No abstract available.
Animals ; Kidney* ; Lactulose* ; Liver* ; Rats* ; Sepsis*

PURPOSE: To evaluate the correlation between colon transit time (CTT) test value and initial maintenance dose of polyethylene glycol (PEG) 4000 or lactulose. METHODS: Of 415 children with chronic functional constipation, 190 were enrolled based on exclusion criteria using the CTT test, defecation diary, and clinical chart. The CTT test was performed with prior disimpaction. The laxative dose for maintenance was determined on the basis of the defecation diary and clinical chart. The Shapiro-Wilk test and Pearson's and Spearman's correlations were used for statistical analysis. RESULTS: The overall group median value and interquartile range of the CTT test was 43.8 (31.8) hours. The average PEG 4000 dose for maintenance in the overall group was 0.68±0.18 g/kg/d; according to age, the dose was 0.73±0.16 g/kg/d (<8 years), 0.53±0.12 g/kg/d (8 to <12 years), and 0.36±0.05 g/kg/d (12 to 15 years). The dose of lactulose was 1.99±0.43 mL/kg/d (<8 years) or 1.26±0.25 mL/kg/d (8 to <12 years). There was no significant correlation between CTT test value and initial dose of laxative, irrespective of the subgroup (encopresis, abnormal CTT test subtype) for either laxative. Even in the largest group (overall, n=109, younger than 8 years and on PEG 4000), the correlation was weak (Pearson's correlation coefficient [R]=0.268, p=0.005). Within the abnormal transit group, subgroup (n=73, younger than 8 years and on PEG 4000) correlation was weak (R=0.267, p=0.022). CONCLUSION: CTT test value cannot predict the initial maintenance dose of PEG 4000 or lactulose with linear correlation.
Child* ; Colon* ; Constipation* ; Defecation ; Humans ; Lactulose ; Laxatives ; Polyethylene Glycols

BACKGROUND/AIMS: The aim of this study was to examine the reproducibility of methane and hydrogen in exhaled air breath after a per-oral load of lactulose. METHODS: Methane was present in the exhaled breath of 21 of 50 healthy subjects recruited by advertisement. Three methane breath tests were performed in 12 women (aged 23.6+/-0.5 years, mean+/-SEM) after they consumed 10 g of lactulose dissolved in 300 ml of water. Short- and medium-term reproducibilities were assessed by paired examinations taken 3 and 17 days (median) apart, respectively. RESULTS: High values of coefficients of variation for paired examinations (CV(p)) indicated a poor short-term reproducibility of parameters characterizing either the methane or hydrogen excretion in breath air: CV(p) values of the maximum net increments over baseline in methane (max CH4_net), and in hydrogen (max H2_net), were 34% and 41%, respectively. Moreover, the reproducibility consistently deteriorated with increasing time gap between repeat measurements (CV(p): 60% for max CH4_net and 64% for max H2_net). CONCLUSIONS: The low reproducibility of parameters characterizing quantitative methane breath excretion suggests that caution is necessary when judging the clinical usefulness of the methane breath test after a per-oral lactulose load for the purpose of diagnosing and classifying functional bowel disorders.
Breath Tests ; Female ; Humans ; Hydrogen ; Lactulose ; Methane ; Water

Seventeen dogs were treated with L-ornithin-L-aspartate (LOLA; experimental group). Three dogs were treated with lactulose recognized therapy (control group). Following LOLA administration, 15 dogs experienced a significant decrease in ammonia level (p < 0.05) and showed clinical signs of improvement. However, there were no clinical signs of improvement in two dogs, even though the ammonia level decreased. Conversely, the clinical signs of the control group also improved and the ammonia level decreased, although these changes were not significant (p > 0.05). These results suggest that LOLA is an effective drug to treat hyperammonemia in veterinary medicine.
Ammonia ; Animals ; Dogs* ; Dipeptides* ; Hepatic Encephalopathy* ; Hyperammonemia ; Lactulose ; Veterinary Medicine

