Hepatic encephalopathy in patients with liver cirrhosis: is there a role of malnutrition?

Hepatic encephalopathy (HE) is a common complication in patients with liver cirrhosis but its pathogenesis remains incompletely understood. Malnutrition is commonly encountered in patients with liver cirrhosis and it has been reported to affect the quality of life of this group of patients. Experimental studies suggest that low energy intake and poor nutritional status may facilitate the development of HE but there are scarce data on the potential role of malnutrition in HE in patients with liver cirrhosis. Two recently published studies have evaluated the potential role of malnutrition in the development of HE in cirrhotic patients with conflicting results. In this letter to the editor we briefly present the results of the two studies as well as potential reasons for the conflicting results reported.