Disease ⇒ Hepatic encephalopathy {40000303} Record Keys Type:Disease Parent:[ ] Definition:Hepatic encephalopathy Details Initialisation date:[ ] Other Terms:HE Meta Information MedDra ID:10019660 MedDra Level:pt ICD:[ ] Category:[ ] Zone:[ ] Mechanism:[ ] Notes: [ ]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. [1.2] - high levels of #Oxindole and #Isatin, after the epithelial and hepatic enzymatic digestion of #Indole in blood and urine, respectively, have been detected in hepatic encephalopathy and #Parkinson’s Disease [1.3] - #Megasphaera is associated with #Cognitive impairment and inflammation in patients with hepatic encephalopathy.References Notes[ ]
