A 50-year-old man with cirrhosis is found to have hepatic encephalopathy precipitated by constipation. After lactulose titration achieves 2–3 stools/d...

Question

A 50-year-old man with cirrhosis is found to have hepatic encephalopathy precipitated by constipation. After lactulose titration achieves 2–3 stools/day, his encephalopathy resolves. He has had only one previous episode. Is rifaximin indicated at this point?

Accepted Answer

No, rifaximin is indicated only after a second episode of overt HE

Answer

Rifaximin is contraindicated in cirrhosis

Answer

Rifaximin is only used in hepatic coma

Answer

Yes, rifaximin should be started after the first episode

Answer

Rifaximin should replace lactulose entirely

uk-sce-gastroenterology MCQ (SBA): Hepatic Encephalopathy

A 50-year-old man with cirrhosis is found to have hepatic encephalopathy precipitated by constipation. After lactulose titration achieves 2–3 stools/day, his encephalopathy resolves. He has had only one previous episode. Is rifaximin indicated at this point?