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.
