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Article |

Lactulose Treatment of Hepatic Encephalopathy in Outpatients

Henry Brown, MD; Charles Trey, MD; William V. McDermott Jr., MD
Arch Surg. 1971;102(1):25-27. doi:10.1001/archsurg.1971.01350010027006.
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Studies with lactulose (galactose-fructose) and sorbitol indicate that they reduce neurologic abnormalities of hepatic encephalopathy. Nine patients greatly incapacitated by encephalopathy after portacaval shunting were able to continue relatively normal day-to-day living for 6 to 20 months without need for hospitalization because of neurologic symptoms. Sorbitol, a relatively inert sugar administered in a double blind prospective study was often as beneficial as lactulose. The mechanism for reducing neurologic symptoms is believed due to decreased absorption of ammonium and other nitrogen-containing compounds from the colon by the cleansing action of catharsis and lowering of the colon pH.


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