Figure 2: Inter-organ trafficking of ammonia in normal physio- logical conditions, in well-nourished patients with end-stage liver failure compared to malnourished end-stage liver failure patients.
dysfunction, altered taste and smell, anorexia as well as altered protein metabolism [43, 44]. Surprisingly, in spite of evidence of hypozincemia in cirrhosis, zinc supplementation in the treatment of HE based on a small number of controlled trials has so far provided inconsistent results, a finding that may be attributable to variations in the nature and doses of zinc salts used and to duration of therapy [45].