Role of Nutrition in the management of hepatic encephalopathy - Do we know all?

We read with interest the randomized controlled trial by Ahuja et al, which pointed out that nutrition therapy prevents the recurrence of overt hepatic encephalopathy (OHE) in patients with cirrhosis and also leads to improvement in anthropometry, ammonia levels, inflammatory markers, and myostatin levels showcasing the pathophysiological basis behind the nutrition therapy i.e. by lowering ammonia, improving sarcopenia and decreasing inflammation. Moreover, this study also showed the benefit of nutrition therapy in the prevention of complications of cirrhosis as well as mortality benefit.