ALB and Ascites: Among patients who experienced recurrence of hepatic encephalopathy there were no significant differences in age, duration of liver disease, INR, serum creatinine, albumin levels, or presence of ascites, highlighting the treatment regimen as the primary factor influencing outcomes.<h4>Conclusion</h4>The addition of probiotics to rifaximin therapy markedly decreased the recurrence of hepatic encephalopathy compared to rifaximin alone, suggesting a more effective strategy for secondary prevention.