Lactulose (want to achieve 2-3 soft bowel movements per day)

  • Lactulose prevents ammonia (NH3) from diffusing out of the colon and into the blood. Thus reducing the amount of ammonia in blood
  • HOW? Intestinal flora metabolizes lactulose producing organic acids and lowering pH => converting NH3 to NH4 (ammonium)

*It also acts as a laxative to eliminate nitrogen-producing bacteria


1. Weber FL Jr. Lactulose and combination therapy of hepatic encephalopathy: the role of the intestinal microflora. Dig Dis. 1996;14 Suppl 1:53-63.

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