Influence of human milk oligosaccharides vs. lactulose on the gut microbiome in patients with hepatic encephalopathy

Abstract

Hepatic encephalopathy (HE) is a neuropsychiatric disorder associated with liver dysfunction. This literature review explores
the therapeutic potential of nutritional and microbiome-based interventions in managing HE, particularly minimal hepatic encephalopathy. Nutritional therapy, along with probiotics, prebiotics, and fecal microbiota transplants, has shown efficacy in reducing ammonia levels, improving cognitive function, and enhancing health-related quality of life. Additionally, the safety of 6'-sialyllactose, a human milk component, has been confirmed in clinical trials, supporting its potential use in HE treatment. Emerging evidence also suggests that bacteriophages within the gut microbiome are linked to cognitive impairment in cirrhotic patients, indicating that microbiome modulation could provide new therapeutic avenues. These findings highlight the promise of nutritional and microbiome-based strategies in managing HE and emphasize the need for further research to fully integrate these approaches into clinical practice.