Lactulose
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Lactulose is a synthetic disaccharide which is metabolized in the colon by bacterial flora, producing short chain fatty acids including lactic acid and acetic acid. These products of lactulose metabolism acidify the colonic contents, thus favouring the formation of ammonium ions from Ammonia. The ions can not be absorbed, and are trapped in the colon until they are excreted in the faeces. This effectively reduces plasma Ammonia concentrations.