CRD Summary: The authors concluded that rifaximin was not superior to non-absorbable disaccharides for acute or chronic hepatic encephalopathy in the long-term or short-term treatment, except that it may be better tolerated. Given the lack of reporting on methodological processes and the small number of included participants, this conclusion should be interpreted with caution.

CRD Commentary: The review addressed a clear research question and was supported by appropriate inclusion criteria. The search strategy was adequate and had no language or publication status restrictions. There was no evidence of publication bias. The study quality assessment tool was appropriate for the included study designs. However, it was not reported how the study quality assessment or data extraction was performed, so these review processes may have been subject to reviewer error or bias. Synthesis methods were appropriate. However, the use of heterogeneity to determine the employment of a fixed-effect or random-effects model may not be reliable. Given the lack of reporting on methodological processes and the small number of included participants, the authors' conclusion should be interpreted with caution.