Nardelli S, et al. - Researchers investigated whether there was an association between minimal hepatic encephalopathy (MHE) and proton pump inhibitors (PPIs) use as well as the role of PPIs use in the development of overt HE and survival via including 310 consecutive cirrhotic patients and followed up for 14.1±12.3 months. PPIs use, previous overt HE, low albumin, low sodium and age were the variables independently related to the presence of MHE. PPIs, history of overt HE, low albumin, MHE and age were variables independently related to the development of overt HE. On the other hand, PPIs, development of overt HE, MELD score, age, low sodium and age were variables independently associated with mortality. In patients with liver cirrhosis, they identified a potentially removable factor associated with the presence of minimal HE and related to the development of overt HE and survival.