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Tavares, Ricardo Silva, Barbara Rocha Gonçalves, Stanrley Viali Gomes, Pauliana Sousa Oliveira, Camila Botelho Miguel, and Wellington Francisco Rodrigues. "Probióticos e lactulose no tratamento da encefalopatia hepática - uma revisão sistemática." Revista Remecs - Revista Multidisciplinar de Estudos Científicos em Saúde 4, no. 6 (June 26, 2019): 12. http://dx.doi.org/10.24281/rremecs2526-2874.2019.4.6.12-17.
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Tendo isso em vista, o objetivo do presente trabalho foi avaliar a eficácia do uso de probióticos e lactulose em pacientes portadores de EH. Foi realizada busca pelos artigos em bases eletrônicas de dados, limitando-se ao período de 2014-2018. A estratégia de busca utilizou os termos: “hepatic encephalopathy”, “probiotics” e “lactulose”. Os critérios de inclusão determinados foram grupos de indivíduos sob uso de probióticos e/ou lactulose como terapia e controle(placebo). Dos 200 artigos levantados nas plataformas de pesquisa, apenas cinco trabalhos foram selecionados. De acordo com os estudos analisados, observou-se melhora significativa na recuperação, efeitos adversos e qualidade de vida dos indivíduos sob tratamento à base de probióticos em comparação ao uso de placebos ou à ausência de tratamento. Além disso, a concentração de amônia plasmática foi menor em pacientes tratados com probióticos comparados aos pacientes que fizeram uso de lactulose.Descritores: Amônia, Neurotransmissor, tratamento.Probiotcs and lactulose in the treatment of hepatic encephalopathy - a systematicAbstract: With this in mind, the objective of this study was to evaluate the efficacy of probiotics and lactulose in patients with HS. A search for articles was conducted on electronic data bases, limiting the period of 2014-2018. The search strategy used the terms: "Hepatic encephalopathy", "Probiotics" and "lactulose". The inclusion criteria were groups of individuals under the use of probiotics and/or lactulose as therapy and control (placebo). Of the 200 articles raised on the research platforms, only five papers were selected. According to the studies analyzed, there was a significant improvement in the recovery, adverse effects and quality of life of the individuals under treatment based on probiotics compared to the use of placebos or the absence of treatment. In addition, plasma ammonia concentration was lower in patients treated with probiotics compared to patients who made use of lactulose.Descriptors: Ammonia, Neurotransmitter, Treatment.Probióticos y lactulose en tratamiento de la encefalopatía hepática - una revisiónResumen: Con esto en mente, el objetivo de este estudio fue evaluar la eficacia de los probióticos y lactulosa en pacientes con HS. Se realizó una búsqueda de artículos sobre bases de datos electrónicas, limitando el período de 2014-2018. La estrategia de búsqueda utiliza los términos: "encefalopatía hepática", "probióticos" y "lactulose". Los criterios de inclusión fueron grupos de individuos bajo el uso de probióticos y/o lactulosa como terapia y control (placebo). De los 200 artículos planteados en las plataformas de investigación, sólo se seleccionaron cinco artículos. De acuerdo con los estudios analizados, hubo una mejora significativa en la recuperación, efectos adversos y calidad de vida de los individuos bajo tratamiento basado en probióticos en comparación con el uso de placebos o la ausencia de tratamiento. Además, la concentración plasmática de amoníaco fue menor en los pacientes tratados con probióticos en comparación con los pacientes que hicieron uso de lactulose.Descriptores: Amoníaco, Neurotransmisor, Tratamiento.
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Hussain, Mazhar, Habib-Ur Rehman, Lubna Akhtar, and Muhammad Bilal Ghafoor. "HEPATIC ENCEPHALOPATHY;." Professional Medical Journal 24, no. 07 (July 3, 2017): 947–51. http://dx.doi.org/10.29309/tpmj/2017.24.07.1087.
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Background: Hepatic encephalopathy is one of the fatal complications of livercirrhosis in clinical setting. A number of drugs with varied response have been tried up till now.Objectives: To compare the efficacy of lactulsoe alone and in combination with rifaxamin incases with hepatic encephalopathy. Study Design: Randomized control trail. Setting: SheikhZayed Hospital (SZH) Rahim Yar Khan (RYK). Period: January 2015 to October 2015. Patientsand Methods: 120 cases of liver cirrhosis with encephalopathy were randomized into differentgrades according to West Haven’s criteria. These cases were then equally divided into group Aand B. Group A was treated with lactulose alone while group B was treated with lactulose plusrifaxamin with their standard doses. The cases were assessed for their improvement in symptomson West Haven’s scale and the cases with complete resolution of symptoms were labeled ascured. The mortality benefit was also noted. Results: The mean age was 43.24± 8.34 yearsand mean duration of symptoms was 3.45± 0.8 days. There was no significant difference interms of child pugh score in both groups with p= 0.69. There was also no significant differencein both groups in terms of grades of encephalopathy (p= 0.21). However there was significantbetter efficacy and decreased mortality in group B as compared to A with p values of 0.02 and0.03 respectively. Conclusion: Lactulose combined with rifaxamin has significant improvementin encephalopathy as well as in reducing mortality in comparison with lactulsoe alone
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&NA;. "Lactulose." Reactions Weekly &NA;, no. 1176 (November 2007): 19–20. http://dx.doi.org/10.2165/00128415-200711760-00057.
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&NA;. "Lactulose." Reactions Weekly &NA;, no. 1364 (August 2011): 29. http://dx.doi.org/10.2165/00128415-201113640-00110.
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Jankowski, Gwendolyn. "Lactulose." Journal of Exotic Pet Medicine 18, no. 2 (April 2009): 156–59. http://dx.doi.org/10.1053/j.jepm.2009.04.009.
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Lee, Gwenyth O., Peter Kosek, Aldo A. M. Lima, Ravinder Singh, Pablo P. Yori, Maribel P. Olortegui, Jesse L. Lamsam, Domingos B. Oliveira, Richard L. Guerrant, and Margaret Kosek. "Lactulose." Journal of Pediatric Gastroenterology and Nutrition 59, no. 4 (October 2014): 544–50. http://dx.doi.org/10.1097/mpg.0000000000000459.
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MCMEEKIN, JUDY. "LACTULOSE." Nursing 21, no. 6 (June 1991): 84–86. http://dx.doi.org/10.1097/00152193-199106000-00035.
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Singh, Monika, Radha Kushwaha, Vinti Singh, Rahul Agrawal, Anil Parajapati, and Devinder Kaur. "Lactulose fortification in guava preserves: Effect on nutritional quality." Food and Health 9, no. 2 (2023): 98–107. http://dx.doi.org/10.3153/fh23009.
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This study examined the lactulose-fortified low-calorie guava preserves. The results showed that sucrose, used as a sweetener in guava preserves, could be partially substituted by lactulose without significantly affecting the overall quality of the preserves. The physicochemical properties, antioxidant activity, and sensory evaluation of guava preserves with substitute lactulose were evaluated. The main aim of this study was to develop prebiotic guava preserves from two guava cultivars, namely, Safeda and Chittidar. The guava preserves without lactulose were used as control samples which contained 50% w/w sucrose of pulp, while lactulose-treated preserves replaced sucrose with 25%, 50%, and 75% w/w of lactulose. The finding showed that prebiotics did not significantly differ between control and treated samples. The range of ascorbic acid content of guava preserves was 98.2-102.6 mg/100g. Lactulose did not show a statistically significant effect on the level of ascorbic acid in guava preserves. The mineral content and antioxidant properties of guava preserves supplemented with lactulose were higher than those not supplemented with lactulose. The guava preserves with 50% lactulose were most accepted.
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Fu, Jian, Yi Gao, and Li Shi. "Combination therapy with rifaximin and lactulose in hepatic encephalopathy: A systematic review and meta-analysis." PLOS ONE 17, no. 4 (April 26, 2022): e0267647. http://dx.doi.org/10.1371/journal.pone.0267647.
