Research
Lactulose
46 peer-reviewed studies curated from PubMed and Semantic Scholar.
Studies
Sorted by quality and recency
Efficacy and safety of vaginal suppositories containing combination of Natamycin and Lactulose in treatment of vulvovaginal candidiasis: international, randomized, controlled, superiority clinical trial (combination of Natamycin and Lactulose for treatment of vulvovaginal candidiasis).
International RCT assessing the efficacy and safety of Natamycin + Lactulose vaginal suppositories in 218 females with vulvovaginal candidiasis. The combination was superior to both Pimafucin and Lactulose alone in achieving clinical recovery and increasing vaginal lactobacilli content.
A prospective, single-blinded, non-inferiority, randomized controlled study comparing the effectiveness and safety of oral lactulose combined with carbohydrate-containing clear liquids versus 3-L polyethylene glycol electrolyte for colonoscopy bowel preparation.
This prospective, single-blinded, non-inferiority RCT compared the effectiveness and safety of oral lactulose combined with carbohydrate-containing clear liquids versus 3L polyethylene glycol electrolyte solution for colonoscopy bowel preparation. The study found that the lactulose regimen was non-inferior to PEG-ELS in terms of bowel preparation adequacy and polyp detection, with no significant differences in tolerability and safety.
Polyethylene glycol combined with lactulose has better efficacy than polyethylene glycol alone in bowel preparation before colonoscopy: A meta-analysis.
Meta-analysis comparing the efficacy and adverse reactions of polyethylene glycol (PEG) combined with lactulose versus PEG alone for bowel preparation before colonoscopy. The combination showed better efficacy and fewer adverse reactions such as nausea and vomiting compared to PEG alone.
Prophylactic Lactulose Therapy in Patients with Cirrhosis and Upper Gastrointestinal Bleeding: A Meta-analysis of Randomized Trials.
Meta-analysis of randomized trials assessing lactulose for primary prophylaxis of hepatic encephalopathy (HE) in patients with cirrhosis and acute upper gastrointestinal bleeding (AUGIB). Lactulose therapy significantly reduced the risk of overt HE compared to placebo, with no effect on mortality. Common adverse events included diarrhea and abdominal discomfort, but these did not require drug discontinuation.
Systematic Review and Meta-Analysis on the Effects of Lactulose and Rifaximin on Patient-Reported Outcomes in Hepatic Encephalopathy.
Systematic review and meta-analysis of 16 studies with 1,376 patients assessing the effects of lactulose and rifaximin on patient-reported outcomes in hepatic encephalopathy. Lactulose significantly improved health-related quality of life, while rifaximin showed nonstatistically significant improvements.
Combination therapy with rifaximin and lactulose in hepatic encephalopathy: A systematic review and meta-analysis.
Systematic review and meta-analysis of 7 RCTs with 843 patients with hepatic encephalopathy comparing rifaximin plus lactulose to lactulose alone. The combination therapy was associated with an increased effective rate and reduced mortality compared to lactulose alone.
Comparative efficacy and safety of lactulose plus paraffin vs polyethylene glycol in functional constipation: a randomised clinical study.
This randomized clinical study compared the efficacy and safety of lactulose plus paraffin versus polyethylene glycol in treating functional constipation. Both treatments significantly decreased the PAC-SYM score from baseline, establishing non-inferiority of lactulose plus paraffin. Adverse events were mild or moderate and unrelated to the study drugs.
Prevention of hepatic encephalopathy by administration of rifaximin and lactulose in patients with liver cirrhosis undergoing placement of a transjugular intrahepatic portosystemic shunt (TIPS): a multicentre randomised, double blind, placebo controlled trial (PEARL trial).
The PEARL trial is a multicentre randomised, double blind, placebo controlled trial investigating the prevention of hepatic encephalopathy in cirrhotic patients undergoing TIPS placement. Patients are prescribed rifaximin and lactulose or placebo and lactulose, with the primary endpoint being the development of overt hepatic encephalopathy within 3 months.
