Everything about Lactulose totally explained
Lactulose is a synthetic
sugar used in the treatment of
constipation and
hepatic encephalopathy, a complication of
liver disease. It is a
disaccharide (double-sugar) formed from one molecule each of the
simple sugars (
monosaccharides)
fructose and
galactose. The commercial syrup used for treatment of constipation is dyed yellow-orange. It is produced commercially by
isomerization of
lactose.
Constipation
In the treatment of chronic
constipation, its metabolites draw water into the bowel, causing a cathartic effect through
osmotic action. Unlike other laxatives that are recommended for temporary relief, lactulose can be taken daily for decades, and is safe for people of all ages, except for those who are
galactose intolerant or are suffering from
renal insufficiency (common to all osmotic laxatives). Dosage may have to be adjusted over time to produce the desired effect.
It can be especially useful for negating the constipating effects of
opiates and
opioids, and for treating children who withhold their bowel movements out of fear.
Lactulose has an overly sweet taste that can be completely masked by mixing it with fruit juice or desserts. It can take 24 to 48 hours to work, but generally produces results within 4 hours if taken on a daily basis. It is best taken at breakfast along with a bowl of bran cereal.
Hepatic encephalopathy
In treating
hepatic encephalopathy, lactulose helps "draw out"
ammonia (NH
3) from the body. The effectiveness of lactulose is somewhat controversial, and whether or not its effects are through ammonia is controversial as well. Lactulose is metabolized in the
colon by
bacterial flora to short chain fatty acids, acidifying the colonic contents. This favors the formation of the nonabsorbable NH
4+ from NH
3, trapping NH
3 in the colon and effectively reducing plasma NH
3 concentrations.
Side effects
Common side effects are abdominal cramping, gas,
borborygmus and
flatulence. Less common side effects are
nausea and
vomiting. Excessively high dosage can cause explosive and uncontrollable
diarrhea.
In sensitive individuals, such as the elderly or people with reduced
kidney function, excess dosage can result in
dehydration and
high sodium levels.
Brand names
- Generlac
- Cephulac
- Cholac
- Constilac
- Enulose
- Acilac
- Heptalac
- Actilax
- Duphalac
- Kristalose
- Apo-Lactulose
Further Information
Get more info on 'Lactulose'.
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