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Rifaximin and lactulose are widely used in patients with hepatic encephalopathy (HE); however, data on whether the combined use of rifaximin and lactulose could yield additional benefits for patients with HE are limited and inconclusive. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the treatment effectiveness of rifaximin plus lactulose versus lactulose alone in patients with HE. Electronic databases (PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure) were searched for eligible RCTs from their inception until November 2020. Relative risks (RRs) with 95% confidence intervals (CIs) were applied to calculate pooled effect estimates for the treatment effectiveness of rifaximin plus lactulose versus lactulose alone by using the random-effects model. Sensitivity, subgroup, and publication bias analyses were also performed. We included 7 RCTs enrolling 843 patients with HE. We noted that the use of rifaximin plus lactulose was associated with an increased incidence of effective rate than lactulose alone (RR, 1.30; 95% CI, 1.10–1.53; P = 0.002). Moreover, the use of rifaximin plus lactulose was associated with a reduced risk of mortality as compared with lactulose alone (RR, 0.57; 95% CI, 0.41–0.80; P = 0.001). This study found that the use of rifaximin in combination with lactulose could provide additional benefits in terms of increased effective rate and decreased mortality than lactulose alone in patients with HE.
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Fu, Jian, Yi Gao, and Li Shi. "Combination therapy with rifaximin and lactulose in hepatic encephalopathy: A systematic review and meta-analysis." PLOS ONE 17, no. 4 (April 26, 2022): e0267647. http://dx.doi.org/10.1371/journal.pone.0267647.
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Rifaximin and lactulose are widely used in patients with hepatic encephalopathy (HE); however, data on whether the combined use of rifaximin and lactulose could yield additional benefits for patients with HE are limited and inconclusive. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the treatment effectiveness of rifaximin plus lactulose versus lactulose alone in patients with HE. Electronic databases (PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure) were searched for eligible RCTs from their inception until November 2020. Relative risks (RRs) with 95% confidence intervals (CIs) were applied to calculate pooled effect estimates for the treatment effectiveness of rifaximin plus lactulose versus lactulose alone by using the random-effects model. Sensitivity, subgroup, and publication bias analyses were also performed. We included 7 RCTs enrolling 843 patients with HE. We noted that the use of rifaximin plus lactulose was associated with an increased incidence of effective rate than lactulose alone (RR, 1.30; 95% CI, 1.10–1.53; P = 0.002). Moreover, the use of rifaximin plus lactulose was associated with a reduced risk of mortality as compared with lactulose alone (RR, 0.57; 95% CI, 0.41–0.80; P = 0.001). This study found that the use of rifaximin in combination with lactulose could provide additional benefits in terms of increased effective rate and decreased mortality than lactulose alone in patients with HE.
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Hiraishi, Keizo, Feiyan Zhao, Lin-Hai Kurahara, Xiaodong Li, Tetsuo Yamashita, Takeshi Hashimoto, Yoko Matsuda, Zhihong Sun, Heping Zhang, and Katsuya Hirano. "Lactulose Modulates the Structure of Gut Microbiota and Alleviates Colitis-Associated Tumorigenesis." Nutrients 14, no. 3 (February 3, 2022): 649. http://dx.doi.org/10.3390/nu14030649.
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Lactulose, a galactose-fructose disaccharide, is made from the milk sugar lactose by heating or isomerization processes. Lactulose is proposed to modulate gut microbiota and thus expected to be beneficial in treating inflammatory bowel disease. In the present study, we investigated the therapeutic effect of lactulose on gastrointestinal inflammation and inflammation-related tumorigenesis in a mouse model of colorectal cancer as well as its effect on gut microbiota composition. Azoxymethane (AOM)/dextran sulfate sodium (DSS) model was used in this study. Lactulose treatment was performed by feeding 2% lactulose for 14 weeks. Stool samples collected at 4 time points were used for metagenomic analysis of the microbiota. Pathological analysis was performed 21 weeks after AOM injection. AOM/DSS increased the macrophage counts, inflammatory cytokine expression, colorectal tumorigenesis, and imbalance in gut microbiota composition, as evidenced by increased pathogen abundance (e.g., Escherichia and Clostridium). Lactulose significantly inhibited the inflammatory events, and ameliorated inflammation and tumorigenesis. The composition of the intestinal microbiota was also restored upon lactulose treatment, and lactulose reduced pathogen abundance and increased the abundance of Muribaculum and Lachnospiraceae. Meanwhile, the pathways related to Crohn’s disease were downregulated after lactulose treatment. Our findings suggest that lactulose restores the structure and composition of the intestinal microbiota, mitigates inflammation, and suppresses inflammatory tumorigenesis.
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Guo, Yaozu, Wenlong Ma, Manxi Song, Wenqiong Wang, Boxing Yin, and Ruixia Gu. "Increase in Lactulose Content in a Hot-Alkaline-Based System through Fermentation with a Selected Lactic Acid Bacteria Strain Followed by the β-Galactosidase Catalysis Process." Foods 12, no. 23 (November 29, 2023): 4317. http://dx.doi.org/10.3390/foods12234317.
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In this study, lactic acid bacteria (LAB) fermentation and β-galactosidase catalysis methods were combined to increase the lactulose concentration and reduce the galactose and lactose content in a hot-alkaline-based system. The optimal conditions for chemical isomerization were 70 °C for 50 min for lactulose production, in which the concentration of lactulose was 31.3 ± 1.2%. Then, the selection and identification of LAB, which can utilize lactose and cannot affect lactulose content, were determined from 451 strains in the laboratory. It was found that Lactobacillus salivarius TM-2–8 had weak lactulose utilization and more robust lactose utilization. Lactobacillus rhamnosus grx.21 was weak in terms of lactulose utilization and strong in terms of galactose utilization. These two strains fermented the chemical isomerization system of lactulose to reduce the content of lactose and galactose. The results showed that the lactose concentration was 48.96 ± 2.92 g/L and the lactulose concentration was 59.73 ± 1. 8 g/L for fermentation lasting 18 h. The β-galactosidase was used to increase the content of lactulose in the fermented system at this time. The highest concentration of 74.89 ± 1.68 g/L lactulose was obtained at an enzymatic concentration of 3 U/mL and catalyzed at 50 °C for 3 h by β-galactosidase.
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&NA;. "Lactulose/senna." Reactions Weekly &NA;, no. 1142 (March 2007): 17–18. http://dx.doi.org/10.2165/00128415-200711420-00047.
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&NA;. "Lactulose/sorbitol." Reactions Weekly &NA;, no. 1305 (June 2010): 20. http://dx.doi.org/10.2165/00128415-201013050-00068.
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Said, Vickey J., and Edith Garcia-Trujillo. "Beyond Lactulose." Gastroenterology Nursing 42, no. 3 (2019): 277–85. http://dx.doi.org/10.1097/sga.0000000000000376.
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Tahir, Furqan, Irfan Younus, Zaid Gul, Adnan Qadir, Muhammad Bilal, and Talha Firoz. "Comparison of Efficacy of Lactulose with and without Polyethylene Glycol in the Treatment of Patients with Hepatic Encephalopathy." Pakistan Journal of Medical and Health Sciences 17, no. 2 (March 6, 2023): 258–60. http://dx.doi.org/10.53350/pjmhs2023172258.
