Quick question from a nurse:
Why do we give our liver failure patients Lactulose?
Let's start by understanding that as we eat protein, it is broken down into AminoAcids which when processed in the digestive system form poisonous Ammonia.
Your healthy liver detoxifies this brain poison into a water soluble Urea so the kidneys can excrete it.
If ammonia builds up- brain damage.
So a healthy liver prevents this. In hepatic failure patients - hepatic brain damage called encephalopathy occurs.
Lactulose prevents ammonia compounds being absorbed from the gut, reducing the workload of a failed liver, and thus prevents that brain damage.
It is an osmotic laxitive so diarrhoea is expected as a consequence of administration, but nurses asked to give it need to know what the rationale is for its addition to the medication orders. If it's for hepatic encephalopathy, then it should not be withheld.
