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86 Combining lactulose with PEG might be helpful, which was assessed in a non-inferiority trial that randomized 40 patients with cirrhosis and HE to receive either lactulose alone (2030 g orally or 200 g enema) or a similar dose of lactulose plus PEG (280 g in 4 L of water orally as a single dose in 30120 m)

& Correll, P

20 (1000 -)

doi: 10.1186/1475-2891-10-24

Polyphenols influence a wide range of cellular and molecular pathways, including those involved in lipid metabolism, primarily through modulation of hepatic transcriptional regulators

It would also be valuable to examine more targeted assessments, such as CT calcium scores or coronary catheterizations, given that disrupted calcium and cholesterol dysregulation are known effects of elevated TMAO
