<prompt> Treatment for poosystemic encephalopathy is all exceptHigh protein dietLactuloseOral neomycinEnema  <response>: It most often results from high gut protein or acute metabolic stress eg, GI bleeding, infection, electrolyte abnormality in a patient with poosystemic shunting. Symptoms are mainly neuropsychiatric eg, confusion, asterixis, coma. Diagnosis is based on clinical findings. Ref Davidson edition23rd pg 864 