Everything You Need to Know About Lactulose

If you’ve been handed a bottle of lactulose, you might wonder what it does and if it’s safe. In short, lactulose is a synthetic sugar used mainly to relieve constipation and to lower ammonia levels in people with liver disease. It works by pulling water into the colon, softening stool, and by changing gut bacteria that help remove toxins. Below you’ll find straight‑forward answers on when to take it, how much, and what to watch out for.

How Lactulose Works

When you swallow lactulose, it isn’t absorbed in the small intestine. Instead, it reaches the large bowel where gut bacteria break it down into short‑chain acids. These acids lower the pH in the colon, which keeps the stool soft and stimulates bowel movements. In liver patients, the same acids trap ammonia—a waste product that can harm the brain—so it gets expelled with the stool instead of re‑entering the bloodstream.

The result is two‑fold: regular, easier bowel movements for constipation, and reduced risk of hepatic encephalopathy for those with cirrhosis. Because it doesn’t act like a stimulant laxative, it’s gentler and less likely to cause cramping.

When to Use Lactulose

Doctors typically prescribe lactulose for:

• Chronic constipation that hasn’t responded to diet changes.
• Patients with liver cirrhosis who need to lower blood ammonia.
• Occasional use before certain procedures to clear the bowels.

If you’re taking it for constipation, start with the lowest dose that works for you. Most adults begin with 15‑30 ml (about one to two tablespoons) once a day, then increase gradually if needed. For liver patients, the dose is often 20‑30 ml three times daily, adjusted based on blood ammonia levels.

Never exceed the prescribed amount without checking your doctor—taking too much can lead to diarrhea, dehydration, and electrolyte imbalance.

Key dosing tips:

• Mix the liquid with water or juice to mask the sweet taste.
• Take it at the same times each day to keep a routine.
• If you use the powder form, dissolve the measured scoop fully before drinking.

It may take 24‑48 hours to notice relief from constipation. If you don’t see improvement after a week, talk to your physician. They may adjust the dose or suggest an alternative.

Possible side effects are usually mild. Expect occasional bloating, gas, or mild stomach cramps as your gut bacteria adjust. Diarrhea can happen if the dose is too high—stay hydrated and tell your doctor if it persists.

Rarely, people develop allergic reactions like rash or breathing trouble. If that happens, stop the medication and seek immediate medical help.

Pregnant or nursing mothers should only use lactulose if a doctor says it’s necessary. The drug is considered low risk, but confirming safety is always wise.

In summary, lactulose is a simple, effective option for constipation and liver‑related ammonia buildup. Start with a low dose, watch for gas or loose stools, and keep the timing consistent. Always follow your provider’s instructions and report any concerning symptoms. With the right approach, lactulose can keep you comfortable and help protect liver health without the harsh side effects of stronger laxatives.