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Jan 15, 2024

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What is Enulose and What is it For?

What is Enulose?

Enulose, known by its generic name lactulose, is a special kind of sugar that our bodies cannot digest or absorb. It's primarily used as a medication for gut-related problems and comes in the form of an oral solution. Here are its main uses:

  • Constipation: Enulose helps to relieve constipation. Since our body can't break it down, it stays in the gut, drawing water into the bowel, which softens stools and makes them easier to pass.
  • Hepatic Encephalopathy: This is a less common but important use. Hepatic encephalopathy is a brain disorder caused by severe liver disease. Normally, the liver filters harmful substances like ammonia from our blood. But if the liver is damaged, these toxins can build up in the blood and reach the brain, leading to symptoms like confusion, sleep disturbances, and tremors. Enulose helps by reducing the amount of ammonia in the blood, thus easing these symptoms and even preventing the condition from developing.

How Enulose Works

Enulose works in a unique way due to the structure of lactulose, a type of sugar, and it functions differently for each of its two main uses:
For Constipation

Enulose is an "osmotic laxative." This means it works by drawing water from the body into the gut. This extra water helps to soften the stool, making bowel movements easier and more frequent. However, it's important to note that Enulose doesn't work immediately. It usually takes a few days for its effects to kick in.

For Hepatic Encephalopathy

The way Enulose works for this condition is a bit more complex and not completely understood. It's believed to help by moving ammonia from the blood into the gut. Since ammonia is a toxin that the liver normally filters out, when the liver is damaged, reducing ammonia levels in the blood is crucial. Enulose traps ammonia in the gut so that it can be passed out of the body in the stool, which helps reduce its buildup in the blood and brain, and thus aids in reversing the symptoms of hepatic encephalopathy.

How to Use Enulose Safely

When using Enulose, adhere strictly to the dosage and administration guidelines provided by your healthcare provider. The prescribed dosage may vary depending on your specific condition and how you respond to the treatment. For effectiveness, it's important to take Enulose consistently, as directed. This might mean daily use for constipation or a different frequency for hepatic encephalopathy.

In terms of dietary considerations, staying well-hydrated is crucial because Enulose can cause dehydration. Additionally, maintaining a balanced diet, especially one rich in fiber, can support the effectiveness of Enulose and overall gut health. This combined approach can enhance the benefits of the medication.

For diabetic patients, it's particularly important to monitor blood sugar levels, as Enulose can have a minor impact on these. Those using Enulose over a long period should be aware of the potential for electrolyte imbalance or dehydration. Look out for signs of these issues and discuss them with your healthcare provider.

If you experience severe side effects like prolonged diarrhea or vomiting, or symptoms of dehydration, seek medical advice immediately. Also, if Enulose does not seem to be working as expected, do not increase the dose on your own. Consult your doctor for further guidance.

Side Effects and Warnings

Enulose, like any medication, has potential side effects, mostly related to its action in the gut.

Common Side Effects
  • Stomach Upset
  • Bloating
  • Diarrhea
  • Flatulence (gas)
  • Nausea or Vomiting

These side effects are due to the way Enulose works in the gut. For instance, diarrhea and bloating can occur because Enulose draws water into the gut. Some side effects, especially diarrhea, might worsen with prolonged use. However, the dosage of Enulose can be adjusted to achieve a balanced number of bowel movements.

Important Warnings

Initially, like Ozempic, Tirzepatide faced shortages due to its growing popularity. The situation changed when the FDA approved Tirzepatide specifically for weight loss on November 8. Following this approval, it was introduced under the brand name Zepbound. This makes Zepbound a dual-purpose drug: effective for both diabetes management and FDA-approved for weight loss.

  • Dehydration: This can happen as Enulose causes the body to release water into the gut. Staying well-hydrated is crucial while taking this medication.
  • Electrolyte Abnormalities: Electrolytes like sodium, potassium, and magnesium are vital for heart, muscle, and brain functions. Excessive diarrhea from Enulose can disrupt these electrolyte levels, which can be dangerous, particularly with long-term use. Regular monitoring is essential in such cases.
Additional Caution for Diabetic Patients

Enulose should be used carefully if you have diabetes. Although it is minimally absorbed, it can still slightly affect blood sugar levels. Those on a sugar-restrictive diet might need to avoid it.

References:

  1. LACTULOSE Lactulose Solution, USP 667 mg/mL. Sanis Health Inc. (Revised July 24, 2015). Retrieved July 10, 2023, from https://pdf.hres.ca/dpd_pm/00031381.PDF
  2. Hepatic encephalopathy. Canadian Liver Foundation. (n.d.). Retrieved July 10, 2023, from https://www.liver.ca

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