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.