How to Treat Hepatic Encephalopathy

Non-selective beta blockers are indicated for prevention of recurrent variceal bleeding, but they have to have the blood pressure room for it. The treatment for hepatic encephalopathy is a non-absorbable disaccharide and we use lactulose because it's just available. Polyethylene glycol, four liters of a colonoscopy prep, has been studied in one small trial to be as effective, if not more effective than lactulose.