Comparative Efficacy of Treatment Options for Minimal Hepatic Encephalopathy: A Systematic Review and Network Meta-Analysis.
Systematic review and network meta-analysis of 25 trials with 1563 participants evaluating treatments for minimal hepatic encephalopathy (HE) in cirrhosis patients. Rifaximin and lactulose were most effective for reversing minimal HE, while L-ornithine L-aspartate and lactulose were most effective in preventing overt HE.
Combination of rifaximin and lactulose improves clinical efficacy and mortality in patients with hepatic encephalopathy.
Meta-analysis of 10 studies involving 2,276 patients with hepatic encephalopathy comparing combination therapy of rifaximin and lactulose to lactulose alone. Combination therapy improved clinical efficacy and reduced mortality, with no significant difference in treatment-related adverse events.
Osmotic and stimulant laxatives for the management of childhood constipation.
Meta-analysis of 25 RCTs with 2310 participants evaluating osmotic and stimulant laxatives for childhood constipation. PEG was found to be superior to placebo, lactulose, and milk of magnesia in increasing stool frequency. Liquid paraffin also showed efficacy. The quality of evidence was low due to bias and heterogeneity.
Non-absorbable disaccharides versus placebo/no intervention and lactulose versus lactitol for the prevention and treatment of hepatic encephalopathy in people with cirrhosis.
Meta-analysis of 38 RCTs with 1828 participants evaluating non-absorbable disaccharides (lactulose and lactitol) for hepatic encephalopathy in cirrhosis. Non-absorbable disaccharides showed beneficial effects on mortality and hepatic encephalopathy compared to placebo/no intervention. No significant differences were found between lactulose and lactitol.
Nonabsorbable disaccharides for hepatic encephalopathy: A systematic review and meta-analysis.
This systematic review and meta-analysis evaluated the effects of nonabsorbable disaccharides, lactulose and lactitol, on hepatic encephalopathy (HE) in patients with cirrhosis. The analysis of 38 randomized controlled trials showed that these substances had a beneficial effect on HE, reduced serious liver-related adverse events, and decreased mortality in patients with overt HE.
Osmotic and stimulant laxatives for the management of childhood constipation.
Meta-analysis of 18 RCTs with 1643 patients evaluating osmotic and stimulant laxatives for childhood constipation. PEG was found to be superior to placebo, lactulose, and milk of magnesia in increasing stool frequency, with no serious adverse events reported. Liquid paraffin also showed efficacy. The overall quality of evidence was low due to methodological concerns.
Clinical efficacy and safety of lactulose for minimal hepatic encephalopathy: a meta-analysis.
Meta-analysis of nine RCTs with 434 patients evaluating lactulose for minimal hepatic encephalopathy (MHE). Lactulose significantly improved neuropsychological test outcomes, reduced progression to overt hepatic encephalopathy, and lowered blood ammonia levels, but increased the incidence of diarrhea.
Rifaximin plus lactulose versus lactulose alone for reducing the risk of HE recurrence.
Pooled post hoc subgroup analysis of adults receiving rifaximin plus lactulose or lactulose alone for 6 months in a phase 3 randomized, double-blind trial and a phase 4 open-label trial. Rifaximin plus lactulose was more efficacious than lactulose alone for reducing the risk of overt HE recurrence and HE-related hospitalization.
Lactulose regulates gut microbiota dysbiosis and promotes short-chain fatty acids production in acute pancreatitis patients with intestinal dysfunction.
Prospective randomized trial of 73 moderate severe acute pancreatitis patients with intestinal dysfunction, comparing lactulose to Chinese herb rhubarb for 1 week. Lactulose improved intestinal function, decreased serum cytokines and gut permeability, enriched beneficial Bifidobacterium, and increased short-chain fatty acids more than rhubarb.
