Prevention of Hepatic Encephalopathy With Mobile Application Based Lactulose Titration

This study is being done to assess the safety and efficacy of using mobile application-based Bristol stool scale to titrate lactulose in prevention episodes of hepatic encephalopathy.

Subjects with cirrhosis who are taking lactulose for the treatment of hepatic encephalopathy will download the Dieta mobile application on their mobile device and take a photo of each bowel movement using the Dieta application

Mobile application that functions on mobile phones and allows for tracking of symptoms, dietary intake, and stool characteristics using logs and pictures. Users of the application track symptoms by completing questionnaires regarding stool frequency, consistency, and mental status changes. Users can track dietary intake and stool characteristics by taking time-stamped photos of all dietary intake and bowel movements.

Number of subject to achieve daily stool goal, determined if use of the mobile application leads to improved rates of meeting daily stool goal (3-4 stools per day of Bristol Stool Scale 3-4)

Inclusion Criteria: Ability to provide written, informed consent. Currently taking lactulose daily for prevention of hepatic encephalopathy. Exclusion Criteria: Recent change in dosing of opioid medication. Previous Colorectal Surgery. Active diarrheal illness. Lack of smartphone or other smart device at home.