Chronic Hepatic Encephalopathy Treated with Oral Lactose in a Patient with Lactose Malabsorption

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Abstract
LACTULOSE has been used successfully in the treatment of hepatic encephalopathy.1 It appears that oral lactulose, by producing a disaccharide malabsorption, makes the intraluminal gut pH more acid, decreasing the absorption of ammonia from the gut.2 Since lactulose is not available in this country for routine clinical use,3 we suggested the use of oral lactose in the treatment of hepatic encephalopathy if the patient has lactose malabsorption.4 If such treatment is successful, it will have worldwide application since 70 to 75 per cent of American blacks, 80 per cent of American Indians, 95 to 100 per cent of Orientals, 50 . . .