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Lactulose--a multifaceted substance

H Huchzermeyer1, C Schumann

  • 1Medizinische Klinik, Klinikum Minden.

Zeitschrift Fur Gastroenterologie
|November 25, 1997
PubMed
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Lactulose, a fermented disaccharide, impacts colonic flora and pH, offering therapeutic benefits for various conditions. Its diagnostic and therapeutic potential extends to gut permeability, metabolic disorders, and inflammatory bowel diseases, warranting further research.

Area of Science:

  • Gastroenterology
  • Microbiology
  • Pharmacology

Background:

  • Lactulose is a semisynthetic disaccharide used for hepatic encephalopathy, constipation, and salmonellosis.
  • It undergoes bacterial fermentation in the colon, producing short-chain fatty acids and altering gut microbiota.
  • This fermentation leads to decreased colonic pH and shifts in microbial composition and activity.

Purpose of the Study:

  • To explore the complex mechanisms of action of lactulose.
  • To investigate its potential for additional diagnostic and therapeutic indications.
  • To review existing research on lactulose's effects on gut health and metabolism.

Main Methods:

  • Literature review of studies on lactulose's effects.
  • Analysis of its role in H2-breath tests for transit time and small intestinal bacterial overgrowth.

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  • Examination of its impact on gut permeability, lipid metabolism, and glucose tolerance.

    • Main Results:

    • Lactulose is used diagnostically for orocecal transit time and small intestinal bacterial overgrowth.
    • It may aid in assessing intestinal permeability, particularly in Crohn's disease.
    • Potential benefits include cholesterol gallstone prophylaxis, hypercholesterolemia therapy, and colorectal adenoma/carcinoma prevention.
    • Improved glucose tolerance and modulation of gut microbiota (favoring Bifidobacteria) are suggested.
    • Reduced endotoxin absorption may benefit inflammatory bowel diseases.

    Conclusions:

    • Lactulose exhibits multifaceted effects on the gut microbiome, metabolism, and host physiology.
    • Its diagnostic applications in breath tests are established.
    • Emerging evidence suggests therapeutic potential in metabolic and inflammatory conditions, though further clinical validation is needed.