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Objective: To compare the effectiveness of the combination of Lactulose and Polyethylene glycol (PEG) versus Lactulose alone in improving the grade of hepatic encephalopathy (HE) within 24 hours of hospital admission in patients with hepatic encephalopathy due to decompensated liver cirrhosis precipitated by constipation. Study Design: Randomized controlled trial. Place and Duration: The Department of Gastroenterology, Hepatology and GI Endoscopy, Shaheed Zulfiqar Ali Bhutto Medical University, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan from 07-05-2020 to 06-05-2021. Methodology: One hundred and sixteen patients (58 in each group) of either gender aged 20-70 years having decompensated liver cirrhosis with HE grade 2 to 4 secondary to constipation were enrolled. Patients were randomly and equally divided into either Lactulose and PEG (Group-1) or Lactulose alone (Group-2) by lottery method. West Haven Criteria was used for labeling HE grades at the baseline and after 24 hours of treatment in both study groups. A one-grade improvement in HE after 24 hours of treatment from the baseline was considered as effectiveness of treatment. Results: Treatment was found effective (at least one HE grade improvement) in 43 (74.1%) patients treated with PEG+Lactulose, while it was 32 (55.2%) in patients who were treated with Lactulose alone (p=0.033). When stratified for age and gender, PEG+Lactulose was significantly effective in improving HE grades in younger age group (p=0.007) and males (p=0.040). Practical Implications: Combination treatment with PEG+Lactulose can be a preferred option for improvement in HE grades in comparison to treatment with lactulose alone Conclusions: Combination treatment with PEG+Lactulose was found to be more effective in improving HE grades when compared to treatment with lactulose alone within 24 hours of hospital admission among patients who had decompensated liver cirrhosis precipitated by constipation. Keywords: Constipation, decompensated liver disease, Hepatic encephalopathy, Lactulose, Polyethylene glycol.
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Sabah Berdawd,, Salar, Sasan Loqa Hanna,, and Yasir Kakameen Hamad. "Lactulose vs Lactuloseand inulin in treatment of pediatric constipation." Diyala Journal of Medicine 24, no. 1 (April 5, 2023): 102–8. http://dx.doi.org/10.26505/djm.v24i1.975.
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Background: Assess the efficacy of combining fiber and lactulose in the treatment of constipation in the pediatric age group.
Objective: To assess the efficacy of combining fiber and lactulose in the treatment of constipation in the pediatric age group.
Patients and Methods: One hundred forty-six patients with fuctionalconstipation were chosen in a non-randomized superiority trial manner as they were convenient to enroll due to their presentation to the outpatient clinic during the period from August 2019 to February 2022.Patient received either a solution of lactulose 3.3g/5ml in group A or a solution of 4.005g Inulin fiber and 4.005g lactulose per 20ml in group B.
Results: Total of 146 children were included; all, 146 patients completed the study. In the lactulose group, 19 patients were on therapy for less than 6 months, and 48 were on therapy for more than 6 months. In the lactulose + fiber group, 59 patients were on therapy for less than 6 months, and 20 were on therapy for more than 6 months. No serious adverse effects were registered but 18 (27%) of children in the lactulose group encountered side effects, while 11 (14%) of children in the lactulose + fiber group encountered side effects.
Conclusion: A solution of Lactulose + fiber is superior to a solution of Lactulose alone in terms of efficacy for the treatment of constipation in the pediatric age group. It also has a lower side effects profile.
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Sabah Berdawd, Salar, Sasan Loqa Hanna, and Yasir Kakameen Hamad. "Lactulose vs Lactuloseand inulin in treatment of pediatric constipation." Diyala Journal of Medicine 24, no. 1 (April 5, 2023): 102–8. http://dx.doi.org/10.26505/djm.24016971011.
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Background: Assess the efficacy of combining fiber and lactulose in the treatment of constipation in the pediatric age group. Objective: To assess the efficacy of combining fiber and lactulose in the treatment of constipation in the pediatric age group. Patients and Methods: One hundred forty-six patients with fuctionalconstipation were chosen in a non-randomized superiority trial manner as they were convenient to enroll due to their presentation to the outpatient clinic during the period from August 2019 to February 2022.Patient received either a solution of lactulose 3.3g/5ml in group A or a solution of 4.005g Inulin fiber and 4.005g lactulose per 20ml in group B. Results: Total of 146 children were included; all, 146 patients completed the study. In the lactulose group, 19 patients were on therapy for less than 6 months, and 48 were on therapy for more than 6 months. In the lactulose + fiber group, 59 patients were on therapy for less than 6 months, and 20 were on therapy for more than 6 months. No serious adverse effects were registered but 18 (27%) of children in the lactulose group encountered side effects, while 11 (14%) of children in the lactulose + fiber group encountered side effects. Conclusion: A solution of Lactulose + fiber is superior to a solution of Lactulose alone in terms of efficacy for the treatment of constipation in the pediatric age group. It also has a lower side effects profile.
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Ma, Jianxia, Houlian Ma, Songbai Zheng, Xiaofeng Yu, Ke Wang, Jun Wang, Yiru Pan, and Jianfeng Yao. "Intestinal flora in the constipation patients before versus after lactulose intervention." Medicine 102, no. 32 (August 11, 2023): e34703. http://dx.doi.org/10.1097/md.0000000000034703.
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This study aimed to investigate the characteristics of intestinal flora in patients with chronic functional constipation before and after lactulose intervention. Twenty-nine patients with constipation in the treatment group received oral lactulose (15 mL/d) for a month. Twenty healthy subjects served as controls. Stool specimens were collected before and after lactulose treatment. Fecal bacteria were examined by 16SrRNA gene sequencing and bioinformatics analysis. After lactulose treatment, most bacteria in the constipation group, including Bifidobacteria, Bacillus cereus, Prevotella, Bacillus, Anaerostipes, Oribacterium, and Mogibacterium increased as compared to those in the healthy control group. Anaerotruncus declined in the healthy control group after lactulose treatment. Our study shows lactulose can increase the abundance of probiotics, optimize the intestinal microenvironment, and alleviate constipation.
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Andrews, Geoffrey R., and S. Krishna Prasad. "Effect of the protein, citrate and phosphate content of milk on formation of lactulose during heat treatment." Journal of Dairy Research 54, no. 2 (May 1987): 207–18. http://dx.doi.org/10.1017/s0022029900025358.
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SummaryMilk ultrafiltrate and milks of varying protein, citrate and phosphate concentrations were heated in sealed containers. Protein was found not to be involved in the mechanism of formation of lactulose, but increasing the protein content of milk reduced the concentration of lactulose after heating. This was considered to be due to increased condensation of lactose and lactulose with amino groups of the protein, Less lactulose was formed in milk ultrafiltrate than in skimmed milk accorded the same heat treatment, which was attributed to the buffering capacity of the milk protein in skimmed milk. Activation energies for lactulose formation in skimmed milk and in ultrafiltrate were 128 and 131 kJ/mol respectively. Citrate and phosphate catalysed the formation of lactulose. It is proposed that the formation of free lactulose in heated milk and ultrafiltrate proceeds exclusively by the Lobry de Bruyn-Alberda van Ekenstein transformation with the naturally occurring phosphate and citrate acting as base catalysts.
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Kabel, Ahmed M. "Ameliorative Potential of Minocycline and/or Lactulose on Experimentally Induced Colitis." International Journal of Pharmacology, Phytochemistry and Ethnomedicine 2 (May 2016): 42–54. http://dx.doi.org/10.18052/www.scipress.com/ijppe.2.42.
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The aim of this study was to compare between the effect of minocycline or lactulose alone and in combination on experimentally-induced colitis in rats.Materials and methods:Seventy albino rats were divided into 7 equal groups: Control untreated group, trinitrobenzenesulphonic acid (TNBS) group, TNBS + lactulose group, lactulose group, TNBS + minocycline group, minocycline group and TNBS + lactulose+ minocycline group. A part of the colon was homogenized for determination of tissue tumor necrosis factor alpha, malondialdehyde, nitric oxide, reduced glutathione and myeloperoxidase. The other part of the colon was examined histopathologically. Also, disease activity index was measured.Results:Administration of each of lactulose or minocycline alone and in combination to TNBS-treated rats induced significant increase in tissue reduced glutathione with significant decrease in disease activity index, tissue tumor necrosis factor alpha, malondialdehyde, nitric oxide and myeloperoxidase and alleviated the histopathological changes compared to the group that received TNBS alone. Minocycline/lactulose combination produced significant improvement in the biochemical and histopathological parameters compared to the groups that received either minocycline or lactulose alone.Conclusion:Lactulose and minocycline had protective effects on TNBS-induced colitis in rats but minocycline/lactulose combination had the upper hand.