Lactulose therapy for patients with cirrhosis, portal hypertension, and poor patient-reported outcomes: The Mi-Kristal trial.
A 28-day randomized trial of crystalline lactulose therapy (20g BID) in 52 patients with cirrhosis and portal hypertension. Lactulose improved sleep quality and activity impairment but did not improve global health-related quality of life.
Comparative effectiveness of lactulose and sennosides for the prevention of peritoneal dialysis-related peritonitis: an open-label, randomized, active-controlled trial.
Open-label, randomized, active-controlled trial comparing lactulose and sennosides for the prevention of peritoneal dialysis-related peritonitis in 100 patients. Lactulose was not more effective than sennosides and was associated with a higher risk of bacterial peritonitis and more frequent diarrhea.
Lactulose ingestion causes an increase in the abundance of gut-resident bifidobacteria in Japanese women: a randomised, double-blind, placebo-controlled crossover trial.
A randomised, double-blind, placebo-controlled crossover trial in 60 Japanese women studied the effect of 2 g/day lactulose ingestion for 2 weeks. Lactulose significantly increased the abundance of intestinal bifidobacteria but did not affect the intestinal microbiota as a whole.
Efficacy and safety of a crystalline lactulose preparation (SK-1202) in Japanese patients with chronic constipation: a randomized, double-blind, placebo-controlled, dose-finding study.
A randomized, double-blind, placebo-controlled, dose-finding study in 250 Japanese patients with chronic constipation to estimate the optimal clinical dose of lactulose. The study found that 26 and 39 g/day of SK-1202 significantly increased spontaneous bowel movements compared to placebo, with improvements in stool consistency and constipation severity. SK-1202 was well tolerated up to 39 g/day.
Lactulose Management of Minimal Hepatic Encephalopathy: A Systematic Review.
Systematic review of randomized clinical trials evaluating lactulose, probiotics, and L-ornithine-L-aspartate for managing minimal hepatic encephalopathy. These treatments were equally effective in reducing abnormal neuropsychiatric test results at 1, 3, and 12 months post-treatment, potentially reducing risk of road traffic accidents.
[Efficacy and safety of lactulose on the treatment of puerperal constipation].
RCT of 200 patients with puerperal constipation comparing oral lactulose solution to defecation habits training and diet management. The lactulose group showed higher defecation frequency and lower recurrence of constipation, indicating its effectiveness and safety.
[Efficacies of lactulose plus live combined Bacillus subtilis and Enterococcus faecium capsules in the treatment of functional constipation: a multicenter, randomized, double blind, controlled trial].
Multicenter RCT of 216 patients with functional constipation comparing lactulose plus live combined Bacillus subtilis and Enterococcus faecium capsules to lactulose plus placebo. The treatment group showed better efficacies, but inter-group differences were not statistically significant.
Meta-analysis of oro-cecal transit time in fasting subjects.
Meta-analysis using subject-level data to construct a statistical model predicting oro-cecal transit time (OCTT) in fasting subjects. Lactulose was used to measure OCTT, and the model could distinguish OCTTs of subjects with altered physical status, such as cystic fibrosis and celiac disease, from healthy individuals.
A randomized controlled trial comparing lactulose, probiotics, and L-ornithine L-aspartate in treatment of minimal hepatic encephalopathy.
RCT comparing lactulose, probiotics, and L-ornithine L-aspartate (LOLA) in the treatment of minimal hepatic encephalopathy (MHE) in patients with cirrhosis. All three treatments significantly improved MHE and health-related quality of life compared to no treatment.
Laxation of critically ill patients with lactulose or polyethylene glycol: a two-center randomized, double-blind, placebo-controlled trial.
RCT in two intensive care units with 308 critically ill patients comparing lactulose, polyethylene glycol, and placebo for promoting defecation. Both lactulose and polyethylene glycol were more effective than placebo, with lactulose associated with a shorter ICU stay and polyethylene glycol with a lower incidence of intestinal pseudoobstruction.
