Late Evening and Early Morning Protein Supplement to Reduce Readmissions for Hepatic Encephalopathy

Inclusion Criteria: * \> 18 years of age * cirrhosis diagnosed by clinical history and liver biopsy and/or clinical, biochemical and imaging evidence of cirrhosis * at least 1 hospitalization for documented HE within the last 12 months. * abdominal CT scan anytime in the past Exclusion Criteria: * Patients with MELD score \> 35 * end stage organ failure (major dysfunction requiring organ support) * kidney injury defined by a creatinine \> 2 mg/dl or rise in creatinine by 0.5 gm/dl from baseline that is unresponsive to withholding diuretics and intravenous albumin administration (1 gm/kg up to 100 gm/day) * active malignancy * uncontrolled diabetes mellitus with A1c\>9.5 (to avoid altered muscle protein metabolism * medications (anabolic steroids, corticosteroids) that affect skeletal muscle mass * recent gastrointestinal surgery within past 12 months * ongoing infection (positive blood or other body fluid cultures) * active gastrointestinal bleeding.