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Duysburgh, Cindy, Pieter Van den Abbeele, Dennis Franckenstein, Martin Westphal, Angelika Kuchinka-Koch, and Massimo Marzorati. "Co-Administration of Lactulose Crystals with Amoxicillin Followed by Prolonged Lactulose Treatment Promotes Recovery of the Human Gut Microbiome In Vitro." Antibiotics 11, no. 7 (July 18, 2022): 962. http://dx.doi.org/10.3390/antibiotics11070962.
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The validated SHIME model was used to assess the effect of repeated administration of two different lactulose dosages (5 g/d and 10 g/d) on the human gut microbiome during and following amoxicillin–clavulanic acid treatment. First, antibiotic treatment strongly decreased Bifidobacteriaceae levels from 54.4% to 0.6% and from 23.8% to 2.3% in the simulated proximal and distal colon, respectively, coinciding with a marked reduction in butyrate concentrations. Treatment with lactulose enhanced acetate and lactate levels during antibiotic treatment, likely through lactulose fermentation by Lachnospiraceae and Lactobacillaceae. One week after cessation of antibiotic treatment, Bifidobacteriaceae levels re-increased to 20.4% and 7.6% in the proximal and distal colon of the 5 g lactulose/d co-administered unit, as compared with 1.0% and 2.2% in the antibiotic-treated unit, and were even further stimulated upon extension of lactulose administration. Marked butyrogenic effects were observed upon prolonged lactulose supplementation, suggesting the establishment of cross-feeding interactions between Bifidobacteriaceae and butyrate producers. Furthermore, a limited Enterobacteriaceae outgrowth following antibiotic treatment was observed upon dosing with 10 g lactulose/d, indicating inhibition of pathogenic colonization by lactulose following antibiotic therapy. Overall, lactulose seems to be an interesting candidate for limiting the detrimental effects of amoxicillin–clavulanic acid on the human gut microbiome, though further studies are warranted to confirm these findings.
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Gubergrits, N. B., N. V. Byelyayeva, and G. M. Lukashevich. "Lactulose: a kaleidoscope of pleiotropic effects (literature review and own data)." Herald of Pancreatic Club 47, no. 2 (April 29, 2020): 89–99. http://dx.doi.org/10.33149/vkp.2020.02.11.
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The article presents in-depth analysis of literature data on the multifaceted effects of lactulose and the opportunities for its practical use. History of the study of lactulose therapeutic effects is described. Currently, lactulose as a medicine is registered in more than 100 states. Indications are constipation and hepatic encephalopathy, in some countries — treatment of salmonella carriage. However, the prospects and possibilities for the clinical use of lactulose are very broad.
In 2005, lactulose was officially recognized as the first choice for chronic constipation from the point of view of evidence-based medicine. Mechanism of lactulose action in case of constipation is analyzed; literature data on its safety in pregnant women, children and the elderly are presented.
Lactulose is superior to other treatment options for hepatic encephalopathy. It has been successfully used for any stage of severity of this condition, including latent encephalopathy and hepatic coma. The effectiveness and safety of lactulose in hepatic encephalopathy is confirmed by a large number of high-evidential studies.
Possible indications are: as a prebiotic for the treatment of bacterial overgrowth syndrome, primary and secondary prevention of gallstone disease, for the elimination of endotoxemia in hepatorenal syndrome, exocrine pancreatic insufficiency, hypercholesterolemia. Despite its sweet taste, lactulose is not contraindicated, but, on the contrary, is useful in diabetes.
Contraindications to treatment with lactulose are limited.
The article also presents authors’ own data demonstrating the effectiveness of Medulak in a prebiotic dose in the treatment of chronic pancreatitis with exocrine pancreatic insufficiency combined with bacterial overgrowth syndrome.
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Ryabtseva, Svetlana, Andrey Khramtsov, Maria Shpak, Alexey Lodygin, Georgy Anisimov, Serafima Sazanova, and Yulia Tabakova. "Biotechnology of Lactulose Production: Progress, Challenges, and Prospects." Food Processing: Techniques and Technology 53, no. 1 (March 21, 2023): 97–122. http://dx.doi.org/10.21603/2074-9414-2023-1-2419.
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Lactulose is a prebiotic that has found a wide application in medicine and food industry. Commercial lactulose is usually synthesized by isomerization in alkaline media at high temperatures. Enzymatic methods offer a more sustainable alternative and require more moderate processing conditions.
This review covers 44 years of scientific publications (1978–2022) on the enzymatic synthesis and purification of lactulose. The materials were retrieved from Scopus, Web of Science, PubMed, and Elibrary databases.
The enzymatic approach to lactose-to-lactulose conversion has two methods: isomerization (direct) and transgalactosylation (via hydrolysis). Isomerization exploits cellulose-2-epimerases, but their safety status is still rather vague. As a result, cellulose-2-epimerases are not commercial. Epilactose is a by-product of isomerization. Transgalactosylation involves β-galactosidases with an official international safety status (GRAS). It is available on the market, and its action mechanism is well understood. This article systematizes various data on the conditions for obtaining the maximal yields of lactulose by different enzymes.
The Kluyveromyces lactis yeast and the Aspergillus oryzae mold are the main sources of β-galactosidases in lactulose production. The yield can reach 30% if the processing conditions are optimal. Fructose remains the main problem in the production process. No scientific publications revealed a direct relationship between the maximal yields of lactulose and the molar fructose-tolactose ratios. Cellobiose epimerases make it possible to achieve high yields of lactulose (70–80%). However, these enzymes are associated with genetic engineering and mutagenesis, which challenges their safety status. The most promising trends in lactulose biotechnology include secondary dairy raw materials, immobilized enzymes, membrane reactors, complex production processes, lactose-to-lactulose conversion, and purification of final product.
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Loguercio, C., C. Del Vecchio Blanco, and M. Coltorti. "Enterococcus Lactic Acid Bacteria Strain SF68 and Lactulose in Hepatic Encephalopathy: A Controlled Study." Journal of International Medical Research 15, no. 6 (November 1987): 335–43. http://dx.doi.org/10.1177/030006058701500602.
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Forty cirrhotic patients with non-advanced hepatic encephalopathy were randomly allocated into groups which were given orally either two capsules three times daily of a preparation of Enterococcus lactic acid bacteria strain SF68 or 30 ml lactulose four times daily. The patients were evaluated over a 10-day course of treatment and for 10 days post-treatment. The Enterococcus SF68 preparation proved to be as effective as lactulose in lowering blood ammonia, and in improving mental state and psychometric performance. Moreover, the effects of Enterococcus SF68, contrary to that of lactulose, persisted longer after treatment withdrawal. Some patients reported diarrhoea and abdominal pain with lactulose. Lactulose is a standard therapy in the treatment of patients with hepatic encephalopathy. In this study, however, the use of the Enterococcus SF68 preparation was shown to offer advantages over lactulose in these patients.
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Mohammad, Rima A., Randolph E. Regal, and Cesar Alaniz. "Combination Therapy for the Treatment and Prevention of Hepatic Encephalopathy." Annals of Pharmacotherapy 46, no. 11 (November 2012): 1559–63. http://dx.doi.org/10.1345/aph.1r146.
