Lactulose is an artificially synthesized stereoisomer of lactose - milk sugar. Like it, the lactulose molecule is made up of residues of the molecules of fructose and galactose, but this substance does not occur in nature.
Lactulose, a well-soluble white powder, was first obtained from lactose in 1929, but its medicinal properties were discovered much later. The results of its application were first described only after thirty years. Currently, drugs based on this substance are one of the most effective and popular laxatives.
Lactulose, the instructions for use which describe in detail its properties, belongs to the class of so-called prebiotics - substances that enter the body along with food, but are not absorbed and not subject to digestion. Their value lies in the fact that they stimulate the growth of beneficial microflora in the intestine, which is involved in digestion. This is the main difference between prebiotics and most laxatives, which have a corresponding effect due to the effect on the smooth muscles of the intestine. Increased intestinal motility of lactulose (instructions for the use of the drug describes its effect) causes due to an increase in osmotic pressure. As a result of this process, stool becomes more voluminous and fluid, as a result of which relaxation occurs.
In addition to the laxative effect, lactulose also increases the secretion of bile, stimulates liver function and alleviates the symptoms of hepatic intoxication. After its use, the amount of toxic substances in the blood , in particular ammonia, is significantly reduced. Normally, they are neutralized by liver cells - hepatocytes. However, in patients with liver failure that occurs, for example, with cirrhosis, toxic metabolites are absorbed from the intestine and have a toxic effect on the brain. As a result, the patient develops a chronic portal systemic encephalopathy (PSE) - a complex neuropsychiatric syndrome. It is characterized by neuromuscular disorders, disorders of behavior and consciousness. Lactulose (instructions for the use of the drug indicates this) is the most effective drug to alleviate the patient’s condition with PSE: it provides rapid excretion of ammonia from the body and prevents its absorption into the blood.
The effect of lactulose on the intestinal microflora is similar to the action of dietary fiber, traditionally used to treat constipation. Studies have shown that as a result of its use in the intestine, the number of lactobacilli involved in the digestion of food increases significantly. In addition, it is used for uncomplicated forms of intestinal infections: a decrease in the number of pathogenic bacteria in the intestine is one of the results of taking Lactulose. Instructions for use of the tool suggests that it inhibits the reproduction of salmonella and dysentery pathogens - shigella. Due to these properties, lactulose is used in the treatment of dysbiosis.
Today, dozens of drugs based on lactulose are produced in the world: Dufalac, Normase, Livolac, Lactofiltrum, Lactusan and others. Lactulose, the instructions for use which describe in detail the possible side effects of the drug, is an ideal laxative for young children, the elderly, pregnant and lactating women. It acts gently and carefully, practically without causing unpleasant sensations. Possible side effects include abdominal pain and flatulence. Nausea and vomiting are sometimes noted, usually associated with an individual intolerance to the drug. In this case, you need to stop taking it.
The course of treatment with lactulose is, on average, about two months. For the treatment of constipation of lactulose (the instructions accurately indicate the recommended doses of the drug), 15-45 ml per day is initially used (the dose is adjusted individually). After a few days, they switch to a maintenance dose - it will be slightly less. For children, lactulose syrup (instructions indicate this) is recommended for use at a dose of 5 ml per day. With PSE, at the beginning of therapy, it dissolves in water and is administered rectally 3-4 times a day. After stabilization of the patient's condition, the drug is taken orally at a dose prescribed by the doctor.