Hepatic encephalopathy (HE) is an important complication of liver cirrhosis. Lactulose is a first line treatment for HE, but the adherence to this treatment is relatively low, due to side effects such as diarrhea, distention, etc.

Lactulose is a first line treatment for HE, but the adherence to this treatment is relatively low due to side effects. Lactulose-paraffin recently available in the market can be used for the treatment of HE, and possibly have fewer side effects.

The aim of this study was to compare the adherence of the treatment of lactulose and lactulose-paraffin.

Inclusion Criteria:

• Liver cirrhosis
• History of an event of hepatic encephalopathy.
• Ambulatory patients

Exclusion Criteria:

• Alcoholism with active ingest of alcohol in the last 6 months
• Labour turn-overs
• Pregnancy
• Personal history of surgery in the last 4 weeks
• Spontaneous bacterial Peritonitis
• Use of neuropsychiatric drugs
• Neuropsychiatric disorders (Schizophrenia, bipolar disorder, major depression, dementia and Attention-deficit hyperactivity disorder)
• Thyroid disorders without replacement therapy
• Renal failure
• Hepatic or renal transplant
• Personal history of hepatocellular carcinoma
• Placement of transjugular intrahepatic portosystemic shunt
• Use of a probiotic in the last 6 month