Lactulose

Lactulose is a semi-synthetic disaccharide that is not absorbed from the GI tract. It produces an osmotic diarrhoea of low faecal pH, and discourages the proliferation of ammonia-producing organisms.

Uses
Constipation
Hepatic encephalopathy

Contraindications
Intestinal obstruction
Galactosaemia

Administration
• Constipation
Orally: 15 ml 12 hourly, gradually reduced according to patient’s needs
May take up to 48 h to act
• Hepatic encephalopathy
Orally: 30–50 ml 8 hourly, subsequently adjusted to produce 2–3 soft stools daily

Adverse effects
Flatulence
Abdominal discomfort