BACKGROUND/AIMS: A prospective, randomized study was performed to evaluate the efficacy and safety of the short-term administration of rifaximin in the treatment of hepatic encephalopathy. METHODS: Of the 64 patients diagnosed as having decompensated liver cirrhosis with hepatic encephalopathy, 39 patients were randomized to receive rifaximin and 25 patients to receive lactulose for seven days. Before and after the treatment we assessed changes in the level of serum ammonia, flapping tremor, patient's mental status, number connection test (NCT), and hepatic encephalopathy indices. RESULTS: In rifaximin-treated group, the mean grade of serum ammonia (1.8->0.9), mental status (1.3->0.3), NCT (3.0->2.0), and flapping tremor (1.7->0.4) were improved after treatment. In the lactulose-treated group, the mean grade of serum ammonia (1.9->1.0), mental status (1.5->0.5), NCT (3.3->2.1), and flapping tremor (1.4->0.3) were improved after treatment. Side effects of abdominal pain (rifaximin group) and excessive diarrhea (lactulose group) were noted in 2 cases. The efficacy of treatment was not significantly different between rifaximin and lactulose-treated groups (84.3% vs. 95.3%). CONCLUSION: Rifaximin was as efficient and safe in the treatment of hepatic encephalopathy as lactulose in terms of efficacy. Rifaximin may be useful drug for the short-term treatment of hepatic encephalopathy.
Abdominal Pain ; Ammonia ; Diarrhea ; Hepatic Encephalopathy* ; Humans ; Lactulose ; Liver Cirrhosis ; Prospective Studies ; Tremor

BACKGROUND/AIMS: Small-intestinal bacterial overgrowth (SIBO) is a frequent finding in patients with irritable bowel syndrome (IBS). Many patients with IBS also have abnormal intestinal permeability, which is probably due to low-grade inflammation in the intestinal mucosa. Our aim was to verify the relationship between SIBO and small-intestinal permeability in IBS patients. METHODS: A cohort of 38 IBS patients (20 women and 18 men; age range 16-70 years; mean age 40.2 years) with symptoms that fulfilled Rome-II criteria, and 12 healthy controls (5 women and 7 men; age range 25-52 years; mean age: 37.8 years) were recruited. All subjects underwent lactulose breath tests (LBTs) and intestinal permeability tests using the polyethylene glycol (PEG) 3350/400 retrieval ratio. RESULTS: A positive LBT was found in 18.4% (7/38) of patients with IBS and 8.3% (1/12) of control subjects. Intestinal permeability was significantly increased in patients with IBS compared with the normal controls (0.82+/-0.09 vs 0.41+/-0.05 [mean+/-SD], respectively; p<0.05). However, the intestinal permeability did not differ significantly between IBS patients with a positive LBT and those with a negative LBT (0.90+/-0.13 and 0.80+/-0.11, respectively; p>0.05). CONCLUSIONS: Intestinal permeability was increased in patients with IBS, but this finding did not correlated with the occurrence of SIBO.
Breath Tests ; Cohort Studies ; Female ; Humans ; Inflammation ; Intestinal Mucosa ; Irritable Bowel Syndrome ; Lactulose ; Permeability ; Polyethylene Glycols

Hydrogen breath tests using various substrates like glucose, lactulose, lactose and fructose are being used more and more to diagnose small intestinal bacterial overgrowth (SIBO) and lactose or fructose malabsorption. Though quantitative culture of jejunal aspirate is considered as gold standard for the diagnosis of SIBO, hydrogen breath tests, in spite of their low sensitivity, are popular for their non-invasiveness. Glucose hydrogen breath test is more acceptable for the diagnosis of SIBO as conventionally accepted double-peak criterion on lactulose hydrogen breath test is very insensitive and recently described early-peak criterion is often false positive. Hydrogen breath test is useful to diagnose various types of sugar malabsorption. Technique and interpretation of different hydrogen breath tests are outlined in this review.
Breath Tests ; Fructose ; Glucose ; Hydrogen ; Intestine, Small ; Irritable Bowel Syndrome ; Lactose ; Lactulose