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OBJECTIVE: To evaluate the efficacy and safety of combination therapy for the treatment and prevention of hepatic encephalopathy (HE). DATA SOURCES: A PubMed MEDLINE search was conducted (1947-June 2012) using the key terms lactulose, lactitol, nonabsorbable disaccharide, metronidazole, rifaximin, neomycin, probiotics, and hepatic encephalopathy. Searches were limited to include articles published in English. STUDY SELECTION AND DATA EXTRACTION: Study selection included published trials, case reports, and case series of humans with HE who were treated with combination therapy of rifaximin, lactulose, lactitol, metronidazole, neomycin, and/or probiotics. DATA SYNTHESIS: Only 6 studies that evaluated the benefits of combination drug therapy in the treatment or prevention of HE were available for review. Four studies addressed the treatment of HE, 2 found no significant difference between lactulose/neomycin versus placebo or rifaximin/lactulose, 1 assessed the use of rifaximin/lactulose without a control group, and the fourth found no significant difference between lactulose/probiotics versus either drug alone, although each group showed improvement from baseline. In the 2 prevention trials, both of which stemmed from the same data, the combination of rifaximin/lactulose was superior to lactulose alone, showing significant improvement in mental status, blood ammonia levels, and health-related quality of life and reductions in HE recurrence and hospitalization. Currently, there are no available clinical studies evaluating dual antibiotic therapy, metronidazole with nonabsorbable disaccharides, or antibiotics with probiotics. CONCLUSIONS: The evidence evaluating the use of combination therapy for the treatment of HE does not support its widespread use. The combination of rifaximin and lactulose may be considered in the treatment of HE and in patients refractory to monotherapy. The combination of rifaximin and lactulose should be considered for the prevention of HE, especially after the second episode of HE recurrence.
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Greig, Barry D., and Gerald A. Payne. "Epimerization of lactose to free lactulose in heated model milk solutions." Journal of Dairy Research 52, no. 3 (August 1985): 409–17. http://dx.doi.org/10.1017/s0022029900024316.
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SUMMARYThe kinetics of the epimerization of lactose to lactulose were determined for two ‘model milk’ solutions, one containing lactose and the other lactose and lysine. The lysine was added to lactose to determine whether amino groups of proteins act as base catalysts promoting the production of free lactulose. The presence of lysine actually reduced the rate of production of free lactulose, presumably by the formation of amino-sugar complexes. The rate of production of free lactulose over the range of processing conditions was shown to be first order for both systems. Thermal effects on lactose were shown to be complex. The epimerization of lactose to lactulose was reversible and both sugars were thermally decomposed to their monosaccharides. The difference in the rate of production of free lactulose between the lactose, and the lactose and lysine solutions was also observed in processed milk and its ultrafiltrate (protein free).
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VAN NIEUWENHOVEN, M. A., E. A. M. DE SWART, H. M. VAN EIJK, N. E. P. DEUTZ, F. BROUNS, and R. J. M. BRUMMER. "Effects of pre- and post-absorptive factors on the lactulose/rhamnose gut permeability test." Clinical Science 98, no. 3 (February 9, 2000): 349–53. http://dx.doi.org/10.1042/cs0980349.
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It is assumed that the outcome of the lactulose/rhamnose gut permeability test is not influenced by pre- or post-absorptive factors. The aim of our study was to investigate the role of a pre-absorptive factor, i.e. small-intestinal transit, and a post-absorptive factor, i.e. renal clearance. Ten healthy male subjects were studied. Urinary lactulose and rhamnose excretion was measured after intraduodenal administration of lactulose and rhamnose following induction of increased intestinal permeability using chenodeoxycholic acid (chenodiol), in the absence and in the presence of accelerated intestinal transit. Urinary sugar excretion was measured after intravenous administration of either a regular dose (50 mg/50 mg) or a high dose (250 mg/250 mg) of lactulose/rhamnose. The intraduodenal experiments showed that a combination of accelerated small-bowel transit and increased permeability did not lead to significant differences in the recovery of lactulose (P = 0.647) or rhamnose (P = 0.889), or in the lactulose/rhamnose ratio, compared with those under conditions of increased permeability alone (P = 0.68). However, lactulose recovery was significantly lower (P = 0.025) after intravenous administration of a high dose of the sugars. There was no significant difference in urinary rhamnose recovery (P = 0.575) between the high and the regular doses. This resulted in a significantly lower lactulose/rhamnose ratio (P = 0.021) after intravenous administration of a high dose, compared with a regular dose, of the sugars. In conclusion, the assumption that post-absorptive processes do not influence the outcome of the lactulose/rhamnose permeability test appears not to be valid.
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Bruns, D. E. "Lactulose interferes in the alkaline picrate assay for creatinine." Clinical Chemistry 34, no. 12 (December 1, 1988): 2592–93. http://dx.doi.org/10.1093/clinchem/34.12.2592.
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Abstract Errors of more than 10 mg/L in measured serum creatinine concentrations were encountered for an azotemic patient who was given lactulose orally. The magnitude of the apparent error fluctuated with the dose of lactulose. Additions of lactulose to serum produced a linear increase in the creatinine measured by each of two automated methods that involve use of the alkaline picrate (Jaffé) reaction. A lactulose concentration of 100 g/L produced positive interferences of 30 and 65 mg/L in kinetic (Beckman Astra) and continuous-flow (Technicon SMAC) assays, respectively, but caused no problem in an enzymatic assay for creatinine. The results of creatinine assays must be interpreted with caution in patients treated with lactulose.
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Sakai, Yohei, Hiroshi Ochi, and Miyuki Tanaka. "Lactulose Ingestion Induces a Rapid Increase in Genus Bifidobacterium in Healthy Japanese: A Randomised, Double-Blind, Placebo-Controlled Crossover Trial." Microorganisms 10, no. 9 (August 26, 2022): 1719. http://dx.doi.org/10.3390/microorganisms10091719.
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Oral administration of a low dose of lactulose increases the abundance of genus Bifidobacterium in the large intestine; however, the details of the daily variation in Bifidobacterium have not been researched. To observe how the intestinal microbiota, including Bifidobacterium, change, especially immediately after the initiation of ingestion, we conducted a randomised, placebo-controlled, double-blind crossover study of ingestion of 4 g lactulose/day for 2 weeks in 36 healthy Japanese (including males and females). The primary outcome was the percentage of Bifidobacterium in the faecal bacteria. In the lactulose-treatment group, the percentage of Bifidobacterium was already significantly higher 2 days after starting lactulose ingestion than in the placebo group (20.5 ± 1.2% vs. 17.1 ± 1.2%, p = 0.021). Significant differences were maintained, gradually widening, until the end of the 2-week intervention period. There were significant increases in the percentage and the number of Bifidobacterium with ingestion of 4 g lactulose/day for 2 weeks, but no significant changes in the beta diversity of the intestinal microbiota between lactulose and placebo ingestion. The percentage of Bifidobacterium in the faecal bacteria returned to its original level within a week of the end of intervention with lactulose.
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Santana, Eliete Souza, Maria Auxiliadora Andrade, Marcos Barcelos Café, José Henrique Stringhini, Tatiane Martins Rocha, and Valéria de Sá Jaime. "Efeitos da lactulose na saúde gastrointestinal de frangos de corte experimentalmente inoculados com Salmonella entérica sorovar Typhimurium." Ciência Animal Brasileira 15, no. 2 (June 2014): 187–94. http://dx.doi.org/10.1590/1809-6891v15i13604.
