hepatic encepalopothy

I have recenly been diagnosed with hepatic encephalopath.  Dr.recently subscribed the lactulose.  My stomach hurt.  any suggestion?

[mikesimon]

The quoted excerpt was taken from the Clinical Care Options website. You must join to view the site but it's free and easy and worth the time and effort.

From what I have read rifaximin looks like a promising treatment.

".....A meta-analysis of clinical trials comparing disaccharides (eg, lactulose), antibiotics, and placebo found that nonabsorbable disaccharides were of unclear benefit in the treatment of hepatic encephalopathy.[9] However, these results have been criticized because of the poor quality of many of the clinical trials included in the analysis. Consequently, nonabsorbable disaccharides remain the recommended initial treatment for hepatic encephalopathy based on extensive clinical experience demonstrating effectiveness in some patients as well as their relative safety and low cost.[8]

Antibiotics, particularly nonabsorbable antibiotics such as neomycin 1000 mg twice daily, are currently the recommended second-line treatment for hepatic encephalopathy.[8] Rifaximin 400 mg 3 times daily is a newer nonabsorbable antibiotic that, according to 2 meta-analyses, is at least as effective as nonabsorbable disaccharides for the treatment of hepatic encephalopathy but with a lower incidence of abdominal pain (P = .04) and fewer hospitalizations.[10,11] A third meta-analysis found rifaximin to be more effective than lactulose in the treatment of hepatic encephalopathy (Capsule Summary).[12] A recent phase III trial in patients with recurrent hepatic encephalopathy found that rifaximin reduced hospitalizations for hepatic encephalopathy by approximately 50% and reduced the risk of hepatic encephalopathy breakthrough by 58% (Capsule Summary).[13]...."