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In addition, the numbers of patients per test group were small enough that even robust differences may have been missed, according to a chi square power analysis of proportions performed by the authors of this review

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Probiotics are hypothesized to benefit patients with HE through reduction of harmful, ammonia-producing bacteria, and decreasing ammonia absorption in the gut by affecting different aspects of the gastrointestinal environment (including enzymatic composition, epithelial permeability, acidic environment and nutritional status of the gut)

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