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Avaliaram-se os efeitos da lactulose na saúde gastrointestinal de frangos de corte pela aferição do pH e enumeração de unidades formadoras de colônias (UFCs) de Salmonella Typhimurium e Escherichia coli no inglúvio e ceco de aves inoculadas experimentalmente, via oral, na dose de 5,0 X 102 UFC /0,5mL com Salmonella Typhimurium. O delineamento adotado foi o inteiramente casualizado, utilizando-se 630 pintos, machos, os quais foram distribuídos em seis tratamentos, com sete repetições e 15 aves por unidade experimental. O tratamento 1: grupo controle (placebo); tratamento 2: grupo que recebeu somente a lactulose na água; tratamento 3: grupo que recebeu somente Salmonella Typhimurium; tratamento 4: grupo que recebeu a lactulose e Salmonella Typhimurium simultaneamente no primeiro dia de vida [L (1d) + ST (1d)]; tratamento 5: grupo que recebeu a lactulose 48 horas antes de serem inoculadas com Salmonella Typhimurium [L (1d) + ST (48h)] e tratamento 6: grupo que foi inoculado com Salmonella Typhimurium no primeiro dia e 48 horas depois receberam a lactulose [ST (1d) + L (48h)]. Aos dias sete, 14, 21 e 28 uma ave por parcela foi sacrificada e os conteúdos do inglúvio e do ceco foram coletados para a aferição do pH e contagem de Salmonella Typhimurium e Escherichia coli. Constatou-se que a lactulose determinou redução nos valores (P<0,05) de pH nos conteúdos do trato digestório aos sete dias de vida, e esta redução se manteve até 28 dias somente para o inglúvio nos tratamentos que receberam a lactulose, independente do período de inoculação do patógeno. Verificou-se, também, que a lactulose reduziu (P<0,05) as UFCs de Escherichia coli e de Salmonella Typhimurium no inglúvio aos 21 e 28 dias de vida nos tratamentos em que se administrou a lactulose antes do patógeno. Pode-se concluir que a lactulose altera os valores de pH do inglúvio e reduza colonização de Salmonella Typhimurium no ceco e as UFCs de Escherichia coli no inglúvio em todo o período experimental.
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Sakai, Y., N. Seki, K. Hamano, H. Ochi, F. Abe, K. Masuda, and H. Iino. "Prebiotic effect of two grams of lactulose in healthy Japanese women: a randomised, double-blind, placebo-controlled crossover trial." Beneficial Microbes 10, no. 6 (July 10, 2019): 629–39. http://dx.doi.org/10.3920/bm2018.0174.
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Sixty healthy Japanese women with a defaecation frequency of 2-4 times/week participated in this randomised, double-blind crossover trial. Participants received 2 g/day lactulose for 2 weeks and placebo in a random order, separated by a washout period of 3 weeks. Eight participants were excluded who did not satisfy the conditions, and therefore data from 52 were analysed. The primary outcome was defaecation frequency and the secondary outcomes were the number of defaecation days, faecal consistency, faecal volume, and the number and percentage of Bifidobacterium in faeces. The defaecation frequency (times/week) was significantly higher during lactulose (4.28±0.23) than placebo (3.83±0.23) treatment (delta (Δ) 0.45 [95% confidence interval (CI) 0.10-0.80], P=0.013). The defaecation days (days/week) was significantly higher during lactulose (3.77±0.17) than placebo (3.47±0.17) treatment (Δ0.30 [95% CI 0.04-0.56], P=0.024). Faecal consistency using the Bristol Stool Scale (/defaecation) was significantly higher during lactulose (3.84±0.10) than placebo (3.68±0.10) treatment (Δ0.16 [95% CI 0.00-0.31], P=0.044). Faecal volume (/week) was significantly higher during lactulose (21.73±3.07) than placebo (17.65±3.07) treatment (Δ4.08 [95% CI 0.57-7.60], P=0.024). The number of Bifidobacterium in faeces (log colony forming units/g faeces) was significantly higher during lactulose (9.53±0.06) than placebo (9.16±0.06) treatment (Δ0.37 [95% CI 0.23-0.49], P<0.0001). The percentage of Bifidobacterium in faeces was also significantly higher during lactulose (25.3±1.4) than placebo (18.2±1.4) treatment (Δ7.1 [95% CI 2.9-11.4], P=0.0014). Finally, straining at defaecation (/defaecation) during lactulose (3.62±0.24) treatment was significantly lower than during placebo (3.97±0.24) treatment (Δ0.35 [95% CI -0.69 – -0.02], P=0.037). No significant difference was observed between lactulose and placebo with regard to flatulence. Severe adverse effects did not occur. Thus, oral ingestion of 2 g/day lactulose had a prebiotic effect, increasing the number and percentage of bifidobacteria in faeces, softening the faeces, and increasing defaecation frequency, but without increasing flatulence.
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Hussain, Tanveer, Misbah Sattar, Sara Mustafa, Uzma Batool, Shafqat Iqbal, and Binish Hassan. "Comparing efficacy of Rifaximin plus Lactulose vs. Lactulose alone in treating Hepatic Encephalopathy." Journal of Rawalpindi Medical College 24, no. 4 (December 30, 2020): 339–43. http://dx.doi.org/10.37939/jrmc.v24i4.1418.
Full textAbstract:
Background: Hepatic Encephalopathy is a syndrome observed in patients with liver cirrhosis. Various treatment modalities are in use for treatment of Porto Systemic Encephalopathy (PSE). Our study aimed to compare the efficacy of Rifaximin plus Lactulose vs.Lactulose alone in treating Hepatic Encephalopathy in local population.
Materials & Methods: The study was conducted at a tertiary care hospital recruiting decompensated chronic liver disease(DCLD) patients with PSE. Using simple random sampling, patients were divided in two groups (A & B). Patients in group A received Lactulose plus Rifaximin while group B received Lactulose alone. Efficacy of treatment was assessed as return of the conscious level to pre-encephalopathy state as per clinical examination within 1 week after start of the treatment.
Results: A total of 124 patients were included in the study with each group (A & B) containing 62 patients. Frequency and percentage of efficacy among group A (Rifaximin plus Lactulose) verses group B (Lactulose alone) in treating Hepatic encephalopathy was 45 (72.6%) and 32 (51.6%) respectively.
Conclusion: The study concluded that there is a significant difference in proportions of patients showing complete recovery from Hepatic encephalopathy treated with Lactulose plus Rifaximin as compared to Lactulose alone.
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Hussain, Tanveer, Misbah Sattar, Sara Mustafa, Uzma Batool, Shafqat Iqbal, and Binish Hassan. "Comparing efficacy of Rifaximin plus Lactulose vs. Lactulose alone in treating Hepatic Encephalopathy." Journal of Rawalpindi Medical College 24, no. 4 (December 30, 2020): 339–43. http://dx.doi.org/10.37939/jrmc.v24i4.1418.
Full textAbstract:
Background: Hepatic Encephalopathy is a syndrome observed in patients with liver cirrhosis. Various treatment modalities are in use for treatment of Porto Systemic Encephalopathy (PSE). Our study aimed to compare the efficacy of Rifaximin plus Lactulose vs.Lactulose alone in treating Hepatic Encephalopathy in local population.
Materials & Methods: The study was conducted at a tertiary care hospital recruiting decompensated chronic liver disease(DCLD) patients with PSE. Using simple random sampling, patients were divided in two groups (A & B). Patients in group A received Lactulose plus Rifaximin while group B received Lactulose alone. Efficacy of treatment was assessed as return of the conscious level to pre-encephalopathy state as per clinical examination within 1 week after start of the treatment.
Results: A total of 124 patients were included in the study with each group (A & B) containing 62 patients. Frequency and percentage of efficacy among group A (Rifaximin plus Lactulose) verses group B (Lactulose alone) in treating Hepatic encephalopathy was 45 (72.6%) and 32 (51.6%) respectively.
Conclusion: The study concluded that there is a significant difference in proportions of patients showing complete recovery from Hepatic encephalopathy treated with Lactulose plus Rifaximin as compared to Lactulose alone.
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Olgac, Asburce, Oya Balcı Sezer, Ferda Ozbay Hosnut, and Figen Ozcay. "Lactobacillus reuteri DSM 17938 and quality of life associated with functional constipation." Slovenian Medical Journal 89, no. 7-8 (September 7, 2020): 347–56. http://dx.doi.org/10.6016/zdravvestn.3024.
