Lactulose Solution USP is primarily used to treat chronic constipation and a serious liver condition called hepatic encephalopathy. It is a synthetic sugar that works by drawing water into the bowel to soften stools or by helping the body remove toxins. Constipation Lactulose is an osmotic laxative that works in the colon to increase the water content in stools, making them softer and easier to pass. It is used to treat chronic (long-lasting) constipation. It can increase the number of bowel movements and the number of days on which they occur. It is often used after dietary or other lifestyle changes have been unsuccessful. Hepatic encephalopathy (HE) Hepatic encephalopathy is a brain condition caused by a buildup of toxins, such as ammonia, in the blood due to liver failure. Lactulose helps to lower ammonia levels in the following ways: Drawing out toxins: It creates an acidic environment in the colon that draws ammonia from the blood into the colon. Expelling toxins: The laxative effect of lactulose then helps remove the ammonia from the body. Improving symptoms: By reducing blood ammonia, lactulose can improve neurological symptoms such as confusion, memory problems, and tremors. Important considerations Timing: Lactulose can take 24 to 48 hours to produce a bowel movement. Prescription: A doctor's prescription is required for its use in children under 14 and for treating hepatic encephalopathy. Side effects: Common side effects include abdominal bloating, cramps, and gas. Prolonged use can lead to diarrhea and an electrolyte imbalance. Dilution: To manage the sweet taste, it can be mixed with water or fruit juice. Contraindications: It should be used with caution in people with diabetes, galactosemia, or irritable bowel syndrome (IBS).