1. Known or suspected hepatocellular carcinoma

2. Prior TIPS placement

3. Severe congestive heart failure

4. Severe pulmonary hypertension

5. Uncontrolled diabetes mellitus (HBA1C \>9.5%)

6. Any autoimmune disorder, which is currently being treated with prednisone or any other immune suppressive medication.

7. Previous surgical bypass surgery for morbid obesity (BMI \>45)

8. Extensive small bowel resection

9. Patients currently receiving total parenteral nutrition if they have contraindications to oral drugs

10. Women who are pregnant

11. Patients who are allergic to acetaminophen/ paracetamol or any other related medications

12. Patients with an acute current exacerbation of chronic obstructive pulmonary disease or bronchial asthma.

13. Patients that are taking hepatotoxin drugs

14. Patient, based on the opinion of the investigator, should not be enrolled into this study

15. Patient is unable or unwilling to sign informed consent.

16. Patients that are participating in other clinical trials evaluating experimental treatments or procedures

Use of Methacetin Breath Test to Predict Liver Failure in Patients With Cirrhosis