Lactulose

Lactulose is a medication used for the treatment of constipation and the management of liver disease. It is a synthetic disaccharide, which means it is a combination of two simple sugars, lactose and ulose. Lactulose is not broken down or absorbed in the small intestine, but instead, it reaches the large intestine where it is fermented by gut bacteria.
In constipation, the primary use of lactulose is to stimulate bowel movements by increasing the water content and softening the stool. This is achieved through the fermentation process, which produces gas and lowers the pH of the intestinal contents. The resulting increase in gas and acidity stimulates peristalsis, the rhythmic contractions of the intestinal muscles that propel the stool through the digestive tract.
In liver disease, lactulose is used to lower the ammonia levels in the bloodstream. When the liver is not functioning properly, ammonia, a toxic substance, can accumulate in the blood. Lactulose acts as a laxative, drawing ammonia from the bloodstream into the intestines, where it is then excreted in the stool. This helps to reduce the levels of ammonia in the blood and alleviate symptoms such as confusion, agitation, and cognitive impairment that can be associated with high ammonia levels.
Lactulose is available in both oral and rectal forms. The oral form is typically administered as a liquid, while the rectal form is available as an enema. The medication should be taken or administered as directed by a healthcare professional, and the dosage may vary depending on the individual’s condition and response to treatment.