Clinical Application of Lactulose March 14, 2001

Clinical Application of Lactulose March 14, 2001

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Artificially synthesized ketone-containing disaccharides lower blood ammonia and treat constipation as their most basic functions. Blood ammonia permeates into an acidic environment, and lactulose is broken down in the intestinal lumen into lactic acid and acetic acid, thereby lowering the pH of the intestinal lumen. Blood ammonia moves from the bloodstream into the intestine; ammonia typically exists in two forms in the intestinal lumen—NH₃ and NH₄⁺—with the former being easily absorbed and the latter easily excreted. The acidic environment binds with NH₃, converting it into NH₄⁺, thus reducing the reabsorption of ammonia. Ordinary vinegar enemas also serve this purpose. Side effects of this product include abdominal distension, abdominal pain, nausea, vomiting, and diarrhea. Caution should be exercised: usually take 20–40 mg three times daily by mouth.