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Minerva Medica 2011 August;102(4):309-19

language: Italian

Bio-ecological control of chronic liver disease and encephalopathy

Bengmark S. 1, Di Cocco P. 2, Clemente K. 2, Corona L. 3, Angelico R. 4, Manzia T. M. 4, Famulari A. 2, Pisani F. 2, Orlando G. 5

1 Division of Surgery & Interventional Science University College London, London, UK
2 Transplant Unit, University of L’Aquila, L’Aquila, Italy
3 Wayne State University School of Medicine, Detroit, USA
4 Transplant Unit, Tor Vergata, University of Rome, Rome, Italy
5 Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK


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Minimal encephalopathy was originally associated with chronic liver disease but is increasingly associated with most other chronic diseases and particularly with diabetes and also chronic disorders in other organs: kidneys, lungs, thyroid and with obesity. It is increasingly with dramatically increased and more or less permanent increase in systemic inflammation, most likely a result of Western lifestyle. Frequent physical exercise and intake of foods rich in vitamins, antioxidants, fibres, lactic acid bacteria etc in combination with reduction in intake of refined and processed foods is known to reduce systemic inflammation and prevent chronic diseases. Some lactic acid bacteria, especially Lb paracasei, lb plantarum and pediococcus pentosaceus have proven effective to reduce inflammation and eliminate encephalopathy. Significant reduction in blood ammonia levels and endotoxin levels were reported in parallel to improvement of liver disease. Subsequent studies with other lactic acid bacteria seem to demonstrate suppression of inflammation and one study also provides evidence of clinical improvement.

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