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Lactulose AIWA is an oral osmotic laxative containing lactulose, a synthetic non-absorbable disaccharide composed of galactose and fructose. Developed and marketed by T&D Pharma GmbH, it is primarily indicated for the treatment of constipation and portocaval encephalopathy. In the colon, lactulose is broken down by bacterial flora into low-molecular-weight organic acids (such as lactic and acetic acids), which increases osmotic pressure and acidifies the colonic contents. This process draws water into the intestinal lumen, increasing stool volume and softening consistency to facilitate evacuation. In hepatic encephalopathy, the acidification of colonic contents traps ammonia as ammonium ions, reducing its absorption into the systemic circulation.
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