest that strictly osmotic laxatives are a preferable alternative for patients long displeased with nonabsorbable disaccharides such as lactulose. The implications of these findings for future research, however, should be evaluated in the context of the study design.


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May 1, 2015
Todd Cutler, MD; Gregory Mints, MD
1Department of Medicine, Weill Cornell Medical Center, New York, New York
JAMA Intern Med. 2015;175(5):867-869. doi:10.1001/jamainternmed.2015.0321.
May 1, 2015
Robert S. Rahimi, MD, MS; Jennifer A. Cuthbert, MD; Don C. Rockey, MD
1Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, Texas
2Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas3Parkland Memorial Hospital, Parkland Health and Hospital System, Dallas, Texas
4Department of Internal Medicine, Medical University of South Carolina, Charleston, South Carolina
JAMA Intern Med. 2015;175(5):868-869. doi:10.1001/jamainternmed.2015.0334.
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