Side Effects of lactulose: A Synthesis of Findings from 31 Studies

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Original Abstract of the Article

Main Research Findings

Lactulose is a commonly used laxative that helps treat constipation by drawing water into the intestines, making stools softer and easier to pass. 13 22 9 6 2 It is often used to treat constipation in children and adults, and is also used to manage hepatic encephalopathy, a serious complication of liver disease. 21 24 While lactulose is generally well-tolerated, some individuals may experience side effects. 25

Reasons for Side Effects

The side effects of lactulose are primarily related to its mechanism of action. Lactulose works by drawing water into the intestines, which can lead to diarrhea and abdominal discomfort in some individuals. 25 5 Additionally, lactulose can alter the balance of bacteria in the gut, leading to increased gas production. 21

Common Side Effects

Diarrhea

Diarrhea is a common side effect of lactulose, especially when taken in higher doses or when the body is not accustomed to it. 25 5 21 3

Abdominal Pain

Some individuals may experience abdominal pain or cramps when taking lactulose, especially when starting the medication. 25 5

Gas and Bloating

Lactulose can cause increased gas production and bloating due to its effect on gut bacteria. 25 21

Other Side Effects

While less common, lactulose may also cause nausea, vomiting, and loss of appetite in some individuals. 25 Studies have shown that lactulose can increase the absorption of calcium and magnesium, so it's important to monitor intake if you're taking lactulose long-term. 25

Countermeasures for Side Effects

Diarrhea

If diarrhea is a concern, reducing the dosage or increasing the interval between doses may help. 21 Consult a doctor if it persists.

Abdominal Pain

If you experience abdominal pain, try to adjust your diet and lifestyle to promote healthy bowel function. 21 Adequate fluid intake is also important.

Gas and Bloating

Dietary changes can help reduce gas production. 21 Staying hydrated can also help alleviate bloating.

Other Side Effects

If you experience nausea, vomiting, or loss of appetite, consult a doctor. 25 If you're taking lactulose long-term, monitor your calcium and magnesium intake. 25

Comparison of Studies

Similarities of Studies

Many studies have demonstrated lactulose's effectiveness in treating constipation. 13 22 9 6 2 Research consistently indicates that it can also lead to side effects such as diarrhea and abdominal pain. 25 5

Differences of Studies

Research into lactulose's effectiveness and side effects varies in terms of participants and methodologies, resulting in some variation in findings. 22 For instance, studies evaluating its effectiveness differ in participant age and constipation severity. 9 Likewise, side effect assessments can vary across studies. 25 Therefore, considering the methodologies and participants when evaluating lactulose's effectiveness and side effects is crucial.

Points to Note for Application in Real Life

While lactulose is an effective treatment for constipation, it can also cause side effects. 25 Therefore, being mindful of potential side effects and following your doctor's instructions is important. 21 Lactulose can interact with other medications. 31 Always inform your doctor about any other medications you are taking.

Limitations of Current Research

Research on lactulose's effectiveness and side effects is still ongoing. 22 17 More research is needed to assess the long-term effects of lactulose and its impact on patients with specific health conditions. 21 Lactulose interactions with other medications also require further investigation. 31

Future Research Directions

Further research on lactulose's effectiveness and side effects is necessary. 22 17 Long-term effects and impact on patients with specific health conditions require more study. 21 Research into the effectiveness of combining lactulose with other treatment methods is also needed. 20

Conclusion

Lactulose is an effective treatment for constipation, but it can cause side effects. 25 Be aware of potential side effects and follow your doctor's instructions. 21 Remember, lactulose can interact with other medications, so inform your doctor about any other medications you are taking. 31 Further research on lactulose's effectiveness and side effects is needed. 22 17

Literature analysis of 31 papers
Positive Content
27
Neutral Content
1
Negative Content
3
Article Type
11
2
3
8
31
2.

PEG 3350 Versus Lactulose for Treatment of Functional Constipation in Children: Randomized Study.

Author: JarzebickaDorota, Sieczkowska-GolubJoanna, KierkusJaroslaw, CzubkowskiPiotr, Kowalczuk-KrystonMonika, PelcMaciej, LebensztejnDariusz, KorczowskiBartosz, SochaPiotr, OraczGrzegorz

Effective for constipation
Fewer side effects
Abdominal pain
Bloating

A randomized trial of 102 patients with functional constipation found that polyethylene glycol 3350 (PEG) was more effective than lactulose in treating constipation in infants and children. PEG led to more defecations per week and fewer side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Effect of probiotic VSL#3 in the treatment of minimal hepatic encephalopathy: A non-inferiority randomized controlled trial.

Author: Pratap MouliVenigalla, BenjaminJaya, Bhushan SinghMamta, ManiKalaivani, GargSushil Kumar, SarayaAnoop, JoshiYogendra Kumar

MHE treatment

This study aims to determine if probiotics are non-inferior to lactulose in improving minimal hepatic encephalopathy (MHE) in patients with chronic liver disease (CLD). Lactulose is the standard treatment for MHE, but has side effects. Probiotics offer a potential alternative therapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Can partially hydrolyzed guar gum be an alternative to lactulose in treatment of childhood constipation?

