Constipation (Chronic Constipation): In all cases of chronic constipation, the initial therapy should include a fiber-rich diet (vegetables, salads, fruits, etc.), enough of liquids, and plenty of physical activity. Lactulose should only be used if these other treatments are ineffective.
Lactulose is a man-made disaccharide. Lactulose is digested in the colon by saccharolytic bacteria, which produces low molecular weight organic acids (mostly lactic acid), which lowers the pH of the colon contents, promotes water retention via an osmotic action, and therefore increases peristaltic activity. Because lactulose is minimally absorbed, the pharmacokinetics of the absorbed substance are unimportant to the primary therapeutic effect.
