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Chemical Compound Review

SureCN1980980     (3S,4R,5R)-1,3,5,6- tetrahydroxy-4-[(2S,3R...

Synonyms: ABP000526, BCP9000833, AC1MI33T
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Disease relevance of lactulose


Psychiatry related information on lactulose


High impact information on lactulose


Chemical compound and disease context of lactulose


Biological context of lactulose

  • Exemplifying the use of this new technique, simultaneous administration of lactulose into the stomach and SASP into the duodenum yielded consistently longer stomach-to-cecum than duodenum-to-cecum transits, attributable to the delay caused by gastric emptying [17].
  • The effect of lactulose in reducing ammonia concentration is attributed to its role as a bacterial substrate in either increasing bacterial assimilation of ammonia or reducing deamination of nitrogenous compounds [18].
  • Bile acid metabolism was studied using bile sampling and 14C-deoxycholate kinetics in patients with colonic adenomatous polyps before and after four and 12 weeks of lactulose, 60 g/day [19].
  • PEG 3350 patients reported less abdominal pain, straining, and pain at defecation than children using lactulose [8].
  • In seven hydrogen producers acidification of stool pH by lactulose pretreatment (20 g tid) decreased hydrogen exhalation and three of seven (43%) became low hydrogen producers [20].

Anatomical context of lactulose

  • Transit time of the small intestine was determined by measuring the rise in breath hydrogen excretion after ingestion of lactulose [21].
  • Intestinal injury was assessed by morphology of duodenal mucosa, differential urinary excretion of lactulose and mannitol, and fecal alpha 1-antitrypsin clearance [22].
  • After direct instillation of SASP and lactulose into the cecum, the appearances of their metabolites (sulfapyridine in plasma and hydrogen in breath) were rapid (1-10 min) and simultaneous [17].
  • Gallstones were completely prevented in animals fed both lignin and lactulose (0 of 22), but gallbladder bile cholesterol saturation was not significantly different from the lignin-fed group [4].
  • Small bowel transit time was unaffected by infusion of nutrients into the colon or jejunum, although jejunal infusion of Intralipid increased the plasma levels of enteroglucagon and neurotensin (p less than 0.01 and p less than 0.02, respectively) after the start of lactulose infusion [23].

Associations of lactulose with other chemical compounds


Gene context of lactulose

  • METHODS: In a geographic area in Southern Italy with high incidence of CD we investigated IP (lactulose/mannitol testing) together with the three main mutations of the NOD2/CARD15 and the D299G polymorphism of the toll-like receptor (TLR)-4 gene in 23 families of CD patients (patients and first-degree relatives) [27].
  • METHODS: We investigated the effect of intragastric and intraduodenal administration of a polymeric diet (125 kcal/h) on gallbladder motility (by ultrasonography), duodeno-cecal transit time (by lactulose H2 breath test), and GI hormone release (including cholecystokinin, pancreatic polypeptide, and gastrin) [28].
  • Intestinal permeability (measured by a lactulose/mannitol test) was also elevated in 69% of the celiac patients and correlated with duodenal intraepithelial counts [10].
  • Nine-hour FBH levels were significantly higher in untreated CD than in healthy volunteers, whereas no difference was found after administration of lactulose [29].
  • Mutations that alter the ebgA gene so that the evolved beta-galactosidase (ebg) enzyme of Escherichia coli can hydrolyze lactose fall into two classes: class I mutants use only lactose, whereas class II mutants use lactulose as well as lactose [30].

Analytical, diagnostic and therapeutic context of lactulose

  • Lactulose hydrogen breath test in the diagnosis of bacterial overgrowth [31].
  • Gastrointestinal transit time was defined as the time of initial rise in breath hydrogen following ingestion of 10 g of lactulose [32].
  • The effect of ileal infusion of intralipid on small bowel transit time of a 100-ml solution containing 13.3 g of lactulose was studied during intravenous infusion of either saline or naloxone (20 micrograms/kg X h) in saline [33].
  • The subjects ingested an isosmotic lactulose solution containing 99mtechnetium-diethylenetriaminepentaacetic acid (Sn) and then remained supine under a large field of view gamma-camera that interfaced with a computer system [34].
  • Lactulose absorption was significantly higher in patients than in controls under basal conditions (P less than 0.001); it reached levels three times higher the second day after chemotherapy, and returned to basal levels by the eighth day [35].


