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Numerous studies have evaluated lactulose in the treatment of minimal HE, overt HE, and as a secondary prophylactic measure in patients with cirrhosis, confirming its efficacy and safety.3033 Clinical trials have shown that lactitol is better-tolerated and is just as efficacious as lactulose for the treatment of HE.34,35 No significant difference has been found with respect to improving HE grade in the comparison of nonabsorbable antibiotics (rifaximin) versus nonabsorbable disaccharides (lactitol and/or lactulose).23,25,27 Probiotics are mixtures of beneficial bacteria that are believed to aid in the treatment of HE by modulating the microbiome

Data Processing, Normalization, and Validation All collected data were processed and normalized to ensure consistency and comparability across regions and time frames

Carnitine is an amino acid that plays a crucial role in fat metabolism by transporting fatty acids to the mitochondria, where they are burned to produce energy

The body creates carnitine from the amino acids lysine and methionine

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