Conditions: Minimal Hepatic Encephalopathy
Keywords: encephalopathy pediatric liver disease pediatric cirrhosis serum ammonia levels
Allocation: RANDOMIZED | Intervention model: CROSSOVER
Enrollment: 16
Healthy volunteers: no

Brief summary:
Pediatric patients with chronic liver disease may have Minimal Hepatic Encephalopathy(MHE)which can cause changes in behavior,intelligence and neurological function.By utilizing cognitive and developmental testing we will determine if patients have MHE. If so, we will trial 3 months of blinded placebo or Lactulose treatment followed by a washout period with no treatment. At this time patients are re-tested and then begin another three month period switching to the opposite treatment of first 3 months.Final cognitive/developmental testing will determine if Lactulose treatment has any effect on MHE.

Detailed description:
In addition ,serum ammonia levels will be obtained at beginning of study,post-washout and at end of study to evaluate Lactulose effect on serum ammonia.

Arms:
arm 1: 3 months of Lactulose therapy based on pt. weight arm 2: 1.5 ml/kg day po of sugar water placebo for three months

Interventions: intervention 1: Lactulose intervention 2: placebo
Intervention descriptions: intervention 1: 1.5cc/kg/day po for three months intervention 2: 1.5 ml sugar water/kg day for three months

Protocol document: