Beyond Lactulose

Hi everyone - My lovely 67 year old mother has non-alcoholic cirhosis of the liver.  Ammonia levels were well over 200.   She is now on lactulose three times a day with a dosage that ranges from 45ml to 60ml (three tablespoons to four tablespoons) depending on her symptoms (confusion, being very very cold, no energy, muscle weakness, etc).  While on lactulose, she is going to her commode every hour during the day with extreme diarrhea.  While I am very grateful for the lactulose, we know that finding the right dosage is tricky.  It is also very hard on her to have her life center around a commode (as well as going through 10-12 Depends each day).   We have heard that there are some new medicines that may be taken in conjunction with or instead of lactulos.   I have heard about the use of antibitoics such as rifaximin 2 to help reduce ammonia levels?  Anyone know more about the success of this or any other medications beyond lactulos?

 

Hi Gabriel,

 

Welcome to the forum.  Xifaxin (rifaximin) is an antibiotic that works within the intestines to control the bacteria that produce ammonia.  It is expensive, but it does help. 

 

If your Mother is having extreme diarrhea, her doctor needs to be notified immediately.  This is not normal.  She could become dehydrated quickly.  Lactulose is intended to produce 3-4 bowel movements a day, not extreme diarrhea.

 

I’m sorry she is having to suffer from the side effects of ESLD.  Good luck to you and your Mother. 

 

Penny