This should answer your question -
(from Wikipedia and NIH)
Lactulose (/ˈlæktjʉloʊz/) is a synthetic, non-digestible sugar used in the treatment of chronic constipation and hepatic encephalopathy, a complication of liver disease. It is a disaccharide (double-sugar) formed from one molecule each of the simple sugars (monosaccharides) fructose and galactose. It is produced commercially by isomerization of lactose.
Constipation
Lactulose is used in the treatment of chronic constipation. The metabolites of lactulose draw water into the bowel, causing a cathartic effect through osmotic action. It is safe for people of all ages, except for those in a very small percentage of the population that are galactose intolerant. Dosage may have to be adjusted over time to produce the desired effect because the laxative effect can decline with daily treatment.
Lactulose works by increasing the water content and volume of the stools in the bowel, making them softer and easier to pass. Lactulose is made up of sugar molecules and is partly broken down by the bacteria that live in the lower part of the gut. This leads to the contents of the gut becoming more acidic because there are carboxylic acids among its metabolites, which are not absorbed from the lower bowel. That in turn causes water to be retained in the lower bowel. This increases the amount of water in the stools, softening them and making them easier to pass. The added volume of gas and flatulence caused by fermentation of the lactulose adds to the volume of the fecal material, and makes it easier to expel. The slightly acidic condition of the colon caused by the presence of acids causes active peristalsis. The combined effect of all of these processes relieves constipation in a very effective manner.
Lactulose is useful in treating people with chronic constipation due to forgetting or ignoring the need for defecation. The treatment is to start the dosage at a low amount and then gradually increase it over a period of weeks until the urgency is such that a daily bowel movement cannot possibly be ignored. After an efficacious dosage is determined, it is maintained indefinitely or increased as needed over time.
Lactulose is useful in treating people who abuse laxatives provided that they use lactulose as their only laxative drug, because it has very low toxicity yet produces powerful results.
Lactulose is useful for negating the constipating effects of opiates and opioids, as in individuals who are on narcotic pain medication, are opioid dependent, or are receiving Opioid Replacement Therapy such as with methadone or buprenorphine for a previous opioid dependency.
Lactulose is useful for treatment of hemorrhoids because it produces a soft bowel movement without any straining.
Lactulose is helpful for treating children who withhold their bowel movements out of fear because when taken in sufficient quantity and then withheld, it produces a very insistent, irresistible and powerful urge to defecate.
Lactulose is considered a prebiotic because it modulates the beneficial bacterial flora of the gut and is considered a digestive aid. Modulation of gut flora presumably works by reducing potential pathogenic bacteria such as Escherichia coli and Staphylococcal species in stool, with increase in non-urease producing Lactobacillus limiting ammonia production.
Moreover, lactulose is converted to lactic and acetic acid which results in acidification of colonic contents. The low pH decreases passive non-ionic diffusion of ammonia thus lowering its systemic concentration. Furthermore, with its prebiotic potential, lactulose also encourages growth of probiotic bacteria such as Bifidobacterium species that are known to have health-promoting effects.
Lactulose has an overly sweet taste that can be completely masked by mixing it with fruit juice or desserts. It can take 24 to 48 hours to work, but generally produces results within 4 hours if taken on a daily basis. It is best taken at breakfast along with a bowl of bran cereal.
For stubborn cases of constipation, lactulose is sometimes combined with polyethylene glycol 3350Da, (sold as Miralax or Dulcolax Balance in the USA without prescription).
Some authorities recommend lactulose twice a day. However, an evening dosage can be problematic. When taken on a regular basis, it tends to work in about four hours. If given to small children who are in diapers, this is not a problem. However, for older children and adults, there is the ever present danger of voluminous defecation during sleep or being awake for hours on the toilet with a feeling of imminent expulsion. A juvenile or adult diaper is recommended along with protective plastic pants. This is especially true if a sleeping pill is taken.[citation needed]
In common with other osmotic laxatives, lactulose can cause electrolytic imbalances in sensitive individuals (see side effects below). However, it tends to do this less because it does not rely on mineral salts to draw fluid into the intestinal tract and also because it relies on nonosmotic modes of action: It stimulates peristalsis through acidification and gas and increases feeling of urgency through enlarging the volume of the bowel contents.
Lactulose is sold over the counter (without prescription) in most countries in the world. In the United States and Austria, it requires a prescription over unfounded fears that it could be dangerous to diabetics. However, it is an indigestible sugar and has been proved to be safe even for them.
From what I've found, it looks OK to take. The key word in the description is that it is non-digestable, which means it goes out the same as it went in and none of the sugars are absorbed so it basically has no carbs.
Also polyethylene glycol and lactulose both work on the same principle of osmosis, that is drawing water from the colon to soften its contents. A research study comparing the two concluded that polyethylene glycol (Miralax, Dulcolax Balance) worked better. I've noted that Miralax and Dulcolax are often reported as working well for constipation on this forum.
Hope this helps
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. Now I am afraid to take it because I don't know if it will effect my weight lose or not. Does anyone here know if it can or will. I really need it. I have tried colace and senna all week with NO results
. Anyone have any tips please?
