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Lactitol versus lactulose in the treatment of acute portal systemic encephalopathy (PSE). A controlled trial.

Abstract
Preliminary data suggest that lactitol (beta-galactoside-sorbitol), a new synthetic non-absorbable disaccharide, has beneficial effects on chronic portal systemic encephalopathy. To compare the efficacy of lactitol vs. lactulose in the treatment of acute portal systemic encephalopathy (PSE), 40 cirrhotic patients with an acute episode of PSE were randomly allocated to one of two groups: group A (20 patients) received lactulose (30 ml/6 h) and group B (20 patients) lactitol (12 g/6 h). These doses were adjusted daily to obtain two bowel movements per day. The duration of treatment was 5 days. Age, sex, hepatic and renal function, precipitating factors and level of PSE measured by clinical examination, EEG and number connection test were similar in the two groups. A complete clinical resolution of PSE occurred in 11 patients in each group. In 5 patients of the lactulose group and in 6 of the lactitol group there was a moderate improvement of PSE during the study. Finally, 4 patients in the lactulose group and 3 in the lactitol group did not respond to treatment. No side effects attributable to therapy were observed in either group. These results indicate that lactitol is as effective as lactulose in the management of patients with cirrhosis and acute PSE.
AuthorsD Heredia, J Caballería, V Arroyo, G Ravelli, J Rodés
JournalJournal of hepatology (J Hepatol) Vol. 4 Issue 3 Pg. 293-8 (Jun 1987) ISSN: 0168-8278 [Print] Netherlands
PMID3598162 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Disaccharides
  • Sugar Alcohols
  • Lactulose
  • lactitol
Topics
  • Acute Disease
  • Adult
  • Aged
  • Bacterial Infections (complications)
  • Disaccharides (therapeutic use)
  • Electroencephalography
  • Female
  • Hepatic Encephalopathy (drug therapy)
  • Humans
  • Lactulose (therapeutic use)
  • Liver Cirrhosis (drug therapy)
  • Male
  • Middle Aged
  • Sugar Alcohols (therapeutic use)

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