Treatment of chronic portal-systemic encephalopathy with lactulose
| Autor: | K. Hoffmann, G. Scollo-Lavizzari, J. Bircher, U.P. Haemmerli |
|---|---|
| Rok vydání: | 1971 |
| Předmět: |
medicine.medical_specialty
Side effect business.industry Advanced cirrhosis Encephalopathy General Medicine Neomycin biochemical phenomena metabolism and nutrition medicine.disease Gastroenterology Portal systemic encephalopathy Surgery Colonic bacteria Lactulose Diarrhea Internal medicine medicine medicine.symptom business medicine.drug |
| Zdroj: | The American Journal of Medicine. 51:148-159 |
| ISSN: | 0002-9343 |
| DOI: | 10.1016/0002-9343(71)90233-6 |
| Popis: | The treatment of chronic portal-systemic encephalopathy (PSE) was approached in a new manner by feeding the nonabsorbable disaccharide lactulose (1-4-beta-galactosido-fructose) in doses sufficiently large to produce a mild artificial disaccharide malabsorption syndrome. Six patients with advanced cirrhosis of the liver complicated by PSE were studied during several periods. Control of PSE as judged by clinical grading, electroencephalographic grading and blood ammonia levels was satisfactory in every case. Control treatment with laxatives and neomycin eliminated the possibility of a nonspecific effect. Protein tolerance increased during lactulose administration. Diarrhea, the major side effect, was not a problem when the administered doses were adjusted to each individual patient. In the literature 114 lactulose-treated patients with PSE have been described. The over-all experience suggests a success rate of 85 per cent and substantiates the impression that this therapy is particularly useful for long-term control of PSE. The beneficial effects of lactulose in PSE cannot be explained by the rather inconsistent decrease in putrefactive colonic bacteria, which correlated poorly with the clinical condition of two patients studied in detail. The lowered blood ammonia levels under treatment are compatible with the idea that ammonia absorption from the colon is decreased under lactulose treatment. |
| Databáze: | OpenAIRE |
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