Lactulose

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Lactulose

Lactulose (IPA: 'læktj?l??z) is a synthetic sugar

Sugar

Sugar is a class of edible crystalline substances, mainly sucrose, lactose, and fructose. Human taste buds interpret its flavor as sweet. Sugar as a basic food carbohydrate primarily comes from sugar cane and from sugar beet, but also appears in fruit, honey, sorghum, sugar maple , and in many other sources....
used in the treatment of constipation

Constipation

Constipation, costiveness, or irregularity, is a condition of the digestive system in which a person experiences hard feces that are difficult to expel....
and hepatic encephalopathy

Hepatic encephalopathy

Hepatic encephalopathy is a potentially-reversible neuropsychiatric abnormality in the setting of liver failure, whether chronic , or acute liver failure....
, a complication of liver disease

Liver disease

Liver disease is a broad term describing any single number of diseases affecting the liver. Many are accompanied by jaundice caused by increased levels of bilirubin in the system....
. It is a disaccharide

Disaccharide

A disaccharide is a sugar composed of two monosaccharides.'Disaccharide' is one of the four chemical groupings of carbohydrates ....
(double-sugar) formed from one molecule each of the simple sugars (monosaccharide

Monosaccharide

Monosaccharides are the most basic unit of carbohydrates. They are the simplest form of sugar and are usually colorless, water-soluble, crystal solids....
s) fructose

Fructose

Fructose is a simple Reducing sugar sugar found in many foods and is one of the three important dietary monosaccharides along with glucose and galactose....
and galactose

Galactose

Galactose is a type of Carbohydrate which is less sweetness than glucose. It is considered a nutritive sweetener because it has food energy.Galactan is a polymer of the sugar galactose....
. The commercial syrup used for treatment of constipation is dyed yellow-orange. It is produced commercially by isomerization of lactose

Lactose

Lactose is a sugar that is found most notably in milk. Lactose makes up around 2?8% of milk . The name comes from the Latin word for milk, plus the -ose ending used to name sugars....
.

Constipation
In the treatment of chronic constipation

Constipation

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Constipation

In the treatment of chronic constipation

Constipation

Constipation, costiveness, or irregularity, is a condition of the digestive system in which a person experiences hard feces that are difficult to expel....
, the metabolites of lactulose draw water into the bowel, causing a cathartic effect through osmotic action. Unlike other laxatives that are recommended for temporary relief, lactulose can be taken daily for decades. It is safe for people of all ages, except for those in a very small percentage of the population that are galactose

Galactose

Galactose is a type of Carbohydrate which is less sweetness than glucose. It is considered a nutritive sweetener because it has food energy.Galactan is a polymer of the sugar galactose....
intolerant. Dosage may have to be adjusted over time to produce the desired effect.

It is useful in treating people with chronic constipation due to forgetting or ignoring the need for defecation. The treament is to start the dosage at a low amount and then gradually increase it over a period of weeks until the urgency is such that a daily bowel movement cannot possibly be ignored.

It is useful in treating people who abuse laxatives because lactulose has no toxic effect when taken at overdose levels, yet produces powerful results.

It is useful for negating the constipating effects of opiates and opioids.

It is useful for treatment of hemorrhoids because it produces a soft bowel movement without any straining.

It is helpful for treating children who withhold their bowel movements out of fear because when taken in sufficient quantity and then withheld, it produces a very insistent, irresistible and powerful urge to defecate.

Lactulose has an overly sweet taste that can be completely masked by mixing it with fruit juice or desserts. It can take 24 to 48 hours to work, but generally produces results within 4 hours if taken on a daily basis. It is best taken at breakfast along with a bowl of bran

Bran

Bran is the hard outer layer of grain and consists of combined aleurone and pericarp. Along with cereal germ, it is an integral part of whole grains, and is often produced as a by-product of milling in the production of refined grains....
cereal.

Hepatic encephalopathy

In treating hepatic encephalopathy

Hepatic encephalopathy

Hepatic encephalopathy is a potentially-reversible neuropsychiatric abnormality in the setting of liver failure, whether chronic , or acute liver failure....
, lactulose helps "draw out" ammonia

Ammonia

Ammonia is a chemical compound with the chemical formula nitrogenhydrogen. It is normally encountered as a gas with a characteristic pungent odor....
(NH₃) from the body.

The effectiveness of lactulose is somewhat controversial, and whether or not its effects are through ammonia is controversial as well. Lactulose is metabolized in the colon

Colon (anatomy)

The colon is the last portion of the digestive system in most vertebrates; it extracts water and salt from feces before they are defecation from the body....
by bacterial flora

Bacterial flora

The bacterial flora is the whole system of bacteria in body cavities that have contact with the outside world. Every place shows another biochemical environment:...
to short chain fatty acids, acidifying the colonic contents. This favors the formation of the nonabsorbable NH₄⁺ from NH₃, trapping NH₃ in the colon and effectively reducing plasma NH₃ concentrations.

Side effects

Common side effects are abdominal cramping, gas, borborygmus

Borborygmus

Borborygmus also known as stomach growling, or rumbling, is the rumbling sound produced by the movement of flatulence through the intestines of animals, including humans....
and flatulence

Flatulence

Flatulence is the production of a mixture of gases in the gastrointestinal tract of mammals or other animals that are byproducts of the digestion process....
. Less common side effects are nausea

Nausea

Nausea is the sensation of unease and discomfort in the stomach with an urge to vomit....
and vomiting

Vomiting

Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Undesired vomiting may result from many causes, ranging from gastritis or poisoning to brain tumors, or elevated intracranial pressure....
. Excessively high dosage can cause explosive and uncontrollable diarrhea

Diarrhea

In medicine, diarrhea, also spelled diarrhoea , is characterized by frequent loose or liquid bowel movements. The spelling of "diarrhea" is an appropriation of the Greek "diarrhoia" meaning "a flowing through." ....
.

In sensitive individuals, such as the elderly or people with reduced kidney

Kidney

The kidneys are Organ that have numerous biological roles. Their primary role is to maintain the homeostasis balance of bodily fluids by filtering and secreting Metabolomics#Metabolitess and minerals from the blood and excreting them, along with water , as urine....
function, excess dosage can result in dehydration

Dehydration

Dehydration is the removal of water from an object. In Physiology terms, it entails a relative deficiency of water molecules in relation to other dissolved solutes....
and high sodium levels

Hypernatremia

Hypernatremia or hypernatraemia is an electrolyte disturbance that is defined by an elevated sodium level in the blood. Hypernatremia is generally not caused by an excess of sodium, but rather by a relative deficit of water in the body....
.

Brand names

Sorbilac (XL Laboratories, India)
Lilac Syrup (Getz Pharma.)
Generlac
Cephulac
Cholac
Constilac
Enulose
Acilac
Heptalac
Actilax
Duphalac
Kristalose
Apo-Lactulose
lactulose-hek
Lactulose Solution

External links

Virtual Cancer Centre