Untersuchungen �ber die Wirkungsweise der Lactulose (?-Galactosido-Fructose) im Darm

Hoffmann, K.; Mossel, D. À. A.; Korus, Wolfgang; Kamer, J. H. Van De

doi:10.1007/bf01479054

Cited by 59 publications

(17 citation statements)

References 15 publications

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“…In a single study, short-chain fatty acids were absorbed from the human colon at rates which increased with increasing chain length and partition into chloroform (Dawson et al, 1964). However, lactulose fermentation produces mainly lactic acid (Hoffmann, Mossel, Korus, and Van de Kamer, 1964) and direct evidence relating to colonic absorption of lactate in man is not available. Perfusion studies in the rat suggest that very little colonic absorption oflactic acid would occur (Heller and Kern, 1968).…”

Section: Discussionmentioning

confidence: 99%

Effects of lactulose and other laxatives on ileal and colonic pH as measured by a radiotelemetry device

Bown¹,

Gibson²,

Sladen³

et al. 1974

Gut

222

102

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SUMMARY Using a pH-sensitive radiotelemetering device the effect of lactulose on luminal pH in the ileum, colon, and rectum has been compared with that of two other laxative agents.Lactulose produced marked acidification of proximal colonic contents but this effect was not consistently maintained into the distal colon. Sodium sulphate acidified distal rather than proximal colonic contents. However, for a similar degree of laxation it was not possible to produce a significantly more uniform reduction of pH along the length of the colon by combining these laxatives compared with lactulose alone. Magnesium sulphate had little effect upon luminal pH except in the rectum where a significant rise occurred.These results are discussed in relation to both normal colonic physiology and to their possible relevance to the treatment of chronic hepatic encephalopathy by colonic acidification.

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Section: Discussionmentioning

confidence: 99%

Effects of lactulose and other laxatives on ileal and colonic pH as measured by a radiotelemetry device

Bown¹,

Gibson²,

Sladen³

et al. 1974

Gut

222

102

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“…Several studies have indicated that lactulose is a particularly good substrate for bifidobacteria and lactic acid bacteria (3,4). Harju (5,6) tested the effects of mucosal homogenates on the hydrolysis of lactulose as an indicator of potential absorption using human, calf and pig mucosal homogenates.…”

Section: Absorption and Metabolism Of Lacfulosementioning

confidence: 99%

Lactulose, Lactic Acid Bacteria, Intestinal Microecology and Mucosal Protection

Salminen

1997

Scandinavian Journal of Gastroenterology

141

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During the fermentation of lactulose, short-chain fatty acids are formed with consequent lowering of the colon pH and modification of the microflora. Lactulose promotes the growth of lactic acid bacteria and bifidobacteria and, more specifically, Lactobacillus acidophilus in the colon. Lactulose and lactulose-containing products fermented with lactic acid bacteria lower colonic pH balancing intestinal microecology and normalizing intestinal transit. In animal studies, lactulose promotes a mainly Gram-positive faecal microflora, but large doses of lactulose may be associated with transient diarrhoea. Our studies indicate that lactulose with lactic acid bacteria effectively relieves constipation in human volunteers. Lactulose with lactic acid bacteria in a fermented diary product can balance and prevent radiotherapy-associated diarrhoea and intestinal side effects. Normalizing the intestinal flora and stabilizing mucosal integrity with lactulose has beneficial effects in intestinal disorders. Lactulose and lactic acid bacteria offer a promising ingredient combination for future functional and special dietary foods in treating intestinal disturbances.

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“…Lactulose is thought to decrease faecal pH by providing a substrate for bacteria which is converted to organic acids, especially acetic and lactic acid (Hoffmann, Mossel, Korus, and van de Kamer, 1964). If inhibition of passive absorption of ammonia by this acid reaction is the main mechanism by which lactulose exerts its beneficial effect, it should be possible to show that the acid stools passed during lactulose administration contain an increased amount of ammonia.…”

mentioning

confidence: 99%

Faecal ammonia and pH during lactulose administration in man: comparison with other cathartics

Agostini¹,

Down²,

Murison³

et al. 1972

Gut

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SUMMARY The effect of lactulose on faecal pH and ammonia has been studied in three normal subjects with the aid of dialysis of faeces in vivo. Observations were also made with sodium sulphate and the two hexahydric alcohols, mannitol and sorbitol, given in doses sufficient to cause a similar increase in stool weight.All four cathartics rendered the stool more acid, but there was no increase in the concentration of faecal ammonia. Lactulose, despite increasing faecal volume, did not cause an increase in the absolute amount of ammonia lost in the faeces, but the other purgatives did show a modest rise.The results are inconsistent with the theory that lactulose benefits the clinical picture of portosystemic encephalopathy by trapping ammonia in an acid stool. An alternative suggestion is advanced, namely, that any cathartic (including lactulose) reduces ammonia absorption from the colon by decreasing colonic transit time, and so reducing the amount of ammonia generated by autolysis of colonic bacteria.Lactulose (1-4 ,B galactosido-fructose) was introduced in 1966 by Bircher, Muller, Guggenheim, and Haemmerli, in the treatment of portosystemic encephalopathy. This step had been suggested by Ingelfinger (1964-65) who recognized that the disaccharide is not hydrolysed in the ileum and when taken by mouth will reach the colon unchanged, where it promotes the growth of lactobacilli, organisms which lack urease, and other ammonia-generating enzymes (Phear and Ruebner, 1956;Macbeth, Kass, and McDermott, 1965). Ingelfinger (1964) suspected that a reduction in the number of proteolytic bacteria in the colon, in favour of lactobacilli, would reduce the formation of ammonia, leading to a decrease in portal venous ammonia.Clinical trials have since tended to confirm the value of lactulose in portosystemic encephalopathy (Bircher, Haemmerli, Scollo-Lavizzari, and Hoffmann, 1971a). Lactulose has also been shown to lower faecal pH (Mayerhofer and Petuely, 1959), a finding which has led to an alternative suggestion, that its effect on non-ionic diffusion of ammonia might explain its efficacy in portosystemic encephalopathy. It was argued (Elkington, Floch, and Conn,

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Untersuchungen �ber die Wirkungsweise der Lactulose (?-Galactosido-Fructose) im Darm

Cited by 59 publications

References 15 publications

Effects of lactulose and other laxatives on ileal and colonic pH as measured by a radiotelemetry device

Effects of lactulose and other laxatives on ileal and colonic pH as measured by a radiotelemetry device

Lactulose, Lactic Acid Bacteria, Intestinal Microecology and Mucosal Protection

Faecal ammonia and pH during lactulose administration in man: comparison with other cathartics

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