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A Novel Use of Tenapanor in Patients With Hepatic Encephalopathy: A Case Series

Y. Yeo, W. Ayoub, Ali Rezaie

ACG Case Reports Journal, 2026

1 citation

Abstract

ABSTRACT Hepatic encephalopathy (HE) is often inadequately managed by standard therapies (lactulose and/or rifaximin). This case series presents 5 patients with decompensated cirrhosis and HE who received tenapanor (50 mg once or twice daily) due to inadequate response to standard therapies. Outcomes included bowel movement frequency, HE symptom improvement, and safety. Four patients showed improved bowel frequency, stool consistency, and HE severity. HE recurred in 3 patients after discontinuation. Tenapanor was well-tolerated, with mild, self-resolved dehydration in one case. Patients preferred tenapanor for taste and dosing convenience over lactulose. The findings suggested that tenapanor may alleviate HE with high safety and compliance.

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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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