Efficacy of Lactulose versus Senna Plus Ispaghula Husk Among Patients with Pre-Dialysis Chronic Kidney Disease and Constipation: A Randomized Controlled Trial
RCT comparing the efficacy of lactulose and senna plus ispaghula husk in treating constipation among patients with pre-dialysis CKD. Both treatments increased complete spontaneous bowel movements weekly, with no significant difference between them. Stool appearance improved similarly in both groups.
A Randomized Controlled Trial Comparing Nitazoxanide Plus Lactulose With Lactulose Alone in Treatment of Overt Hepatic Encephalopathy.
RCT comparing nitazoxanide plus lactulose versus lactulose and placebo in 120 cirrhotic patients with overt hepatic encephalopathy. The NTZ group showed significantly better improvement in CHESS score and mental status compared to the lactulose and placebo group.
Lactulose improves cognition, quality of life, and gut microbiota in minimal hepatic encephalopathy: A multicenter, randomized controlled trial.
This multicenter, open-label randomized controlled trial assessed the efficacy of lactulose in the recovery of minimal hepatic encephalopathy (MHE) in terms of cognitive function, quality of life, and gut microbiota impact. The study included 98 cirrhotic patients, with a significantly higher MHE reversal rate in the lactulose group compared to the control group. Lactulose treatment also improved physical functioning and altered gut microbiota composition.
Is Lactulose Plus Rifaximin Better than Lactulose Alone in the Management of Hepatic Encephalopathy?
RCT comparing lactulose plus rifaximin to lactulose alone in 130 patients with hepatic encephalopathy. No significant difference in effectiveness was found between the two treatments after 10 days.
A Randomized Controlled Trial Comparing the Efficacy of a Combination of Rifaximin and Lactulose with Lactulose only in the Treatment of Overt Hepatic Encephalopathy.
RCT comparing the efficacy of lactulose and rifaximin combination therapy versus lactulose only in 96 patients with hepatic encephalopathy. The study found that patients on lactulose only had lower mortality and better neurological improvement compared to those on the combination therapy. No statistical difference in survival was observed between the groups, but mean survival was higher in the lactulose only group.
Primary Prophylaxis to Prevent the Development of Hepatic Encephalopathy in Cirrhotic Patients with Acute Variceal Bleeding.
RCT comparing primary prophylaxis with lactulose, L-ornithine L-aspartate, or rifaximin to placebo in cirrhotic patients with variceal bleeding to prevent hepatic encephalopathy. L-ornithine L-aspartate and rifaximin were effective in preventing hepatic encephalopathy compared to placebo.
Randomized controlled trial comparing lactulose plus albumin versus lactulose alone for treatment of hepatic encephalopathy.
RCT comparing lactulose plus albumin versus lactulose alone in 120 patients with overt hepatic encephalopathy. The combination treatment showed higher rates of complete reversal of HE, lower mortality, and shorter hospital stays compared to lactulose alone.
Lactulose vs polyethylene glycol 3350--electrolyte solution for treatment of overt hepatic encephalopathy: the HELP randomized clinical trial.
The HELP randomized clinical trial compared polyethylene glycol 3350-electrolyte solution (PEG) and lactulose treatments in 50 patients with cirrhosis hospitalized for hepatic encephalopathy (HE). PEG led to more rapid HE resolution than lactulose, with 91% of PEG-treated patients showing improvement compared to 52% in the lactulose group.
A randomized, double-blind, controlled trial comparing rifaximin plus lactulose with lactulose alone in treatment of overt hepatic encephalopathy.
A randomized controlled trial comparing the efficacy of lactulose plus rifaximin versus lactulose alone in 120 patients with overt hepatic encephalopathy. The combination treatment showed a higher rate of complete reversal of HE, reduced mortality, and shorter hospital stays compared to lactulose alone.
Prophylaxis of hepatic encephalopathy in acute variceal bleed: a randomized controlled trial of lactulose versus no lactulose.
