Overview
TIPS is a standard for the treatment of portal hypertension related complications. However, it remains at risk of HE after TIPS (around 40% the first year). Dysbiosis plays a key role in pathophysiology of HE.
Polydextrose (PDX) is consider as a prebiotic. Preliminary studies showed that PDX:
- modified gut microbiota, enhancing "good bacteria"
- improved gut permeability and immunity in 2 experimental models: infarction and colitis.
The aim of this study is to assess PDX efficacy to prevent HE during the first 6 months after TIPS in cirrhotic patients.
Description
TIPS is a standard for the treatment of portal hypertension related complications. However, it remains at risk of HE after TIPS (around 40% the first year). Dysbiosis plays a key role in pathophysiology of HE.
Polydextrose (PDX) is consider as a prebiotic. Preliminary studies showed that PDX:
- modified gut microbiota, enhancing "good bacteria"
- improved gut permeability and immunity in 2 experimental models: infarction and colitis.
Patients will receive PDX 15 days prior to and 6 months after TIPS. We will assess the cumulative incidence of HE 6 months after TIPS. Patients will be followed-up for 12 months after TIPS.
Eligibility
Inclusion Criteria:
- Male or female at least 18 years of age
- Affected (c) cirrhosis in which the establishment of a TIPS is scheduled within the month for: the treatment of ascites or a refractory hydrothorax or the prevention of the recurrence of a related digestive hemorrhage portal hypertension
- Having signed the consent to participate in the study
- Women of childbearing age on effective contraception
- Affiliated to a social security scheme
Exclusion Criteria:
- Contraindication for TIPS
- Digestive short circuit, chronic inflammatory bowel diseases
- Indications of TIPS in emergency or as part of the preparation for a surgical procedure,
- Liver transplant,
- Patient for whom the follow-up is considered impossible due to non-compliance with care or because the vital prognosis is estimated less than 6 months because of an incurable chronic pathology,
- Pregnant or lactating women,
- Those unable to receive enlightened information,
- Those participating in another interventional research including an exclusion period
- Persons placed under safeguard of justice, tutelage or curators.