Effect of Lactitol and Lactulose Administration on the Fecal Flora in Cirrhotic Patients

Riggio, Oliviero; Varriale, Maria; Testore, Gian Piero; Rosa, Roberta; Rosa, E. Di; Merli, Manuela; Romiti, Adriana; Candiani, C.; Capocaccia, L.

doi:10.1097/00004836-199008000-00016

Cited by 103 publications

(59 citation statements)

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“…As there is no satisfactory definition of a bifidogenic effect and no data available about the absolute rise in bifidobacteria CFU counts to obtain a biological relevance, we considered, as most authors, that a substrate is bifidogenic if a statistically significant rise is observed. We did not find a significant increase in Lactobacillus spp after lactulose ingestion, neither faecal pH acidification, as has been previously reported (Riggio et al, 1990;Terada et al, 1992;Salminen & Salminen, 1997). However, results obtained in stool are not necessarily a good indicator for fermentation and acidity in the more proximal colon, which is very difficult to study in vivo due to its relative inaccessibility.…”

Section: Discussionsupporting

confidence: 63%

Lactulose ingestion increases faecal bifidobacterial counts: A randomised double-blind study in healthy humans

et al. 2004

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Objective: Faecal bifidobacteria and lactobacilli, perceived as exerting health-promoting properties, may be increased by ingestion of high-dose lactulose in humans. The effects of low and well-tolerated doses of lactulose are not well known. The aim of the study was to assess the effects of prolonged low-dose lactulose administration on faecal bifidobacteria and selected metabolic indexes potentially involved in colonic carcinogenesis. Subjects and methods: In all, 16 healthy volunteers were included in this controlled, randomised, double-blind, parallel group trial. Participants ingested lactulose or placebo (sucrose) at a dose of 5 g b.i.d. for 6 weeks. Stools were regularly collected at baseline (d0), and after 3 (d21) and 6 (d42) weeks of sugar ingestion. Tolerance was evaluated using a daily chart. Results: Faecal bifidobacterial counts were higher in lactulose than in sucrose group (P ¼ 0.03). Lactulose ingestion led to a significant increase in faecal bifidobacteria counts from d0 to d21 and d42 ((m7s.e.m.) 8.2570.53, 8.9670.40 and 9.5470.28 log colony-forming units/g wet wt (CFU/g), respectively (P ¼ 0.048)). Placebo ingestion did not lead to any faecal bifidobacterial count change. Total anaerobes, Lactobacillus and pH were not significantly changed throughout the study in the two groups. Neither faecal bile acids nor neutral sterols were modified by lactulose. Excess flatus was more common in the lactulose group (P ¼ 0.03), but was very mild. Bloating and borborygmi did not differ between both the groups. Conclusions: A measure of 10 g lactulose/day increases faecal bifidobacterial counts, and lactulose fulfils the criteria requested to be considered as a prebiotic.

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Section: Discussionsupporting

confidence: 63%

Lactulose ingestion increases faecal bifidobacterial counts: A randomised double-blind study in healthy humans

et al. 2004

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“…In healthy adults the daily intake of 3 g of lactulose for 2 weeks resulted in a significant increase in the number of bifidobacteria in faecal samples, while the numbers of lecithinasepositive clostridia and Bacteroidaceae decreased significantly (Terada, Hara, Kataoka, & Mitsuoka, 1992;Terada et al, 1994). In cirrhotic patients treatment with lactulose for 10 days resulted in a higher number of faecal lactobacilli (Riggio et al, 1990).…”

Section: Lactulose As a Prebiotic?mentioning

confidence: 96%

Intestinal fermentation of lactose and prebiotic lactose derivatives, including human milk oligosaccharides

Venema¹

2012

International Dairy Journal

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“…Riggio et al studied 21 cirrhotic patients with lactitol and lactulose and found a 2 log increase in lactobacilli in both groups with smaller degrees of reduction in Enterobacteria and Enterococci. 10 Tarao et al found that lactitol, when administered for up to 4 weeks in 8 patients significantly increased the occupation ratio, defined as number of that specific bacteria divided by to the total number of bacteria detected, of Bifidobacterium as well as the total Lactobacillus count. 11 They also found a reduced occupation ratio of Clostridium and Bacteroides but no absolute change in number.…”

Section: Culture-based Studies Of Microbiota In Cirrhosis and Hementioning

confidence: 97%

The role of microbiota in hepatic encephalopathy

2014

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Effect of Lactitol and Lactulose Administration on the Fecal Flora in Cirrhotic Patients

Cited by 103 publications

References 0 publications

Lactulose ingestion increases faecal bifidobacterial counts: A randomised double-blind study in healthy humans

Lactulose ingestion increases faecal bifidobacterial counts: A randomised double-blind study in healthy humans

Intestinal fermentation of lactose and prebiotic lactose derivatives, including human milk oligosaccharides

The role of microbiota in hepatic encephalopathy

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