Resistant potato starch for gut bacteria in people with cirrhosis and hepatic encephalopathy

You may qualify if

• Able to provide consent, with signed and dated informed consent form.
• Stated willingness to comply with all study procedures and availability for the duration of the study.
• Diagnosis of cirrhosis based on liver biopsy, imaging, or evidence of clinical decompensation.
• History of at least one episode of overt Hepatic Encephalopathy (HE) in the last year.; Defined by West Haven Criteria Grades II to IV; Can be precipitated Hepatic Encephalopathy (HE) episode.
• Sexually active women of childbearing potential enrolled in the study must agree to use a highly-effective method of contraception (defined in the protocol) for the duration of the study.

You can't join if

• Hospitalization in the last 4 weeks
• Current refractory ascites (requiring large volume paracentesis to manage ascites)
• Gut-absorbable or intravenous antibiotic therapy in the last 4 weeks (rifaximin is permitted)
• Anticipated antibiotics in the coming 4 weeks
• Use of lactulose in the last 4 weeks
• Alcohol or illicit drug intake in the last 4 weeks; By history; Alcohol use will be characterized as >1 alcoholic drink / week
• History of inflammatory bowel disease
• History of primary sclerosing cholangitis
• Total bilirubin in the last 3 months > 4 mg/dL
• Prior diagnosis of dementia or other primary neurocognitive disorder
• Pregnancy or breast feeding
• Placement of a portosystemic shunt or transjugular intrahepatic portosystemic shunt in the last 3 months (permissible if placed >3 months before enrollment)
• Allergy to resistant potato starch