Background.. Several reports about usefulness of probiotics, including Enterococcus faecium in the treatment of
chronic hepatic encephalopathy in patients with liver cirrhosis have been recently published. The results obtained
by the administration of Enterococcus faecium M-74 + seleniumwill be evaluated and compared with those published
by Loguercio et al. for Enterococcus faecium SF 68.
Methods and Results. Fifteen patients with liver cirrhosis, portal hypertension and chronic hepatic encephalopathy
were treated, beside the standard therapy, alsowith one capsule of probiotic „Enterococcus faeciumM-74 + Selenium“
per day in three four-week periods, separated by two fortnight pauses. During the treatment, every patient was
examined 9-times. The severity of chronic hepatic encephalopathy was evaluated with the aid of the portal systemic
encephalopathy index, calculated from5 parameters (mental stage, asterixis, number connecting test, blood ammonia,
EEG). The indexes of initial and final values were compared. The time course of blood ammonia levels and that of
results from number connecting test in either study were mutually compared on the basis of interval estimates of
quadratic regression function. Significant improvement of the portal systemic encephalopathy index after the
treatment was found: it decreased in average by 70 % (55 to 85 %, interval 95% confidence interval). The mental
stage improved and the asterixis disappeared. The blood ammonia levels as well as the results from the number-connecting
test after 8–9 weeks significantly approached the normal pattern. EEG findings improved and they were
often normalised. Our starting blood ammonia levels (increased by 31%above norm) and results fromthe connecting
test (increased by 60 %) were significantly lower accordingly the Loguercio et al. (increased by 243 and 238 %,
respectively). During the treatment, the values in our study decreased by 25 % and 30 %, in the compared study by
50 % and 70 %.
Conclusions. Our results proved the hypothetical favourable effect of probioticum Enterococcus faecium M-74 +
Selenium on chronic hepatic encephalopathy. Interestingly, a markedly higher relative therapeutic effect has been
achieved in more serious disorder in comparison with the less severe disorders in the present study.
hepatic cirrhosis, Enterococcus faecium M-74 + Selenium, chronic hepatic encephalopathy, portal
systemic encephalopathy index, number connecting test, blood ammonia.