Summary
Both lactulose and lactitol are nonabsorbable disaccharides. In an effort to determine similarities or dissimilarities in their effect on the normal human gut flora, parallel in vitro and in vivo experiments were carried out using pyxigraphy. Stools from healthy volunteers were used to determine pH, ammonia concentrations, and numbers of microorganisms in caecal contents and stool samples. There was a marked inhibition of ammonia production and a fall in pH, the latter depending on the concentration of sugar added in both in vitro and in vivo experiments. The numbers of aerobes and anaerobes in all suspensions fell, both in vitro and in vivo. The fermentation of the disaccharides by the most important intestinal microorganisms (in vitro) was also determined: all quantitatively important intestinal microorganisms fermented both disaccharides. Both lactulose and lactitol caused acid to form, and both reduced the formation of ammonia by selected bacteria. Lactitol and lactulose can, therefore, be regarded as similar in their mode of action on the normal human intestinal flora.
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Bircher J, Buhrer M, Franz K, van Velthuisen JA. Erstmalige Anwendung von Lactitol in der Behandlung der portosystemischen Enzephalopathie. Schweizerische Medizinische Wochenschrift 112: 1306–1307, 1982
Brown RL, Gibson JA, Sladon GE, Hicks B, Dawson AM. Effects of lactulose and other laxatives on ileal and colonic pH as measured by a radiotelemetry device. Gut 15: 999–1004, 1974
Conn HO, Lieberthal MM. The hepatic coma syndromes and lactulose, pp. 46–121, 278–294, 306–316, 323–339, Williams and Wilkins, Baltimore, Maryland, 1979
Crowther JS. Transport and storage of faeces for bacteriological examination. Journal of Applied Bacteriology 34: 477–483, 1971
Drasar BS. Some factors associated with geographical variations in the intestinal microflora. In Skinner & Carr (Eds) The normal microbial flora of man, pp. 187–196, Academic Press, London, 1974
Hallmann K. Klinische Microbiologie, 4th Ed., Thieme Publishers, Stuttgart and New York, 1984
Heredia D, Caballeria J, Orteu N, Ballesta A, Ravelli G, et al. Lactitol versus lactulose in the treatment of acute portal-systemic encephalopathy. A controlled trial. Journal of Hepatology 1 (Suppl. 1): S65, 1985
Hoffmann K, Mossel DA, Korus W, Kamer JH. Untersuchung uber die Wirkungsweise von Lactulose im Darm. Klinische Wochenschrift 42: 126–130, 1964
Perrenoud JP. La pyxigraphie, procede d’exploitation du contenu du tube digestif au moyen de capsules de prelevement. Gastroenterologie (Basel) 87: 349–355, 1957
Perrenoud JP, Ruedi B, Rossel J, Claros R, Pantillon JP, et al. Pyxigrafie. Medicine et Chirurgie Digestives 12: 173–179, 1983
Reim HG, Koken M. Die Therapie mit lactulose. Fortschritte Medizin 102: 1167–1170, 1984
Richerich R. Klinische Chemie, Theorie und Praxis, S. Karger, Basel, Switzerland, 1968
Ruttloff H, Hanel H, Taufel A, Taufel K. Die intestinalenzymatische Spaltung von Galakto-Oligosacchariden im Darm von Mensch und Tier mit Besonderer Berucksichtigung von lactobacillus bifidus. Carbohydratische Aktivitat ausgewahlter Organismen der Darmflora. Nahrung 11: 17–54, 1968
Schaedler RW, Dubos R, Costello R. The development of the bacterial flora in the gastrointestinal tract of mice. Journal of Experimental Medicine 122: 59–66, 1965
Vince A, Burridge SM. Ammonia production by intestinal bacteria: the effects of lactose, lactulose, and glucose. Journal of Medical Microbiology 13: 177–191, 1980
Vince A, Zeegen R, Drinkwater JE, O’Grady F, Dawson AM. The effect of lactulose on the fecal flora of patients with hepatic encephalopathy. Journal of Medical Microbiology 7: 163–168, 1974
Vince A, Killingley M, Wrong OM. Effect of lactulose on ammonia production in a fecal incubation system. Gastroenterology 74: 544–549, 1978
Wrong O, Metcalfe-Gibson A, Morrison RBI, Ng ST, Howard AV. In vivo dialysis of feces as a method of stool analysis. Clinical Science 28: 357–375, 1965
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Kitler, M.E., Luginbuhl, M., Lang, O. et al. Lactitol and Lactulose. Drug Invest 4, 73–82 (1992). https://doi.org/10.1007/BF03258384
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DOI: https://doi.org/10.1007/BF03258384