Patients and Methods: The prospective single-blind randomized controlled trial, 43 cirrhotics with overt hepatic encephalopathy without portal systemic shunting admitted to gastroenterology department of Cho Ray Hospital from March 2019 to August 2019, were randomized into two groups (group A lactulose plus rifaximin 1.100 mg / day, n = 21; and group B only lactulose; n = 22).