Efficacy and Safety of Nifuroxazide in the Treatment of Hepatic Encephalopathy in Egyptian Patients With Liver Cirrhosis

Inclusion Criteria: * Patients suffering from liver cirrhosis aging above 18 years who will be admitted to hospital with neuropsychiatric condition suggestive of hepatic encephalopathy (grade II or III) confirmed by their known previous hepatic disease by history, clinical examination and laboratory investigations in the form of hyperammonemia with Model for End-Stage Liver Disease (MELD) score ≤ 25 and patients are able to swallow. Exclusion Criteria: * Patients with neurological or communication problems. * Degenerative central nervous system (CNS) disease. * Any significant psychiatric illness. * Patients with previous intake of nifuroxazide and rifaximin within the last month. * Presence of underlying renal impairment (serum creatinine ≥ 2 mg/dL). * Alcohol consumption within prior 4 weeks. * Non-hepatic metabolic encephalopathy. * Anemia with hemoglobin level \< 7 g/dL.