Abstract
A double-blind crossover trial was performed to test the therapeutic usefulness and safety of lactitol, a beta-galactoside sorbitol, against lactose in 18 patients with chronic portal-systemic encephalopathy (PSE). The study included four periods: two for washout and two for lactitol and lactose administration. During washout periods, which lasted two weeks each, patients were stabilized with neomycin plus milk of magnesia. Lactitol and lactose were administered during four weeks each. Ten patients were randomly assigned to receive lactose (group A) and eight patients to receive lactitol (group B) first. PSE parameters, ie, mental state, number connection test performance, asterixis and blood ammonia levels were assessed fortnightly. Electroencephalographic tracings and stool pHs were evaluated at the end of each study period. After the first administration of lactose and lactitol, no statistically significant differences in PSE parameters were found. At the same stage, a significant stool acidification (P<0.05) was detected. It is concluded that lactitol seems to be safe and efficacious in treating patients with chronic PSE.
Similar content being viewed by others
References
Uribe M, Moreno Berthier J, Lewis H,et al: Lactose enemas plus placebo tablets vs neomycin tablets plus starch enemas in acute portal-systemic encephalopathy. A doubleblind randomized controlled study. Gastroenterology 81: 101–106, 1981
Atterbury CE, Maddrey WC, Conn HO, et al: Neomycin sorbitol and lactulose in the treatment of acute portal-systemic encephalopathy. A controlled, double-blind clinical trial. Am J Dig Dis 23:398–406, 1978
Conn HO, Leevy CM, Vlacevic ZR, et al: Comparison of lactulose and neomycin in the treatment of chronic portalsystemic encephalopathy. A double-blind controlled trial. Gastroenterology 72:573–583, 1977
Uribe M, Marquez MA, Garcia Ramos G, et al: Treatment of chronic portal-systemic encephalopathy with lactose in lactase deficient patients. Dig Dis Sci 25:924–928, 1980
Lewis H, Rojas S, Uribe M, et al: Simllar effect of lactose and lactulose onin vitro fecal ammonia generation and bacterial flora. Gastroenterology 78:1206, 1980 (abstract)
Van Velthuijsen JA: Food additives derived from lactose: Lactitol and lactitol palmitate. J Agric Food Chem 27:760–786, 1979
Bircher J, Buehrer M, Franz JA, Van Velthuijsen JA: Erstmalige Anwendung von ZY 15060 in der Behandlung der porto-systemischen Enzephalopathie. Schweiz Med Wochenschr 38:1306–1307, 1982
Lanthier RL, Morgan MY: Lactitol in the treatment of chronic hepatic encephalopathy: An open comparison with lactulose. Gut 26:415–420, 1982
Lisker R, Lopez Habib G, Daltabut M: Lactose deficiency in a rural area of Mexico. Am J Clin Nutr 27:7569, 1974
Lisker R, Lopez Habib G, Mora MA: Correlation in the diagnosis of intestinal lactase deficiency between the radiological methods and the lactose tolerance test. Rev Invest Clin (Mex) 27:1–5, 1975
Conn HO: Trailmaking and number connection tests in the assessment of mental state in portal-systemic encephalopathy. Dig Dis Sci 22:541–550, 1977
Uribe M, Farca A, Marquez MA, et al: Treatment of chronic portal-systemic encephalopathy with bromocriptine. A double-blind controlled trial. Gastroenterology 76:1347–1351, 1979
McDermont MV, Adams PD, Riddell AG: Ammonia levels in blood and cerebrospinal fluid. Proc Soc Exp Biol 88: 380–382, 1955
Hills M, Armitage P: The two period cross-over clinical trial. Br J Clin Pharmacol 8:7–20, 1979
Richerss A, Todd HN: Introduccion a la Estadistica. Barcelona, Editorial Continental SA, 1974, p 90
Hoyumpa AM, Desmond PV, Avant PR, et al: Hepatic encephalopathy. Gastroenterology 76:184–195, 1977
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Uribe, M., Toledo, H., Perez, F. et al. Lactitol, a second-generation disaccharide for treatment of chronic portal-systemic encephalopathy. Digest Dis Sci 32, 1345–1353 (1987). https://doi.org/10.1007/BF01296659
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01296659