A Nutritional Approach to Minimal Hepatic Encephalopathy

Inclusion Criteria: * All consented adults (age \> 18), with the diagnosis of CHILD A cirrhosis with MELD score of \< 10. * Diagnosis of liver cirrhosis as documented by liver biopsy (stage IV) and / or fibroscan (score \> 12 kpa) and / or fibrotest (score \> 0.74) and /or imaging. Exclusion Criteria: * History of \> grade II hepatic encephalopathy (HE). * Diagnosis of dementia, Parkinson disease, Schizophrenia (Patients with major depression will be noted but not excluded). * Use of sedatives, tranquilizers or anti- psychotic medication during and/or 2 weeks prior to enrolling Use of antibiotics for any length of period during and/or 2 weeks prior to enrolling. * Current use of lactulose or neomycin. * Use of alcohol or elicit drugs during and/ or 6 months prior to enrolling.