Kosman M E
JAMA. 1976 Nov 22;236(21):2444-5. doi: 10.1001/jama.236.21.2444.
Lactulose is a synthetic disaccharide that lowers elevated blood ammonia levels and improves symptoms in patients with portosystemic encephalopathy. It is generally well tolerated and appears to be a suitable alternative to neomycin sulfate for maintenance therapy to prevent recurrent attacks and to improve protein tolerance.