Author: ÜstündağGonca, KuloğluZarife, KirbaşNihan, KansuAydan

Constipation Treatment

Partially hydrolyzed guar gum (PHGG) was as effective as lactulose in relieving stool withholding and constipation-associated abdominal pain in children. PHGG also improved stool consistency. Lactulose had more side effects, including flatulence and sensation of bad taste.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

[Lactitol in chronic idiopathic constipation in children].

Author: PitzalisG, DeganelloF, MarianiP, Chiarini-TestaM B, VirgiliiF, GasparriR, CalvaniL, BonamicoM

Lactitol effective
Lactitol safe

Lactitol was an effective treatment for chronic idiopathic constipation in children, with fewer side effects than lactulose. Lactitol had a better compliance rate and was found to be more palatable. Orocecal transit time was not significantly affected by either lactitol or lactulose, suggesting that their activity is primarily in the colon.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Italian

6.

PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial.

Author: VoskuijlW, de LorijnF, VerwijsW, HogemanP, HeijmansJ, MäkelW, TaminiauJ, BenningaM

Improved constipation symptoms
Bad taste

Polyethylene glycol 3350 (PEG 3350) was more effective than lactulose in treating pediatric constipation with a higher success rate and fewer side effects. PEG 3350 should be the laxative of first choice in childhood constipation.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

8.

[Treatment of Chronic Functional Constipation during Pregnancy and Lactation].

Author: GharehbaghiK, GharehbaghiD R, WierraniF, SliutzG

Tenesmus

Macrogol and lactulose are recommended as first-line therapies for chronic constipation during pregnancy. Diphenolic laxatives, such as bisacodyl and sodium picosulfate, can be used as second-line treatments.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : German

9.

A comparative study: the efficacy of liquid paraffin and lactulose in management of chronic functional constipation.

Author: UrganciNafiye, AkyildizBasak, PolatTugçin Bora

Improve constipation
Poor symptom control
Side effects

Liquid paraffin is more effective than lactulose in treating children with constipation, with faster response times and fewer side effects. However, compliance rates were lower for both drugs due to side effects and poor symptom control.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

10.

Constipation--modern laxative therapy.

Author: KlaschikE, NauckF, OstgatheC

Constipation treatment
Abdominal cramping
Bloating
Flatulence

Constipation affects many people. While most causes are manageable, chronic constipation in palliative care presents a challenge. This abstract discusses the use of macrogol as a preferred laxative in palliative care due to its efficacy and tolerance.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

Lactitol in treatment of chronic hepatic encephalopathy. A meta-analysis.

Author: CammàC, FiorelloF, TinèF, MarchesiniG, FabbriA, PagliaroL

Palatable
Treats encephalopathy
Side effects

Lactitol is as effective as other disaccharides in treating chronic hepatic encephalopathy, with fewer side effects and improved palatability.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Polyethylene glycol 4000 vs. lactulose for the treatment of neurogenic constipation in myelomeningocele children: a randomized-controlled clinical trial.

Author: RendeliC, AusiliE, TabaccoF, FocarelliB, PantanellaA, Di RoccoC, GenoveseO, FundaròC

Bowel frequency increase
Constipation remission

Polyethylene glycol 4000 compared with lactulose provided a higher success rate, without significant side effects, for the treatment of constipation in myelomeningocele children.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

13.

Systematic review of stimulant and nonstimulant laxatives for the treatment of functional constipation.

Author: ParéPierre, FedorakRichard N

Constipation treatment

Constipation is a common condition that affects people of all ages. This review explores the history of constipation treatment and prevention, noting that approaches have varied significantly throughout history.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

14.

Is the Treatment of Constipation Can Relieve the Migraine Symptoms? A Randomized Clinical Trial Study.

Author: RezaeiashtianiAlireza, JadidiAli, Khanmohammadi-HezavehAli, AghaeipourSeyyed Mohammad, PourandishYasaman, MalekhosseiniShima, GhassamiKeivan, MohammadbeigiAbolfazl

Migraine treatment

Treating constipation with lactulose improved migraine headache in patients who referred to neurology clinics in Arak.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Evaluation of rifaximin in management of hepatic encephalopathy.

Author: WahibAli A, El-Deen SalemM Negm, AhmedMostafa A, El-DessoukyYasser M M, El-TibyDiaa M, El-MolaKhaled, El-SayedAbeer M

Ammonia reduction
HE treatment
Hospitalization reduction

This study compared the efficacy of rifaximin and lactulose in treating hepatic encephalopathy, finding rifaximin to be a potentially better alternative.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

16.

Comparison of acupuncture and other drugs for chronic constipation: A network meta-analysis.

