Lactulose

Lactulose is a synthetic sugar used in the treatment of constipation and hepatic encephalopathy, a complication of liver disease. It consists of the monosaccharides fructose and galactose and is yellow.

Constipation

In the treatment of chronic constipation, its metabolites draw water into the bowel, causing a cathartic effect through osmotic action.

It can be especially useful for negating the constipating effects of opiates and opioids. The United States is the only country in the world that requires a prescription for purchase.

Hepatic encephalopathy

In treating hepatic encephalopathy, lactulose helps "draw out" ammonia (NH3) from the body. The effectiveness of lactulose is somewhat controversial, and whether or not its effects are through ammonia is also 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 NH4+ from NH3, trapping NH3 in the colon and effectively reducing plasma NH3 concentrations.

Side effects

Side effects include diarrhoea and resultant dehydration and high sodium levels. In rare cases or in excess amounts, lactulose can cause stomach pain, gas, vomiting, or diarrhoea.

Brand names

  • Generlac®
  • Cephulac®
  • Cholac®
  • Constilac®
  • Enulose®
  • Acilac®
  • Heptalac®

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