Poop pills could clear brain fog in liver disease

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Diagnosis of cirrhosis: Based on liver biopsy or clinical assessment of a hepatologist based on history, exam, laboratory and radiographic evidence * History of at least one episode of overt HE, defined by West Haven Criteria Grades II to IV; episodes of HE that were precipitated by gastrointestinal hemorrhage requiring transfusion of at least 2 units of blood, by medication use, by renal failure requiring dialysis, or by injury to the central nervous system will not be counted as previous HE episodes * Compliant with lactulose and rifaximin treatment (lactulose: at least one dose at least 5 days per week; rifaximin: at least one dose at least 5 days per week) Exclusion Criteria: * Current episode of overt HE as defined by West Haven Criteria Grades II to IV * Expectation of liver transplantation within two months of the screening visit * Current infection * Variceal bleeding in the last 4 weeks * Gut-absorbable or intravenous antibiotic therapy (including ciprofloxacin for SBP prophylaxis) in the last 3 months * Alcohol or illicit drug intake within 3 months, by history and available serum testing; alcohol use will be characterized as \>1 alcoholic drink / month * PSC as etiology of liver disease, as prior literature has suggested these individuals have a unique microbiome * History of Roux-en-Y Gastric bypass * On immunosuppressive medications * Positive C. difficile test * Scoring above a threshold cut-off on the Psychometric Hepatic Encephalopathy Score (PHES) * MELD \> 17 * History of spontaneous bacterial peritonitis * History of low ascites protein ( ≤ 1g/dL) in the last year * Hemodialysis in the last 30 days * Other significant laboratory abnormalities: serum creatinine \> 2.0 mg/dL, hemoglobin \< 8 g/dL, serum sodium \< 125 mmol/L, serum calcium \> 11.0 mg/dL, serum potassium \< 2.5 mmol/L * Placement of a portosystemic shunt or transjugular intrahepatic portosystemic shunt * Unstable doses of opiates, benzodiazepines or other sedating medication * Unable to provide consent; a. If MMSE is \< 18 or the patient is deemed to not have capacity by an investigator, a legally authorized representative (surrogate) will be allowed to provide consent