Lactulose for Hepatic Encephalopathy: Is It An Effective Therapy?


How much do you know about hepatic encephalopathy (H.E)? What treatment options are you aware of? H.E is a complication that occurs as a result of liver disease. What happens is that blood flow begins to bypass your liver as a result of portal hypertension. The unfiltered blood then goes into your general circulation and carries toxins with it. These toxins then enter your brain and begin to affect its normal function. These toxic effects on your brain are what doctors call encephalopathy. The toxic effects range from personality or behavioral changes to altered cognitive functions to loss of consciousness. One of the drugs used for treating H.E is lactulose. How effective is lactulose for hepatic encephalopathy? Read on to find out.

Some of the symptoms of H.E include confusion, poor memory, sleepiness, general sleep disorders, tremor, and irritability. How do doctors treat cases of hepatic encephalopathy treated? There are many treatment options. Lactulose is one of them. Lactulose helps because the toxins that cause H.E come from your foods. What it does is to decrease how many toxins your large intestines would absorb. SO with lactulose, no matter how dysfunctional your liver is, toxins are not even entering into your bloodstream in the first place. There are different brand names for Lactulose. Some of them include Enulose, Kristalose, Constulose, and Generac. They alter your colon’s acidity, thus preventing the absorption of toxins, such as ammonia.

How to Use Lactulose for Hepatic Encephalopathy

There are two ways to use lactulose for H.E. You can either use it by mouth or rectally. However, we must clarify that lactulose is not a cure for H.E, but it can only improve your mental status.

Lactulose is an artificial sugar solution and an acidifier of the colon. It decreases how much ammonia can pass into your blood from your colon. But Lactulose has many uses. H.E is not the only condition that lactulose treats. So how you would use it will rely on what you are using it to treat.

If you are using lactulose to treat liver disease, you would have to take it like 3 to 4 times daily. But if your doctor recommends otherwise, follow his directions.

Lactulose may not have so much of a great taste. But you can improve its taste by mixing the drug into fruit juice, soft dessert, or even just water. The goal of using lactulose is for you to have about two to three soft stools daily.

Sometimes, your doctor will adjust your dosage with how you are responding to the therapy. This is determined by how many soft stools you are passing each day.

You can use lactulose as an enema to treat H.E or any other liver disease. You would mix the recommended amount with 24 ounces (700 milliliters) of normal saline or water. Then, you can pass the liquid into your rectum. Keep the solution inside for about 30 to 60 minutes, except your doctor directs otherwise.

One thing with using lactulose is that you must use it regularly if you will get maximum benefits from it. And try as much as possible to keep to the exact same time daily.

When you use lactulose rectally to treat H.E, your mental status can improve in just 2 hours. But oral use can take up to one full day or two (24-48 hours) to see results.

Be watchful, however, when you are using lactulose. If you experience any side effects or the condition either persists or even worsens, you should reach out to your doctor immediately.

What Are The Side Effects of Lactulose?

Quite a few adverse effects may occur when you use lactulose. They include bloating, gas, stomach rumbling, burping, stomach pain, cramps, and nausea. If you experience any one of these, you should notify your physician or pharmacist.

Sometimes, you may be afraid of adverse effects even before you use the drug. But remember, your doctor knows about these adverse effects. Yet, he prescribed it for you because he believes that its benefits far outweigh the risks or side effects.

In truth, most people that use lactulose have no serious adverse effects whatsoever. But then, some unlikely but severe effects require urgent attention. You should let your doctor know right away in case you experience any of them. They include:

  • Diarrhea
  • Muscle cramps
  • General body weakness
  • Vomiting
  • Mood changes
  • Mental changes
  • Irregular heartbeat
  • Seizures

There are also serious allergic reactions, but they are quite unlikely. But you must seek immediate expert care if ever it occurs. Some allergic reactions that may occur include:

  • Rash
  • Swelling/itching (especially on your face, throat, or tongue)
  • Trouble breathing
  • Severe dizziness

The list above is not exhaustive. So you may notice some other effects that are not on the list. If you experience any strange effects, you should contact your pharmacist or physician or pharmacist.

One precaution you must bear in mind is to let your healthcare provider know before you use lactulose. Also, inform him or her about any allergies you may have had in the past. The medication may contain some inactive ingredients that may cause allergies.

Also, you should steer clear of lactulose if you have any of the following conditions:

  • Bowel problems
  • Lactose intolerance
  • History of diabetes

Avoid laxative drugs if you are using lactulose. And if you use it too frequently, it can cause severe dehydration. So you should watch against that also. Children and elderly people are at more risk for this.

Dehydration symptoms that you should be wary of include muscle cramps, general weakness, and dizziness.

Is Lactulose An Effective Therapy?

Using lactulose for hepatic encephalopathy is a very effective therapy. But remember that it does not in any way cure H.E. It only helps to manage the symptoms, especially when it comes to your mental status. However, ensure to follow all of your doctor’s directions and carry him or her along with how you feel as you use the medication.

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