Disease ⇒ Hepatic encephalopathy {40000303}

Shared Reference Notes

• [1.1] 
  - #lactulose exerts its beneficial effects on hepatic encephalopathy through different pathways. - First, the product of #lactulose fermentation is #Lactic acid, which is able to reduce the colonic lumen pH by releasing H+. - The #Ammonia in the gut reacts with proton and produces ammonium. This conversion develops a concentration gradient that increases the amount of #Ammonia reuptake from the blood into the gastrointestinal tract. - Second, in the presence of #lactulose in the gastrointestinal tract, the bacteria utilize the energy of #lactulose fermentation instead of the conversion of amino acids to #Ammonia energy. - Third, #lactulose can inhibit glutaminase and prevent the production of #Ammonia from #Glutamine. - Finally, #lactulose shortens the colonic transit time. Thus, it can reduce the level of #Ammonia in the gastrointestinal tract.

References Notes