Lactulose is used to treat constipation and hepatic encephalopathy

1.1 Drug use for constipation
Lactulose is a synthetic disaccharide made from galactose and fructose (fruit sugar). Lactulose is extremely safe even with prolonged use. Due to the lack of necessary digestive enzymes, the human body cannot break down the sugar lactulose. Lactulose is metabolized by intestinal bacteria to lactic acid and small amounts of acetic and formic acids. The lactulose drug reaches the large intestine intact and is broken down to acetic and lactic acid by bacteria.
The environment in the large intestine is acidified thereby altering the resident bacteria in the intestine, leading to the production and absorption of ammonia. As a result, toxicity symptoms are reduced as the patient's toxin level decreases. As a result, the absorption of toxins formed from the intestine is also reduced. Lactulose provides a nutritional environment for the bacteria in the gut, helping to reduce ammonia by the bacteria in the gut using nitrogen. Thus, less ammonia is formed and absorbed.
Although Lactulose is safe, there are still some side effects such as:
Stomach bloating Diarrhea Abdominal pain, nausea, vomiting Hypernatremia However, these symptoms will quickly disappear after a while. adaptation to the drug. In case of diarrhea, the dose should be reduced immediately; If diarrhea persists, stop taking the medicine.

1.2 Use of drugs for hepatic encephalopathy
Drugs are effective in treating hepatic encephalopathy, but need to be used in high doses. One of the causes of CNS toxicity in people with hepatic coma is increased blood ammonia. In order for the drug to be most effective during the treatment of psoriasis, the patient should be combined with a diet that limits protein.
Patients with diabetes do not need to worry about the carbohydrate level in lactulose, because lactulose is not absorbed by the body, so it does not raise blood sugar.

2.1 For constipation
Constipation : Depending on the condition of constipation, the dose can be adjusted according to each person, starting with 2 times a day. However, you should follow these guidelines:
Adults: 10g, 2 times/day, increase to 40g/day, if necessary. Maintenance dose 7-10g/day. Children 5 - 10 years old: 6g, 2 times/day. Children under 5 years old: 3g, 2 times/day. Children under 1 year old: 2g, 2 times/day. The usual dosage for syrup is 15-50 mL 3 times per day. Dosage is 6g lactulose 3 - 5 times daily when using granules. You can use whole or dilute 6 to 10 sachets when nasogastric.

2.2 Prevention of hepatic encephalopathy
For adults, initially use only 20-30g with a dose of 3 times/day. To be able to defecate 2-3 times a day, it is necessary to adjust the drug gradually. For children, it is necessary to divide into more doses, but the dose is smaller, only 2-6g/day. Dosage for older children and adolescents is 30-60g/day, divided into several times. In the process of using the drug, the patient may have diarrhea, need to reduce the dose immediately, if it persists, stop taking the drug. Diabetics when using the drug, need to be careful because small amounts of free lactose and galactose are present in some dosage forms of the drug. The drug should be stored in a dry place, the temperature is below 30 degrees Celsius

The drug lactulose works well in the treatment of constipation and liver damage, however, it also causes interactions with some other drugs. Therefore, patients should consult their doctor about possible drug interactions. Besides, it is necessary to list a list of drugs / functional foods being used for the doctor. Some drugs cause interactions, such as:
Laxatives, which will make it difficult to determine the exact dose of lactulose for the treatment of hepatic encephalopathy, due to causing frequent bowel movements. Antacids are not absorbed. Antibacterial drugs (except neomycin).

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