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Background: Functional constipation (FC) defines the form of constipation without an organic aetiology and influences the quality of life of the child in many aspects. In the present study, we aimed to compare the effects of Lactobacillus reuteri (L. reuteri) DSM 17938 and lactulose treatments on the health-related quality of life (HR-QoL) of constipated children and their families.Methods: Children with FC were divided into two groups to receive either L. Reuteri DSM 17938 (n = 25) or lactulose (n = 24), for four weeks. All patients and their parents completed the KINDL® HR-QoL questionnaire before and at the end of the treatment period.Results: The final total and disease perception scores and the subscale analyses of the probiotic and lactulose groups were comparable. The final mean total scores of parent questionnaires increased in both groups (68 % to 71.3 % in the probiotic group, 66.1 % to 70.9 % in the lactulose group), and the increase in the lactulose group was found statistically significant.Conclusion: In our study, L. reuteri DSM 17938 has showed to have comparable effects on the HR-QoL in children with FC, when compared to lactulose. Lactulose was more efficient regarding satisfaction of families and the family perception of HR-QoL.
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Flick, J. A., R. L. Schnaar, and J. A. Perman. "Thin-layer chromatographic determination of urinary excretion of lactulose, simplified and applied to cystic fibrosis patients." Clinical Chemistry 33, no. 7 (July 1, 1987): 1211–12. http://dx.doi.org/10.1093/clinchem/33.7.1211.
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Abstract Urinary excretion of orally administered lactulose is used as an index of intestinal permeability. We have developed a simple thin-layer chromatographic technique for measuring lactulose in urine, using silica gel 60 plates and a propanol-borate solvent system. Lactulose concentrations as low as 62.5 mg/L can be detected with high reproducibility and without interference by urinary chromogens. After oral administration, the urinary excretion of lactulose in 8 h equaled 2.33 (SD 1.86)% in 15 patients with cystic fibrosis, as compared with 0.13 (SD 0.12)% in 16 healthy subjects (P less than 0.001).
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Vinogradova, E. V., M. K. Chugreev, and N. I. Kulmakova. "The effect of prebiotic with bifidogenic properties on morphometric parameters of rabbits." Agricultural Science Euro-North-East 22, no. 6 (December 14, 2021): 928–34. http://dx.doi.org/10.30766/2072-9081.2021.22.6.928-934.
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The research was aimed at study of the potential and effectiveness of lactulose use in rabbit breeding. Lactulose is an isomer of milk sugar (disaccharide), it serves as a nutrient substrate for saccharolytic bacteria. The latter decompose it into short-chain fatty acids - lactic, acetic, propionic, butyric. At that time, the pH of the contents of the colon decreases. The microbiocenosis uses lactulose as a source of carbohydrates and energy. In this work, the optimal dosage and method of introducing lactulose into the diet of young rabbits of the California breed are calculated and determined experimentally. The experiment (2013-2016) involved male rabbits at the age of 45 days. The duration of the experiment was 60 days. The control group and two experimental groups of 20 heads each were formed by the method of analog pairs. The dry type of feeding was used using full-grain granular compound feed KK-92. Lactulose concentrate "Lactusan" was used, being added to drinking water. As the basic value of the norm for the introduction of lactulose into the diet of rabbits for further planned experiments, 0.06 g/kg of live weight per day was taken. As a result of the conducted studies, some responses of the rabbit body were revealed when they were raised using the lactulose prebiotic, which has bifidogenic properties. The influence of different dosages of lactulose on some morphological parameters and meat productivity of rabbits was established. The mass of the examined internal organs did not undergo critical changes. The introduction of lactulose into the diet of California rabbits for 60 days at a dosage of 0.06 g/kg of live weight per day increased the slaughter yield by 3.1 %, and at a dosage of 0.12 g/kg ‒by 0.5 %.
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Cardelle-Cobas, Alejandra, María Fernández, Nuria Salazar, Cristina Martínez-Villaluenga, Mar Villamiel, Patricia Ruas-Madiedo, and Clara G. de los Reyes-Gavilán. "Bifidogenic effect and stimulation of short chain fatty acid production in human faecal slurry cultures by oligosaccharides derived from lactose and lactulose." Journal of Dairy Research 76, no. 3 (May 18, 2009): 317–25. http://dx.doi.org/10.1017/s0022029909004063.
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Bifidogenic effect and stimulation of short chain fatty acid (SCFA) production by fractions of oligosaccharides with a DP⩾3 and Gal β(1-6) linkages synthesised from lactose or lactulose by Pectinex Ultra SP-L and Lactozym 3000 L HP G were evaluated in human faecal slurries. Results were compared with those obtained for the commercial oligosaccharide mixture Vivinal®-GOS. Quantitative real-time PCR showed that all galacto-oligosaccharide (GOS) fractions stimulated slightly higher bifidobacteria growth than lactose, lactulose and Vivinal®-GOS. GOS fractions promoted the production of total SCFA and acetic acid in a similar way to Vivinal®-GOS and more than glucose, lactose and lactulose. In conclusion, oligosaccharides derived from lactose and lactulose may represent a suitable alternative to lactulose for the design of new functional food ingredients.
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Celli, M., P. D'Eufemia, R. Dommarco, R. Finocchiaro, D. Aprigliano, F. Martino, E. Cardi, and O. Giardini. "Rapid gas-chromatographic assay of lactulose and mannitol for estimating intestinal permeability." Clinical Chemistry 41, no. 5 (May 1, 1995): 752–56. http://dx.doi.org/10.1093/clinchem/41.5.752.
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Abstract We developed a gas-chromatographic method to determine urinary mannitol and lactulose. The procedure for purification of urine by a resin was optimized for purification of analytes and high recovery; the aliquot of resin chosen (500 mg) was kept in contact with the urine for 1 min. The recoveries of mannitol and lactulose were > 85% at concentrations that include both normal and pathological values. Sugars were converted to oximes before the silylation step to avoid multiple peaks for the anomeric forms. The calibration was linear over the range 0.1-1 microgram of sugar injected. Analytical recovery of the sugars ranged from 90% to 95.3% for mannitol and from 90.4% to 95.8% for lactulose. The mean within-day imprecision (CV) was 6.2% for mannitol and 4.7% for lactulose; the between-day CV was 6.7% for mannitol and 5.1% for lactulose. A lactulose/mannitol ratio of 0.035 completely differentiated 28 normal children and 28 children with active gluten-sensitive enteropathy, whose mean ratios were 0.022 (SD 0.007) and 0.084 (SD 0.054), respectively.
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Kohout, Pavel. "Small Bowel Permeability in Diagnosis of Celiac Disease and Monitoring of Compliance of a Gluten-Free Diet (Gut Permeability in Celiac Disease)." Acta Medica (Hradec Kralove, Czech Republic) 44, no. 3 (2001): 101–4. http://dx.doi.org/10.14712/18059694.2019.93.
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Background & Aim: Celiac disease is an autoimmune disease with the damage of the intestinal barrier. The aim of study was to measure gut permeability in patients with untreated celiac disease and during treatment with a gluten free diet. Methods: 30 patients with celiac disease before and during treatment with gluten-free diet were investigated, 30 patients without organic damage of the gastrointestinal tract served as control. Small bowel permeability was measured using lactulose/mannitol and lactulose/D-xylose ratios. The saccharides were examined in the 5 hours collected urine using capillary gas chromatography. Results: Small bowel permeability (indices lactulose/mannitol and/or lactulose/xylose) increased significantly in patients with untreated celiac disease. 23 patients were followed up before and during treatment with a gluten-free diet 2-6 months after beginning of this treatment and small bowel permeability (measured as indices lactulose/ mannitol and/or lactulose/xylose) significantly decreased. Conclusion: Small bowel permeability test is a non-invasive test suitable for the diagnosis of celiac disease and monitoring of compliance to a gluten-free diet in these patients.
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Özer, D., S. Akin, and B. Özer. "Effect of Inulin and Lactulose on Survival of Lactobacillus AcidophilusLA-5 and Bifidobacterium Bifidum BB-02 in Acidophilus-Bifidus Yoghurt." Food Science and Technology International 11, no. 1 (February 2005): 19–24. http://dx.doi.org/10.1177/1082013205051275.