RCT evaluating the role of lactulose for prophylaxis of hepatic encephalopathy (HE) after acute variceal bleed (AVB) in cirrhosis patients. Lactulose was effective in preventing HE, with fewer patients developing HE in the lactulose group compared to the control group.
An open-label randomized controlled trial of lactulose and probiotics in the treatment of minimal hepatic encephalopathy.
RCT comparing lactulose, probiotics, and their combination in 105 cirrhotic patients with minimal hepatic encephalopathy (MHE). Significant improvements were observed in psychometry tests, P300ERP, and venous ammonia levels across all treatment groups, with normalization rates of 54.8%, 51.6%, and 56.6% respectively.
Effect of dietary intervention with different pre- and probiotics on intestinal bacterial enzyme activities.
Randomized crossover study in 53 healthy volunteers evaluating the effect of prebiotics (lactulose, OF-IN) and probiotics (L. casei Shirota, B. breve, S. boulardii) on faecal enzyme activities. Lactulose and OF-IN significantly decreased beta-glucuronidase activity, while B. breve increased beta-glucosidase levels. Synbiotic combinations were not more beneficial than individual compounds.
Comparison of rifaximin and lactulose for the treatment of hepatic encephalopathy: a prospective randomized study.
Prospective randomized study comparing rifaximin and lactulose for the treatment of hepatic encephalopathy in 54 Korean patients with liver cirrhosis. Both treatments were effective, with significant improvements in blood ammonia, flapping tremor, mental status, and number connection test. Rifaximin was as safe and effective as lactulose.
Microbiota stability in healthy individuals after single-dose lactulose challenge-A randomized controlled study.
RCT with 32 healthy volunteers comparing single-dose ingestion of 50 g lactulose to 50 g sucrose. Lactulose ingestion resulted in increased H2 levels and diarrhea in some participants, but did not significantly alter E. coli density or microbiota composition in stool samples.
Effect of lactulose and Saccharomyces boulardii administration on the colonic urea-nitrogen metabolism and the bifidobacteria concentration in healthy human subjects.
A placebo-controlled crossover study in 43 healthy volunteers evaluated the effects of lactulose and Saccharomyces boulardii on colonic urea-nitrogen metabolism and bifidobacteria concentration. Lactulose administration significantly decreased urinary (15)N-excretion and increased faecal (15)N-output, with a rise in Bifidobacterium population, indicating a bifidogenic effect. No significant effects were observed with S. boulardii.
Clinical efficacy of lactulose in cirrhotic patients with and without subclinical hepatic encephalopathy.
RCT of 75 cirrhotic patients with hyperammonemia, divided into lactulose-treated and non-treated groups. Lactulose treatment significantly improved psychometric test results in patients with subclinical hepatic encephalopathy (SHE) over 8 weeks, with SHE disappearing in 50% of treated patients.
The laxative effects of lactulose in normal and constipated subjects.
RCT comparing lactulose syrup to placebo in 42 normal and 24 constipated volunteers. Lactulose significantly increased stool frequency, weight, volume, and water content, and softened stool consistency compared to baseline and placebo. The study suggests dose-related laxative effects.
Long-Term Effect of Rifaximin with and without Lactulose on the Active Bacterial Assemblages in the Proximal Small Bowel and Faeces in Patients with Minimal Hepatic Encephalopathy.
RCT analyzing the effect of rifaximin with and without lactulose on gut microbiota in 5 patients with minimal hepatic encephalopathy. No significant changes in bacterial community composition were observed, but MHE improved, suggesting a prolonged effect on microbiota metabolic function.
A painless treatment for patients undergoing Milligan-Morgan haemorrhoidectomy.
RCT of 30 patients undergoing Milligan-Morgan haemorrhoidectomy comparing treatment with lactulose, metronidazole, and glyceryl-trinitrate to placebo. The treatment group experienced reduced pain and analgesic consumption, with earlier return to normal activities.