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Oct 19, 2023

Gut Health

What is Enulose and What is it For?

What is Enulose?

Enulose is a brand name for the medication, lactulose. Lactulose is a synthetic disaccharide sugar used for treating constipation and hepatic encephalopathy. Our bodies cannot break down or absorb disaccharide sugar, which makes Enulose an effective medication for gut-related issues.

How Enulose Works

Enulose, which contains lactulose as its active ingredient, works in a couple of ways depending on the condition being treated.


Enulose functions as an osmotic laxative. When taken orally, lactulose passes through the digestive system without being fully absorbed. Once it reaches the colon, it undergoes fermentation by the gut bacteria. This fermentation process produces organic acids, which lower the pH in the colon. The lowered pH attracts water into the bowel, softening the stool and increasing its bulk. This, in turn, stimulates bowel contractions and facilitates regular bowel movements, providing relief from constipation.

Hepatic encephalopathy

Hepatic encephalopathy is a condition which occurs as a result of severe liver disease. The liver is usually responsible for filtering out toxins such as ammonia. When the liver is damaged, ammonia can build up in the blood and makes its way to the brain. Symptoms of hepatic encephalopathy include confusion, sleep disturbances, and tremor.

Enulose is used to reduce ammonia levels in the blood. It works by converting ammonia into ammonium ions in the colon. This conversion reduces the absorption of ammonia into the bloodstream, helping to lower its levels. By reducing ammonia levels, Enulose helps alleviate the neurological symptoms associated with hepatic encephalopathy.


Lactulose is typically available as a liquid or syrup, and it is generally taken orally. The dosage and frequency of lactulose will vary depending on the condition being treated and the individual's response to the medication.

Here are general dosage guidelines for each condition:

  • Adults: The usual starting dose is 15 to 30 milliliters (ml) (or tablespoons) of Enulose syrup once daily. The dosage can be adjusted based on individual response, with some individuals requiring higher doses.
  • Children (ages 7 to 14): The usual starting dose is 15 ml (or tablespoon) of Enulose syrup once daily, which can be adjusted as needed.
  • Children (ages 1 to 6): The recommended starting dose is 5 to 10 ml (or teaspoon) of Enulose syrup once daily, with adjustments as necessary.
Hepatic Encephalopathy

The dosage of Enulose for hepatic encephalopathy is typically higher compared to constipation. The specific dosing regimen is determined by the healthcare professional depending on the severity of the condition. The initial dose may range from 30 to 45 ml (or tablespoons) of Enulose syrup three times daily. The dose can be adjusted based on individual response, aiming to achieve two to four soft bowel movements per day.

Common Side Effects

Most of the side effects of Enulose are related to its effects and location of action. For example, the most common side effects with Enulose include:

  • Stomach upset
  • Bloating
  • Diarrhea
  • Flatulence
  • Nausea/vomiting

Some of these side effects can get worse the longer you take this medication, such as diarrhea. Luckily, the dosage can be adjusted toward a target number of bowel movements per day.

Warnings Associated With Enulose

The main concern for Enulose comes from the risks associated with prolonged diarrhea.

  • Dehydration
    Dehydration can occur as your body is pushing out water to loosen the stool. It is therefore essential to remain hydrated while taking this medication.
  • Electrolyte abnormalities
    Electrolytes, such as sodium, potassium, and magnesium, are important components of our blood. They serve essential purposes within the heart, muscles, and brain. Excessive diarrhea can cause changes in the levels of those electrolytes, which can be extremely dangerous. This is not often a major concern for short-term use, however when used long term this must be taken into consideration and monitored.

The medication should also be used cautiously in individuals with diabetes, as even though the absorption is minimal, it may have minor effects on blood sugar. It may have to be avoided altogether if you are on a sugar-restrictive diet.


  1. LACTULOSE Lactulose Solution, USP 667 mg/mL. Sanis Health Inc. (Revised July 24, 2015). Retrieved July 10, 2023, from
  2. Hepatic encephalopathy. Canadian Liver Foundation. (n.d.). Retrieved July 10, 2023, from

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