  1. Hypernatremia and lactulose therapy. Nelson, D.C., McGrew, W.R., Hoyumpa, A.M. JAMA (1983) [Pubmed]
  2. Intestinal permeability in patients with Crohn's disease and their healthy relatives. Katz, K.D., Hollander, D., Vadheim, C.M., McElree, C., Delahunty, T., Dadufalza, V.D., Krugliak, P., Rotter, J.I. Gastroenterology (1989) [Pubmed]
  3. Lactobacillus species prevents colitis in interleukin 10 gene-deficient mice. Madsen, K.L., Doyle, J.S., Jewell, L.D., Tavernini, M.M., Fedorak, R.N. Gastroenterology (1999) [Pubmed]
  4. Prevention of cholesterol gallstones by lignin and lactulose in the hamster. Rotstein, O.D., Kay, R.M., Wayman, M., Strasberg, S.M. Gastroenterology (1981) [Pubmed]
  5. Clinical efficacy of lactulose in cirrhotic patients with and without subclinical hepatic encephalopathy. Watanabe, A., Sakai, T., Sato, S., Imai, F., Ohto, M., Arakawa, Y., Toda, G., Kobayashi, K., Muto, Y., Tsujii, T., Kawasaki, H., Okita, K., Tanikawa, K., Fujiyama, S., Shimada, S. Hepatology (1997) [Pubmed]
  6. Gastrointestinal transit in cirrhotic patients: effect of hepatic encephalopathy and its treatment. Van Thiel, D.H., Fagiuoli, S., Wright, H.I., Chien, M.C., Gavaler, J.S. Hepatology (1994) [Pubmed]
  7. Lactitol vs. lactulose in the treatment of acute hepatic encephalopathy in cirrhotic patients: a double-blind, randomized trial. Morgan, M.Y., Hawley, K.E. Hepatology (1987) [Pubmed]
  8. PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial. Voskuijl, W., de Lorijn, F., Verwijs, W., Hogeman, P., Heijmans, J., Mäkel, W., Taminiau, J., Benninga, M. Gut (2004) [Pubmed]
  9. Effect of casein and casein hydrolysate on small bowel motility and D-xylose absorption in dogs. Defilippi, C., Gómez, E. Neurogastroenterol. Motil. (1995) [Pubmed]
  10. Lymphocytic gastritis and gastric permeability in patients with celiac disease. Vogelsang, H., Oberhuber, G., Wyatt, J. Gastroenterology (1996) [Pubmed]
  11. Differential in vivo and in vitro intestinal permeability to lactulose and mannitol in animals and humans: a hypothesis. Bijlsma, P.B., Peeters, R.A., Groot, J.A., Dekker, P.R., Taminiau, J.A., Van Der Meer, R. Gastroenterology (1995) [Pubmed]
  12. CD45RO expression on circulating CD19+ B cells in Crohn's disease correlates with intestinal permeability. Yacyshyn, B.R., Meddings, J.B. Gastroenterology (1995) [Pubmed]
  13. Bacterial overgrowth without clinical malabsorption in elderly hypochlorhydric subjects. Saltzman, J.R., Kowdley, K.V., Pedrosa, M.C., Sepe, T., Golner, B., Perrone, G., Russell, R.M. Gastroenterology (1994) [Pubmed]
  14. Lactulose/mannitol test: an ideal screen for celiac disease. Juby, L.D., Rothwell, J., Axon, A.T. Gastroenterology (1989) [Pubmed]
  15. Comparison of lactulose and neomycin in the treatment of chronic portal-systemic encephalopathy. A double blind controlled trial. Conn, H.O., Leevy, C.M., Vlahcevic, Z.R., Rodgers, J.B., Maddrey, W.C., Seeff, L., Levy, L.L. Gastroenterology (1977) [Pubmed]
  16. Evolutionary genomics of ecological specialization. Zhong, S., Khodursky, A., Dykhuizen, D.E., Dean, A.M. Proc. Natl. Acad. Sci. U.S.A. (2004) [Pubmed]
  17. Sulfapyridine appearance in plasma after salicylazosulfapyridine. Another simple measure of intestinal transit. Kellow, J.E., Borody, T.J., Phillips, S.F., Haddad, A.C., Brown, M.L. Gastroenterology (1986) [Pubmed]
  18. Effect of lactulose on ammonia production in a fecal incubation system. Vince, A., Killingley, M., Wrong, O.M. Gastroenterology (1978) [Pubmed]
  19. Effect of long term lactulose ingestion on secondary bile salt metabolism in man: potential protective effect of lactulose in colonic carcinogenesis. van Berge Henegouwen, G.P., van der Werf, S.D., Ruben, A.T. Gut (1987) [Pubmed]
