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Barriers to Lactulose Adherence
| Barrier | Comments |
|---|---|
| Adverse effects | Diarrhea/flatulence, abdominal pain/cramping, nausea, anorexia |
| Lack of understanding | Patients frequently do not understand titrating to 2–3 bowel movements a day |
| Overuse | Leads to dehydration and hyponatremia leading to worsening of hepatic encephalopathy |
