Skip to main content
Gut logoLink to Gut
. 1974 Dec;15(12):999–1004. doi: 10.1136/gut.15.12.999

Effects of lactulose and other laxatives on ileal and colonic pH as measured by a radiotelemetry device

R L Bown, J A Gibson, G E Sladen, B Hicks, A M Dawson
PMCID: PMC1413067  PMID: 4448417

Abstract

Using a pH-sensitive radiotelemetering device the effect of lactulose on luminal pH in the ileum, colon, and rectum has been compared with that of two other laxative agents.

Lactulose produced marked acidification of proximal colonic contents but this effect was not consistently maintained into the distal colon. Sodium sulphate acidified distal rather than proximal colonic contents. However, for a similar degree of laxation it was not possible to produce a significantly more uniform reduction of pH along the length of the colon by combining these laxatives compared with lactulose alone. Magnesium sulphate had little effect upon luminal pH except in the rectum where a significant rise occurred.

These results are discussed in relation to both normal colonic physiology and to their possible relevance to the treatment of chronic hepatic encephalopathy by colonic acidification.

Full text

PDF
999

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Agostini L., Down P. F., Murison J., Wrong O. M. Faecal ammonia and pH during lactulose administration in man: comparison with other cathartics. Gut. 1972 Nov;13(11):859–866. doi: 10.1136/gut.13.11.859. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bircher J., Haemmerli U. P., Scollo-Lavizzari G., Hoffmann K. Treatment of chronic portal-systemic encephalopathy with lactulose. Report of six patients and review of the literature. Am J Med. 1971 Aug;51(2):148–159. doi: 10.1016/0002-9343(71)90233-6. [DOI] [PubMed] [Google Scholar]
  3. Bown R. L., Sladen G. E., Rousseau B., Gibson J. A., Clark M. L., Dawson A. M. A study of water and electrolyte transport by the excluded human colon. Clin Sci. 1972 Dec;43(6):891–902. doi: 10.1042/cs0430891. [DOI] [PubMed] [Google Scholar]
  4. Brown H., Trey C., McDermott W. V., Jr Lactulose treatment of hepatic encephalopathy in outpatients. Arch Surg. 1971 Jan;102(1):25–27. doi: 10.1001/archsurg.1971.01350010027006. [DOI] [PubMed] [Google Scholar]
  5. Carmel R., Rosenberg A. H., Lau K. S., Streiff R. R., Herbert V. Vitamin B12 uptake by human small bowel homogenate and its enhancement by intrinsic factor. Gastroenterology. 1969 Mar;56(3):548–555. [PubMed] [Google Scholar]
  6. DAWSON A. M., HOLDSWORTH C. D., WEBB J. ABSORPTION OF SHORT CHAIN FATTY ACIDS IN MAN. Proc Soc Exp Biol Med. 1964 Oct;117:97–100. doi: 10.3181/00379727-117-29505. [DOI] [PubMed] [Google Scholar]
  7. Down P. F., Agostini L., Murison J., Wrong O. M. The interrelations of faecal ammonia, pH and bicarbonate: evidence of colonic absorption of ammonia by non-ionic diffusion. Clin Sci. 1972 Jul;43(1):101–114. doi: 10.1042/cs0430101. [DOI] [PubMed] [Google Scholar]
  8. Elkington S. G., Floch M. H., Conn H. O. Lactulose in the treatment of chronic portal-systemic encephalopathy. A double-blind clinical trial. N Engl J Med. 1969 Aug 21;281(8):408–412. doi: 10.1056/NEJM196908212810803. [DOI] [PubMed] [Google Scholar]
  9. Elkington S. G. Lactulose. Gut. 1970 Dec;11(12):1043–1048. doi: 10.1136/gut.11.12.1043. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Giller J., Phillips S. F. Electrolyte absorption and secretion in the human colon. Am J Dig Dis. 1972 Nov;17(11):1003–1011. doi: 10.1007/BF02239140. [DOI] [PubMed] [Google Scholar]
  11. HAEMMERLI U. P., KISTLER H., AMMANN R., MARTHALER T., SEMENZA G., AURICCHIO S., PRADER A. ACQUIRED MILK INTOLERANCE IN THE ADULT CAUSED BY LACTOSE MALABSORPTION DUE TO A SELECTIVE DEFICIENCY OF INTESTINAL LACTASE ACTIVITY. Am J Med. 1965 Jan;38:7–30. doi: 10.1016/0002-9343(65)90156-7. [DOI] [PubMed] [Google Scholar]
  12. HOFFMANN K., MOSSEL D. A., KORUS W., VAN DE KAMER J. H. UNTERSUCHUNGEN UEBER DIE WIRKUNGSWEISE DER LACTULOSE (BETA-GALACTOSIDO-FRUCTOSE) IM DARM. Klin Wochenschr. 1964 Feb 1;42:126–130. doi: 10.1007/BF01479054. [DOI] [PubMed] [Google Scholar]
  13. Hamilton J. D., Dyer N. H., Dawson A. M., O'Grady F. W., Vince A., Fenton J. C., Mollin D. L. Assessment and significance of bacterial overgrowth in the small bowel. Q J Med. 1970 Apr;39(154):265–285. [PubMed] [Google Scholar]
  14. Heller M. D., Kern F., Jr Absorption of lactic acid from an isolated intestinal segment in the intact rat. Proc Soc Exp Biol Med. 1968 Apr;127(4):1103–1106. doi: 10.3181/00379727-127-32882. [DOI] [PubMed] [Google Scholar]
  15. MCMICHAEL H. B., WEBB J., DAWSON A. M. LACTASE DEFICIENCY IN ADULTS. A CAUSE OF "FUNCTIONAL" DIARRHOEA. Lancet. 1965 Apr 3;1(7388):717–720. doi: 10.1016/s0140-6736(65)92081-7. [DOI] [PubMed] [Google Scholar]
  16. Palva I. P., Salokannel S. J., Timonen T., Palva H. L. Drug-induced malabsorption of vitamin B 12 . IV. Malabsorption and deficiency of B 12 during treatment with slow-release potassium chloride. Acta Med Scand. 1972 Apr;191(4):355–357. [PubMed] [Google Scholar]
  17. Vince A., Dawson A. M., Park N., O'Grady F. Ammonia production by intestinal bacteria. Gut. 1973 Mar;14(3):171–177. doi: 10.1136/gut.14.3.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Watson B. W., Meldrum S. J., Riddle H. C., Brown R. L., Sladen G. E. pH profile of gut as measured by radiotelemetry capsule. Br Med J. 1972 Apr 8;2(5805):104–106. doi: 10.1136/bmj.2.5805.104. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Zeegen R., Drinkwater J. E., Fenton J. C., Vince A., Dawson A. M. Some observations on the effects of treatment with lactulose on patients with chronic hepatic encephalopathy. Q J Med. 1970 Apr;39(154):245–263. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES