Megacolon during treatment with lactulose
Van der Vliet, H.J.; van Bodegraven, A.A.
Nederlands Tijdschrift Voor Geneeskunde 148(20): 998-1001
2004
ISSN/ISBN: 0028-2162 PMID: 15181726 Document Number: 570571
Two female patients aged 88 and 82 who were being treated for constipation with lactulose, developed life-threatening dilatation of the bowel. Both underwent surgery. One of them was found to have cancer of the bowel; she had an uneventful postoperative recovery. No mechanical abnormalities were found in the second patient but she died due to respiratory insufficiency following aspiration. Lactulose is one of the most frequently prescribed laxatives. In the colon it is metabolized by bacteria into short-chain fatty acids, hydrogen and carbon dioxide. The resulting production of gas in the colon can contribute to a non-toxic megacolon, particularly in patients with delayed intestinal passage.