Wednesday, March 24, 2010

Wednesday March 24, 2010


Q; What are the 3 mechanisms by which lactulose improve hepatic encephelopathy?


Answer:

  • The conversion of Lactulose to lactic acid results in acidification of the gut lumen. This favors conversion of NH4 + to NH3 and the passage of NH3 from tissues into the lumen.
  • Gut acidification inhibits ammoniagenic coliform bacteria, leading to increased levels of nonammoniagenic lactobacilli.
  • Lactulose also works as a cathartic, reducing colonic bacterial load.

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