TIPS is a standard for the treatment of portal hypertension related complications. However, it remains at risk of HE after TIPS (around 40% the first year). Dysbiosis plays a key role in pathophysiology of HE.~Polydextrose (PDX) is consider as a prebiotic. Preliminary studies showed that PDX:~modified gut microbiota, enhancing good bacteria~improved gut permeability and immunity in 2 experimental models: infarction and colitis.~Patients will receive PDX 15 days prior to and 6 months after TIPS. We will assess the cumulative incidence of HE 6 months after TIPS. Patients will be followed-up for 12 months after TIPS.
TIPS is a standard for the treatment of portal hypertension related complications. However, it remains at risk of HE after TIPS (around 40% the first year). Dysbiosis plays a key role in pathophysiology of HE.~Polydextrose (PDX) is consider as a prebiotic. Preliminary studies showed that PDX:~modified gut microbiota, enhancing good bacteria~improved gut permeability and immunity in 2 experimental models: infarction and colitis.~The aim of this study is to assess PDX efficacy to prevent HE during the first 6 months after TIPS in cirrhotic patients.