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The effect of supplementation of lactulose and inulin as prebiotics on the growth of L. acidophilusLA-5 and B. bifidumBB-02 in Acidophilus-Bifidus (AB) yoghurt and some quality parameters of the resulting products were studied. Yoghurts produced from milks with added inulin at levels of 0.5% and 1.0%, or with lactulose at levels of 0.25% and 2.5% were compared with classical yoghurt and AB yoghurt (without added prebiotics). The results showed that inulin and lactulose did not affect the growth of yoghurt starter bacteria, but stimulated the growth of B. bifidumBB-02 to a great extent. Lactulose was found to be more effective on the growth of both probiotic strains than inulin. Inulin did not stimulate the growth of L. acidophilusLA-5. The cell counts of B. bifidumBB-02 and L. acidophilusLA-5 were dependent upon concentrations of lactulose and inulin used. No significant (p< 0.05) difference between the samples were observed with regard to the pH and lactic acid values. However, lactulose or inulin added samples had lower acetaldehyde and tyrosine contents than the untreated samples.
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Leclercq‐Foucart, J., P. P. Forget, and J. L. Van Cutsem. "Lactulose‐Rhamnose Intestinal Permeability in Children With Cystic Fibrosis." Journal of Pediatric Gastroenterology and Nutrition 6, no. 1 (January 1987): 66–70. http://dx.doi.org/10.1002/j.1536-4801.1987.tb09246.x.
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SummaryThe lactulose‐rhamnose intestinal permeability test was performed in 10 cystic fibrosis (CF) children. Urine was collected for 5 h after oral intake of the test solution. A single thin‐layer chromatography followed by densitometry was used for the measurement of lactulose and rhamnose concentrations in the urine specimens. The excretion of each molecule was expressed as the percentage of the orally administered dose excreted and the lactulose‐rhamnose ratio was the ratio of the percentage quantities of each probe molecule excreted. The mean lactulose‐rhamnose excretion ratio in CF patients and controls was 0.16 and 0.038, respectively (p < 0.001). The mean 5‐h lactulose excretion was 2% and 0.28% in CF patients and control subjects, respectively (p < 0.001). The mean 5‐h rhamnose excretion was 12.8% and 7.6% in CF patients and control subjects (p < 0.05). We conclude that CF patients have an increased intestinal permeability to lactulose and rhamnose. Further studies are needed in order to elucidate the mechanisms involved as well as the eventual nutritional implications.
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Ferchaud-Roucher, V., E. Pouteau, H. Piloquet, Y. Zaïr, and M. Krempf. "Colonic fermentation from lactulose inhibits lipolysis in overweight subjects." American Journal of Physiology-Endocrinology and Metabolism 289, no. 4 (October 2005): E716—E720. http://dx.doi.org/10.1152/ajpendo.00430.2004.
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One of the strategies to prevent insulin resistance is to reduce circulating free fatty acids (FFA). The aim of this study is to assess the effect of an oral lactulose load on fatty acid metabolism in overweight subjects. Eight overweight subjects received a primed constant intravenous infusion of [1-13C]acetate and of [1,1,2,3,3-2H5]glycerol for 9 h. After 3 h of tracer infusion, patients ingested 30 g lactulose, or saline solution. Arterialized blood samples were collected every 20 min. Basal plasma concentrations of acetate were similar before and between oral treatments as well as glycerol and FFA concentrations. Plasma acetate turnover was 11.4 ± 2.4 vs. 10.7 ± 1.4 μmol·kg−1·min−1 [not significant (NS)], and plasma glycerol turnover was 3.8 ± 0.4 vs. 4.8 ± 1.9 μmol·kg−1·min−1 (NS). After lactulose ingestion, acetate concentration increased twofold and then decreased to baseline. Acetate turnover rate increased to 15.5 ± 2.2 μmol·kg−1·min−1 after lactulose treatment, whereas it was unchanged after saline treatment (10.3 ± 2.2 μmol·kg−1·min−1, P ≤ 0.0001). In contrast, FFA concentrations decreased significantly after lactulose ingestion and then increased slowly. Glycerol turnover decreased after lactulose ingestion compared with saline, 2.8 ± 0.4 vs. 3.5 ± 0.3 μmol·kg−1·min−1 ( P ≤ 0.05). A significant negative correlation was found between glycerol and acetate turnover after lactulose treatments ( r = −0.78, P ≤ 0.02). These results showed in overweight subjects a short-term decrease in FFA level and glycerol turnover after lactulose ingestion related to a decrease of lipolysis in close relationship with an increase of acetate production.
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Younis, Irfan, Zamir Butt, Malik Irfanullah Yasir, and Syed Muhammad Ali Shah. "RIFAXAMIN VS LACTULOSE." Professional Medical Journal 23, no. 07 (July 10, 2016): 817–21. http://dx.doi.org/10.29309/tpmj/2016.23.07.1645.
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Objectives: To compare Rifaxamin and Lactulose in improving the gradesof hepatic encephalopathy in patients with decompensated liver disease. Study design:Randomized controlled trial comparing the use of rifaxamin and Lactulose. Place and durationof study: 1st July 2014 to 30th June 2015 in Department of Medicine, Aziz Bhatti ShaheedTeaching Hospital Gujarat. Results: 1st July 2014 to 30th June 2015 in medical departmentof Aziz Bhatti Shaheed Teaching Hospital Gujarat. Results: 400 cases were divided in twoequal groups: Group A took Rifaximin & Group B Lactulose. Improvement in grades of hepaticencephalopathy were calculated on weekly bases. Monitoring was done by checking bloodammonia levels, number connection tests, flapping tremors and mental status. 40 patients(10%) did not stay in ward for one week. In ninety percent etiology of decompensated liverdisease was hepatitis C virus. Improvement was noted in 76.96% (n=137) in Group-A and72.52% (n=132) in Group-B, p value was found insignificant (>0.05). Conclusions: Rifaximinand lactulose had similar efficacy in the treatment of mild to moderate hepatic encephalopathy.
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Herrmann, R., and F. L. Weber. "LACTULOSE AND AMMONIA." Lancet 330, no. 8571 (December 1987): 1333. http://dx.doi.org/10.1016/s0140-6736(87)91224-4.
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Wright, Richard A. "Lactulose-induced megacolon." Gastrointestinal Endoscopy 34, no. 6 (November 1988): 489–90. http://dx.doi.org/10.1016/s0016-5107(88)71452-2.
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Kitler, Mary Ellen, Martin Luginbuhl, Oswald Lang, Fréderic Wuhl, André Wyss, and Gerhard Lebek. "Lactitol and Lactulose." Drug Investigation 4, no. 1 (February 1992): 73–82. http://dx.doi.org/10.1007/bf03258384.
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Bloom, Patricia P., and Elliot B. Tapper. "Lactulose in cirrhosis: Current understanding of efficacy, mechanism, and practical considerations." Hepatology Communications 7, no. 11 (October 12, 2023). http://dx.doi.org/10.1097/hc9.0000000000000295.
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HE is a complication of cirrhosis characterized by neuropsychiatric and motor dysfunction, and results in decreased quality of life and increased mortality. Lactulose is a synthetic disaccharide used to treat HE since 1966, though many questions about its use remain unanswered. Lactulose reverses minimal HE, prevents overt HE, improves quality of life, increases the rate of recovery from overt HE, and improves survival rates. Lactulose’s clinical effect appears to be derived from its impact on intestinal microbes, likely a result of its enteric acidifying effect, positive pressure on beneficial taxa, and improvement of gut barrier function. There are several practical considerations with lactulose including (1) a need to avoid excessive bowel movements and subsequent dehydration, (2) treatment titration protocols need further investigation, (3) baseline or treatment-induced gastrointestinal side effects limit adherence in some cases, and (4) the utility of monitoring stool consistency or pH remains unknown. Further research is needed to optimize our use of this effective treatment for HE.
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"Lactulose." Reactions Weekly 1904, no. 1 (April 2022): 272. http://dx.doi.org/10.1007/s40278-022-14204-x.
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"Lactulose." Reactions Weekly 1882, no. 1 (November 2021): 267. http://dx.doi.org/10.1007/s40278-021-05734-3.
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