Prevention of Post-TIPS Hepatic Encephalopathy by Administration of Rifaximin and Lactulose

This study is testing whether giving the medications rifaximin (an antibiotic) and lactulose (a laxative) can prevent brain confusion (called hepatic encephalopathy) after a procedure called TIPS (transjugular intrahepatic portosystemic shunt) — a procedure used to reduce pressure in veins around the liver in people with severe liver disease. **You may be eligible if...** - You have liver disease with complications such as fluid buildup in the belly (ascites) that does not respond to diuretics, or repeated bleeding from swollen veins in the esophagus (variceal bleeding) - You are scheduled to have an elective TIPS procedure to manage these complications **You may NOT be eligible if...** - You have very advanced liver failure (Child-Pugh C score above a certain level) - You have had a prior episode of significant brain confusion (overt hepatic encephalopathy) - You have other conditions that make TIPS inadvisable Talk to your doctor to see if this trial is right for you.