Author: ZhuLingping, MaYunhui, DengXiaoyan

Chronic constipation treatment
Side effects

Acupuncture is more effective than drugs in treating chronic constipation and has the fewest side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Retracted PublicationCases where a publication has been formally withdrawn due to the discovery of serious errors or misconduct.

Language : English

17.

Efficacy and safety of laxatives for chronic constipation in long-term care settings: A systematic review.

Author: AlsalimyN, MadiL, AwaisuA

Constipation relief
Side effects

Senna and lactulose were the most studied laxatives in LTC patients, and senna was found to be superior to or as effective as other laxatives. There is a need to conduct more robust RCTs to evaluate long-term outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

18.

Efficacy of L-ornithine-L-aspartate as an adjuvant therapy in cirrhotic patients with hepatic encephalopathy.

Author: AbidShahab, JafriWasim, MumtazKhalid, IslamMuhammad, AbbasZaigham, ShahHasnain Ali, HamidSaeed

HE treatment
None

L-ornithine-L-aspartate (LOLA) was safe and effective as an adjuvant therapy for cirrhotic patients with hepatic encephalopathy (HE), particularly those with advanced HE (grade II and above). LOLA treatment resulted in faster improvement and a shorter hospital stay compared to placebo.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

End-stage liver disease complications.

Author: RahimiRobert S, RockeyDon C

Ascites treatment
EVH treatment
HRS treatment
MHE treatment
Hemorrhagic ascites
Paracentesis-induced circulatory dysfunction

Several new treatment strategies have been developed for complications of chronic liver disease, including hepatic encephalopathy, ascites, hepatorenal syndrome, and esophageal variceal hemorrhage. These strategies have improved patient outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Multistrain probiotic and lactulose in the treatment of minimal hepatic encephalopathy.

Author: ShavakhiAhmad, HashemiHuriyeh, TabeshElham, DerakhshanZhaleh, FarzamniaSomaye, MeshkinfarShirin, ShavakhiSara, MinakariMohammad, GholamrezaeiAli

Improved MHE
Long-term effects
Hospitalization
Overt encephalopathy

Lactulose and probiotics are effective for the treatment of minimal hepatic encephalopathy (MHE), with probiotics demonstrating long-term effects. Further studies are needed to determine if probiotics should be part of the standard treatment for MHE.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

22.

[The effect of polyethylene glycol in chronic constipation is not sufficiently evaluated. A systematic literature review].

Author: OhlénKarin

Increased bowel movement frequency
Severe side effects

Polyethylene glycol (PEG) is effective in increasing bowel movement frequency compared to placebo. While data on its superiority to lactulose is limited, it is generally well tolerated with rare severe side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : Swedish

24.

Management of overt hepatic encephalopathy.

Author: SharmaPraveen, SharmaBarjesh C

HE treatment

Lactulose and lactitol are considered first-line therapies for hepatic encephalopathy (HE), with lactitol having fewer side effects. Rifaximin is effective in treating and preventing HE. Combination therapy of disaccharides with rifaximin, l-ornithine l-aspartate, or probiotics needs further evaluation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

25.

Effect of lactulose on calcium and magnesium absorption: a study using stable isotopes in adult men.

Author: SekiNobuo, HamanoHirokazu, IiyamaYuriko, AsanoYuzo, KokuboSadayuki, YamauchiKoji, TamuraYoshitaka, UenishiKazuhiro, KudouHideki

Calcium absorption enhancement
Magnesium absorption enhancement

This double-blind, randomized crossover study investigated the effect of lactulose on calcium and magnesium absorption in 24 healthy adult men. The study found that lactulose significantly enhanced the absorption of calcium and magnesium, with higher doses leading to greater absorption. No side effects were observed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

26.

[Duphalac (lactulose) in the treatment of chronic constipation in children].

Author: RomańczukW, KorczowskiR

Constipation treatment

DUPHALAC, a lactulose preparation, was found to be very effective in treating functional chronic constipation in 112 children aged 10 months to 15.5 years. The medication quickly improved peristalsis, defecation rhythm, stool consistency, pain, encopresis, and appetite, without any reported side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Polish

30.

Cochrane Review: Osmotic and stimulant laxatives for the management of childhood constipation (Review).

Author: GordonMorris, NaidooKhimara, AkobengAnthony K, ThomasAdrian G

Increased defecation
Reduced need for additional therapies
Adverse events

Polyethylene glycol (PEG) preparations may be superior to placebo, lactulose, and milk of magnesia for childhood constipation. Liquid paraffin also showed evidence of efficacy. More research is needed to investigate long-term use of these agents.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

31.

The sugar absorption test in the evaluation of the gastrointestinal intolerance to bisphosphonates: studies with oral pamidronate.

Author: TwissI M, BurggraafJ, SchoemakerR C, van ElburgR M, den HartighJ, CohenA F, VermeijP

Gastrointestinal side effects

This study investigated the feasibility of the sugar absorption test to assess the gastrointestinal effects of oral enteric-coated pamidronate.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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