Effect of sorbitol on psychomotor function: its use in alcoholic cirrhosis

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Abstract
Sorbitol solution had been used as a control substance in evaluating the efficacy of lactulose therapy for hepatic encephalopathy (HE). Recent in vitro studies suggested that sorbitol may not be an inert placebo and may have therapeutic relevance. The in vivo metabolism of sorbitol was studied in healthy volunteers and alcoholic cirrhotic patients. Sorbitol was metabolized by gut bacteria in a similar manner to lactulose. The effect of sorbitol treatment on 5 psychomotor performance tests was studied in cirrhotic patients. Patients receiving sorbitol demonstrated improvement in all psychomotor tests; similar patients not receiving sorbitol showed no improvement. Sorbitol is metabolized by gut bacteria in man, sorbitol therapy improved psychomotor performance in cirrhotic patients and previous studies using sorbitol as a control underestimated the beneficial effects of lactulose.