  20. Acidic colonic microclimate--possible reason for false negative hydrogen breath tests. Vogelsang, H., Ferenci, P., Frotz, S., Meryn, S., Gangl, A. Gut (1988) [Pubmed]
  21. Effect of lidamidine hydrochloride and loperamide on gastric emptying and transit of the small intestine. A double-blind study. Sninsky, C.A., Davis, R.H., Clench, M.H., Thomas, K.D., Mathias, J.R. Gastroenterology (1986) [Pubmed]
  22. Intestinal function and injury in acquired immunodeficiency syndrome-related cryptosporidiosis. Goodgame, R.W., Kimball, K., Ou, C.N., White, A.C., Genta, R.M., Lifschitz, C.H., Chappell, C.L. Gastroenterology (1995) [Pubmed]
  23. Effect of infusion of nutrient solutions into the ileum on gastrointestinal transit and plasma levels of neurotensin and enteroglucagon. Read, N.W., McFarlane, A., Kinsman, R.I., Bates, T.E., Blackhall, N.W., Farrar, G.B., Hall, J.C., Moss, G., Morris, A.P., O'Neill, B. Gastroenterology (1984) [Pubmed]
  24. Transit of a meal through the stomach, small intestine, and colon in normal subjects and its role in the pathogenesis of diarrhea. Read, N.W., Miles, C.A., Fisher, D., Holgate, A.M., Kime, N.D., Mitchell, M.A., Reeve, A.M., Roche, T.B., Walker, M. Gastroenterology (1980) [Pubmed]
  25. The diagnosis of small bowel bacterial overgrowth. Reliability of jejunal culture and inadequacy of breath hydrogen testing. Corazza, G.R., Menozzi, M.G., Strocchi, A., Rasciti, L., Vaira, D., Lecchini, R., Avanzini, P., Chezzi, C., Gasbarrini, G. Gastroenterology (1990) [Pubmed]
  26. Gastrointestinal transit: the effect of the menstrual cycle. Wald, A., Van Thiel, D.H., Hoechstetter, L., Gavaler, J.S., Egler, K.M., Verm, R., Scott, L., Lester, R. Gastroenterology (1981) [Pubmed]
  27. Intestinal permeability and genetic determinants in patients, first-degree relatives, and controls in a high-incidence area of Crohn's disease in Southern Italy. Fries, W., Renda, M.C., Lo Presti, M.A., Raso, A., Orlando, A., Oliva, L., Giofré, M.R., Maggio, A., Mattaliano, A., Macaluso, A., Cottone, M. Am. J. Gastroenterol. (2005) [Pubmed]
  28. Effect of intragastric or intraduodenal administration of a polymeric diet on gallbladder motility, small-bowel transit time, and hormone release. Ledeboer, M., Masclee, A.A., Biemond, I., Lamers, C.B. Am. J. Gastroenterol. (1998) [Pubmed]
  29. Fermentation of endogenous substrates is responsible for increased fasting breath hydrogen levels in celiac disease. Di Stefano, M., Miceli, E., Missanelli, A., Malservisi, S., Strocchi, A., Corazza, G.R. J. Lab. Clin. Med. (2004) [Pubmed]
  30. Evolution of a new enzymatic function by recombination within a gene. Hall, B.G., Zuzel, T. Proc. Natl. Acad. Sci. U.S.A. (1980) [Pubmed]
  31. Lactulose hydrogen breath test in the diagnosis of bacterial overgrowth. Rhodes, J.M., Jewell, D.P. Gastroenterology (1990) [Pubmed]
  32. Coordination of gastric and gallbladder emptying after ingestion of a regular meal. Lawson, M., Everson, G.T., Klingensmith, W., Kern, F. Gastroenterology (1983) [Pubmed]
  33. Effect of naloxone on feedback regulation of small bowel transit by fat. Kinsman, R.I., Read, N.W. Gastroenterology (1984) [Pubmed]
  34. Scintigraphic determination of small intestinal transit time: comparison with the hydrogen breath technique. Caride, V.J., Prokop, E.K., Troncale, F.J., Buddoura, W., Winchenbach, K., McCallum, R.W. Gastroenterology (1984) [Pubmed]
  35. Effects of anthracycline therapy on intestinal absorption in patients with advanced breast cancer. Parrilli, G., Iaffaioli, R.V., Martorano, M., Cuomo, R., Tafuto, S., Zampino, M.G., Budillon, G., Bianco, A.R. Cancer Res. (1989) [Pubmed]
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