简介：Dr Sharma: Currently we are using either non-absorbable disaccharides such as lactitol or lactulose as well as antibiotics which are poorly absorbed from the gut. The main purpose of these agents is to reduce ammonia levels because it is ammonia which is the main precursor for the pathogenesis of HE. However although many people are using these non-absorbable disaccharides the evidence to support their use is not there: