PEG (Polyethylene Glycol)Versus Lactulose For Treatment Of Overt Hepatic Encephalopathy
Status:
Unknown status
Trial end date:
2019-12-01
Target enrollment:
Participant gender:
Summary
The current standard of care for patients with HE includes non-absorbable
disaccharides(lactulose);The chemical name for lactulose is
4-O-β-D-galactopyranosyl-D-fructofuranose.The exact mode of action by lactulose is thought to
be the conversion to lactic acid and acetic acid by colonic bacteria resulting in
acidification of the gut lumen. This favors conversion of ammonia (NH3) to ammonium (NH4+),
which is relatively membrane impermeable; therefore, less ammonia is absorbed by the colon.
Gut acidification inhibits ammoniagenic coliform bacteria, leading to increased levels of
nonammoniagenic lactobacilli. Nonabsorbable disaccharides also work as a cathartic, clearing
the gut of ammonia before it can be absorbed.