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Lactulose is useful in treating hyperammonemia (high blood ammonia), which can lead to hepatic encephalopathy. Lactulose helps trap the ammonia (NH 3 ) in the colon and bind to it. [ 16 ] It does this by using gut flora to acidify the colon, transforming the freely diffusible ammonia into ammonium ions ( NH +
Hyperammonemia, or high ammonia levels, is a metabolic disturbance characterised by an excess of ammonia in the blood. Severe hyperammonemia is a dangerous condition that may lead to brain injury and death. It may be primary or secondary. Ammonia is a substance that contains nitrogen. It is a product of the catabolism of protein.
[2] [6] It may be supported by blood ammonia levels, an electroencephalogram, or computer tomography (CT scan) of the brain. [4] [6] Hepatic encephalopathy is possibly reversible with treatment. [1] This typically involves supportive care and addressing the triggers of the event. [4] Lactulose is frequently used to decrease ammonia levels. [1]
Most pharmaceutical approaches to treating hepatic encephalopathy focus on reducing ammonia levels. [138] Per 2014 guidelines, [ 139 ] the first-line treatment involves the use of lactulose , a non-absorbable disaccharide which decreases the pH level of the colon when it is metabolized by intestinal bacteria.
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The complications are hepatic encephalopathy and impaired protein synthesis (as measured by the levels of serum albumin and the prothrombin time in the blood). The 1993 classification defines hyperacute as within 1 week, acute as 8–28 days, and subacute as 4–12 weeks; [ 1 ] both the speed with which the disease develops and the underlying ...
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