Lactulose is the unabsorbed sugar used in the treatment of constipation and liver encephalopathy. It is used by mouth for constipation and either by mouth or in the rectum for liver encephalopathy. Usually start working after eight to twelve hours but it can take up to two days to fix constipation.
Common side effects include flatulence and cramps. There is potential for electrolyte problems to occur as a result of the diarrhea they produce. Lactalose is a drug Category B Pregnancy. Generally considered safe during breastfeeding. These are classified as osmotic laxatives.
Lactulose was first made in 1929 and has been used medically since the 1950s. It's in the List of Essential Medicines of the World Health Organization, the most effective and safe drugs needed in the health system. It is available as a generic and brand name product. In many countries can be purchased about <$ 0.16 per 15 ml of syrup (10 g lactulose) by 2015. In the United States, the cost of this amount is about US $ 0.63. Lactulose is made from lactose milk sugar, which consists of two simple sugars, galactose and glucose.
Video Lactulose
Medical use
Constipation
Lactulose is used in the treatment of chronic constipation in patients of all ages as long-term treatment. Lactulose is used for chronic idiopathic constipation, which is chronic constipation that occurs without any identifiable cause. Lactulose can be used to counter the effects of opioid constipation, and in the treatment of symptomatic hemorrhoids as stool softeners.
The lactulose dose for chronic idiopathic constipation is adjusted depending on the severity of constipation and the desired effect, from mild fecal softeners to cause diarrhea. The dose is reduced in the case of galactosemia because most preparations contain galactose monosaccharides because of its synthesis process.
Hyperammonemia
Lactulose is useful in treating hyperammonemia (high blood ammonia), which can lead to liver encephalopathy. Lactulose helps to catch ammonia (NH 3 ) in the colon and bind it. This is done by using the intestinal flora to acidify the large intestine, converting the free ammonia diffusibly into ammonium ( NH
4 ) that can not re-spread into the blood. It is also useful for preventing hyperamonemia caused as a side effect of valproic acid administration.
Lactulose for liver encephalopathy generally requires relatively large oral doses of three or four times daily with episodic diarrhea and constant flatulence almost certain side effects. People taking lactulose at this dose level generally end up wearing adult diapers and plastic pants for any activity away from home or at night (with chux pads for mattresses) because diarrhea can occur quickly and without much warning.
Excessive bacterial small intestine growth
Lactulose is used as a test for overgrowth of small intestinal bacteria (SIBO). Recent reliability for diagnosing SIBO has been seriously questioned. A large amount is given by subsequent molecular hydrogen gas testing in breath. This test is positive if an increase in hydrogen exhaled occurs before it is expected by normal colonosit digestion. Previous results have been hypothesized to show digestion occurring in the small intestine. An alternative explanation for the difference in outcome is the variance in the transit time of the small intestine among the subjects tested.
Custom population
Lactulose is a drug Category B Pregnancy. Generally considered safe during breastfeeding.
Maps Lactulose
Side effects
Common side effects of lactulose are abdominal cramping, borborygmus and flatulence. In normal individuals, overdose is considered uncomfortable, but not life-threatening. Rare side effects are nausea and vomiting. In sensitive individuals, such as elderly or people with reduced kidney function, excessive lactulose doses can cause dehydration and electrolyte disturbances such as low magnesium levels. Ingestion of lactulose does not cause weight gain because it can not be digested without nutritional value. Although lactulose is less likely to cause dental caries than sucrose, because sugar has the potential for this. This should be considered when taken by people with high vulnerability to this condition.
Action mechanism
It is a disaccharide (double-sugar) formed from one molecule each of a simple sugar (monosaccharide) fructose and galactose. Lactulose is usually absent in raw milk but is a product of a hot process: the hotter, the more this substance (from 3.5 mg/L in low temperature pasteurized milk to 744 mg/L in sterilized milk containers). It is produced commercially by lactose isomerization.
Lactulose is not absorbed in the small intestine or is not decomposed by human enzymes, so it stays in the digestive bolus through most of its journey, causing water retention through osmosis which leads to softer, easier to defecate. It has a secondary laxative effect in the colon, where it is fermented by intestinal flora, producing metabolites that have osmotic strength and peristaltic-stimulating effects (such as acetate), but also methane associated with flatulence.
Lactulose is metabolized in the colon by bacterial flora into short chain fatty acids, including lactic acid and acetic acid. This partially dissociates, acidifying the contents of the colon (increasing the concentration of H in the gut). This supports the formation of nonabsorbable NH 4 from NH 3 , trapping NH 3 in colon and effectively reduce the concentration of NH plasma 3 . Lactulose is therefore effective in treating liver encephalopathy. Especially effective as a secondary prevention of hepatic encephalopathy in people with cirrhosis. In addition, recent studies have shown improved cognitive function in people with cirrhosis with minimal hepatic encephalopathy treated with lactulose.
Society and culture
Name
Lactulose is an international nonpropriet name (INN). It is sold under various brand names.
Cost
It is available as a generic drug. The wholesale price is about US $ 0.18 per 15ml dose. In the United States, 30 doses of liquid are approximately US $ 20.
Availability
Lactulose is available without a prescription in most countries, but prescription is required in the United States, Nigeria, and Austria
Food additives
Lactulose is commonly used as a food additive to enhance flavor and increase intestinal transit.
References
External links
Source of the article : Wikipedia
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