5-Fluorouracil (5-FU) is a chemotherapeutic agent commonly used in the treatment of a variety of solid tumors. Common adverse effects of fluorouracil chemotherapy include diarrhea, mucositis and myelosuppression. However, neurologic toxicities including hyperammonemic encephalopathy are rare and not well recognized. Transient hyperammonemic encephalopathy related to continuous infusion of high-dose 5-FU has rarely been reported. We report four cases of transient hyperammonemic encephalopathy in patients receiving continuous infusion of 5-FU. The mentality of all patients was altered during or just after the infusion of 5-FU. There were no focal neurological signs, laboratory excluding hyperammonemia or radiological abnormalities. After patients received adequate hydration and repeated lactulose enema, the mental status completely recovered within one or two days, and serum ammonium level subsequently returned to normal. In conclusion, we suggest that a transient hyperammonemic encephalopathy should be considered in differential diagnosis of patients receiving continuous 5-FU infusion with altered mentality.
Ammonium Compounds ; Diagnosis, Differential ; Diarrhea ; Drug Therapy ; Enema ; Fluorouracil* ; Humans ; Hyperammonemia ; Lactulose ; Mucositis

PURPOSE: The aim of this study was to compare 2 laxatives, namely, polyethylene glycol 4000 without electrolytes and lactulose, evaluating the efficacy and safety for the treatment of constipation in children. METHODS: Fifty-six children with chronic functional constipation were randomly assigned to receive polyethylene glycol 4000 (24 patients) or lactulose (32 patients). Patients or their parents reported defecation frequency, stool consistency, abdominal pain, stool incontinence and side effects after 1, 3, 6 and 12 months of treatment. Percentage of recovered patients were compared with each group. RESULTS: Defecation frequency, abdominal pain and stool incontinence were improved in each group. At 12 months of follow up, 60% of patients treated with polyethylene glycol and 57.7% of patients treated with lactulose were considered as recovered. CONCLUSION: In this study, both polyethylene glycol and lactulose were equally effective and safe in the long-term treatment of constipation in children. There were no significant differences in recovery rates between 2 groups.
Abdominal Pain ; Child* ; Constipation* ; Defecation ; Electrolytes ; Follow-Up Studies ; Humans ; Lactulose* ; Laxatives ; Parents ; Polyethylene Glycols* ; Polyethylene*

BACKGROUNDS/AIMS: High intraluminal pressure has been reported to cause left colonic diverticula. However, the pathophysiology of right colonic diverticula is still unclear. Methane gas has been reported to delay small intestinal transit and to increase intraluminal pressure. The aim of this study was to evaluate the relationship between right colonic diverticula and intestinal gas produced by enteric bacteria. METHODS: Lactulose breath tests were performed in 30 patients who were diagnosed with right colonic diverticula via colonoscopy. The control group consisted of 30 healthy adults with no specific symptoms or medical histories. A hydrogen or methane producer was defined in 2 ways: either one that exhibited a breath hydrogen level > or = 20 ppm (methane > or = 10 ppm) baseline or one that exhibited an increase in breath hydrogen > or = 20 ppm (methane > or = 10 ppm) above baseline within the first 90 minutes of the test. RESULTS: The lactulose breath test (LBT) positivity in the diverticular group and the control group were 40.0% and 33.3%, respectively, without a statistically significant difference. The concentrations of methane and hydrogen gas measured by LBT increased over time, but there was no significant difference between the control and the diverticular groups. CONCLUSIONS: There was no significant relationship between right colonic diverticula and intestinal gases produced by enteric bacteria. However, time-dependent formation of diverticula should be taken into consideration, therefore long-term, large-scale follow-up studies may reveal further pathogenesis of right colonic diverticulosis.
Adult ; Breath Tests ; Colon ; Colonoscopy ; Diverticulosis, Colonic ; Diverticulum ; Diverticulum, Colon ; Enterobacteriaceae ; Gases ; Humans ; Hydrogen ; Lactulose ; Methane