Hepatic Encephalopathy
Another medical application field of lactulose is Portal Systemic Encephalopathy (PSE), also known as Hepatic Encephalopathy (HE).
This is a disease state that results from liver damage, for example in advanced cirrhosis. The impaired liver function allows toxic substances, including ammonia, to accumulate in the bloodstream. Elevated blood ammonia interferes with brain functions, causing cognitive dysfunction and psychiatric disorders.

At high doses, lactulose helps to promote the excretion of ammonia and to restore normal neurological function.