Original Research

Polyethylene Glycol in the Treatment of Hepatic Encephalopathy in patients with Liver Cirrhosis

DOI https://doi.org/10.70302/jpsim.v6i4.2569
Received: 11 Apr 2024 Revised: 14 Jun 2025 Accepted: 10 Oct 2025 Published Online: 21 Nov 2025

Abstract

Objective

This study aims to determine the effectiveness and safety of polyethylene glycol (PEG) in patients with hepatic encephalopathy.

Methods

This cross-sectional study was conducted at Northwest General Hospital and Research Centre, Peshawar, Pakistan. All patients participated in this study were diagnosed with hepatic encephalopathy from January 2019 to August 2021. All patients were given 3 sachets of polyethylene glycol daily. Recovery days, length of hospital stay, and recurrent episodes were assessed.

Results

A total of 75 patients with different hepatic diseases admitted to the hospital due to hepatic encephalopathy were given 3 sachets of polyethylene glycol daily. On average, 2.81 days for recovery and 5 days of hospital stay were required. The mean number of recurrent hepatic encephalopathy episodes was 0.52.

Conclusion

Polyethylene glycol is considered effective and safe in patients with hepatic encephalopathy, with short recovery days, hospital stay, and few recurrent episodes.

Keywords
Hepatic encephalopathy polyethylene glycol liver cirrhosis.

How to Cite This Article

Khan KA, Qureshi SU, Khan ZN. Polyethylene Glycol in the Treatment of Hepatic Encephalopathy in patients with Liver Cirrhosis. J Pak Soc Intern Med. 2025;6(4):373–375. doi:10.70302/jpsim.v6i4.2569

⭳ Download PDF

Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

  1. Rudler M, Weiss N, Bouzbib C, Thabut D. Diagnosis and management of hepatic encephalopathy. Clin Liver Dis. 2021;25(2):393-417.
  2. Weiss N, Jalan R, Thabut D. Understanding hepatic encephalopathy. Inten Care Med. 2018;44:231-4.
  3. Butterworth RF, Layrargues GP. Hepatic Encephalopathy: Pathophysiology and Treatment. Springer Science & Business Media; 2012; ISBN: 1461245060, 9781461245063
  4. Tsoris A, Marlar CA. Use of the Child Pugh score in liver disease. StatPearls Publishing, Treasure Island (FL). 2023;PMID: 31194448.
  5. Salerno F, Merli M, Cazzaniga M, Valeriano V, Rossi P, Lovaria A, et al. MELD score is better than Child–Pugh score in predicting 3-month survival of patients undergoing transjugular intrahepatic portosystemic shunt. J Hepatol. 2002;36(4):494-500.
  6. European Association for the Study of the Liver. EASL Clinical Practice Guidelines on the management of hepatic encephalopathy. J Hepatol. 2022;77(3):807-24.
  7. Fallahzadeh MA, Rahimi RS. Hepatic Encephalopathy: Current and Emerging Treatment Modalities. Clin Gastroenterol Hepatol. 2022;20(8):S9-19.
  8. Jalan R, Rose CF. Heretical thoughts into hepatic encephalopathy. J Hepatol. 2022; 77(2):539-48.
  9. Li M, Zhang Z, Chen Q, Zhou X, Shui D, Huang J. Comparative effectiveness and safety of polyethylene glycol electrolyte solution versus lactulose for treatment of hepatic encephalopathy: a systematic review and meta-analysis. J Clin Gastroenterol. 2022;56(1):41.
  10. Sawhney R, Jalan R. The gut is a key target of therapy in hepatic encephalopathy. Nat Rev Gastroenterol Hepatol. 2015;12(1):7-8.
  11. Rahimi RS, Singal AG, Cuthbert JA, Rockey DC. Lactulose vs polyethylene glycol 3350-electrolyte solution for treatment of overt hepatic encephalopathy: the HELP randomized clinical trial. JAMA Int Med. 2014;174(11):1727-33.
  12. Shehata HH, Elfert AA, Abdin AA, Soliman SM, Elkhouly RA, Hawash NI, Soliman HH. Randomized controlled trial of polyethylene glycol versus lactulose for the treatment of overt hepatic encephalopathy. Eu J Gastroenterol Hepatol. 2018;30(12):1476-81.
  13. Rose CF, Amodio P, Bajaj JS, Dhiman RK, Montagnese S, Taylor-Robinson SD, et al. Hepatic encephalopathy: Novel insights into classification, pathophysiology and therapy. J Hepatol. 2020;73(6):1526-47.
  14. Raja WJ, Sebastian B, Mathai SK. To compare the effect of polyethylene glycol vs. lactulose in the treatment of overt hepatic encephalopathy. Hepatol Gastroint Dis. 2019;5:166.
  15. Hoilat GJ, Ayas MF, Hoilat JN, Abu-Zaid A, Durer C, Durer S, et al. Polyethylene glycol versus lactulose in the treatment of hepatic encephalopathy: a systematic review and meta-analysis. BMJ Open Gastroenterol. 2021;8(1):e000648.

Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2025 Journal of Pakistan Society of Internal Medicine.