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Quality of evidence: I-A, Strength of recommendation: 1 Panel level of agreement: In total agreement 87%, in partial agreement 13% Lactulose has been shown to be efficacious in preventing HE in patients with cirrhosis and variceal bleeding (VB)

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Preclinical and clinical data suggest that FXR and PPAR dual modulators can improve insulin sensitivity, reduce hepatic steatosis, and attenuate fibrosis, which may complement the actions of GLP-1/GIP/GCG receptors agonists

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It can also boost immunity and support overall cellular health by neutralizing free radicals