{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T10:55:19Z","timestamp":1792839319083,"version":"4.5.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":10289,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1987,7]]},"abstract":"\n \n A double-blind, controlled trial to study the efficacy of acidifying enemas of lactitol, a new galactoside-sorbitol disaccharide, and lactose vs. nonacidifying tapwater enemas was performed in 45 episodes of acute portal-systemic encephalopathy. At the time of randomization, all patients had encephalopathy of at least Grade 2+ severity, delay in the performance of number connection tests and hyperammonemia. A sequential analysis was performed which revealed after the inclusion of the first 20 patients, a significant failure of the non-acidifying enemas as compared to the lactitol enemas (p < 0.004). The tap-water enema group was, therefore, suspended but the rest of the study continued after rerandomization for lactose and lactitol groups. A favorable response to treatment was obtained in 19 (86%) of the patients receiving lactitol enemas and in 14 (78%) of those receiving lactose enemas. A similar significant improvement in portal-systemic encephalopathy parameters and index was observed after both treatments. Both types of acidifying enemas induced a significant pH decrease in stool (p < 0.05). These data suggest that acidifying agents like lactose and lactitol are effective and superior to tap-water enemas for the treatment of acute nitrogenous portal-systemic encephalopathy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/hep.1840070404","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T20:47:46Z","timestamp":1172954866000},"page":"639-643","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":121,"title":["Acidifying enemas (lactitol and lactose) vs. nonacidifying enemas (tap water) to treat acute portal-systemic encephalopathy: A double-blind, randomized clinical trial"],"prefix":"10.1097","volume":"7","author":[{"given":"Misael","family":"Uribe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Octavio","family":"Campollo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florencia","family":"Vargas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Paolo","family":"Ravelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Mundo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Zapata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Gil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Garcia-Ramos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"10.1002\/hep.1840070404-BIB1","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1007\/BF01308043","volume":"25","author":"Uribe","year":"1980","journal-title":"Dig Dis Sci"},{"key":"10.1002\/hep.1840070404-BIB2","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/S0016-5085(77)80135-2","volume":"72","author":"Conn","year":"1977","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.1840070404-BIB3","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/0016-5085(81)90658-2","volume":"81","author":"Uribe","year":"1981","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.1840070404-BIB4","first-page":"331","volume":"49","author":"Rodriguez","year":"1984","journal-title":"Rev Mex Gastroenterol"},{"key":"10.1002\/hep.1840070404-BIB5","first-page":"1344","volume":"86","author":"Uribe","year":"1984","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.1840070404-BIB6","author":"Uribe","year":"1984","unstructured":", . Successful use of lactitol in acute portal systemic encephalopathy (Abstract). Berne, Switzerland: Proc IASLD, 1984: 81."},{"key":"10.1002\/hep.1840070404-BIB7","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1136\/gut.26.4.415","volume":"26","author":"Lanthier","year":"1985","journal-title":"Gut"},{"key":"10.1002\/hep.1840070404-BIB8","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/0016-5085(81)90669-7","volume":"81","author":"Weber","year":"1981","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.1840070404-BIB9","first-page":"204","volume-title":"The design and analysis of sequential clinical trials","author":"Whitehead","year":"1983","unstructured":"The comparison of more than two treatments. In: The design and analysis of sequential clinical trials. Great Britain: Ellis Horwood Limited, 1983: 204\u2013216."},{"key":"10.1002\/hep.1840070404-BIB10","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1007\/BF01072510","volume":"22","author":"Conn","year":"1977","journal-title":"Dig Dis Sci"},{"key":"10.1002\/hep.1840070404-BIB11","doi-asserted-by":"crossref","first-page":"380","DOI":"10.3181\/00379727-88-21594","volume":"88","author":"McDermott","year":"1955","journal-title":"Proc Soc Exp Biol"},{"key":"10.1002\/hep.1840070404-BIB12","first-page":"295","volume-title":"The hepatic coma syndrome and lactulose","author":"Conn","year":"1979","unstructured":". Measurement of stool pH. In: , eds. The hepatic coma syndrome and lactulose, Chap. II. Baltimore, Maryland: Williams and Wilkins, 1979: 295\u2013305."},{"key":"10.1002\/hep.1840070404-BIB13","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/0002-9610(70)90182-0","volume":"119","author":"Bond","year":"1970","journal-title":"Am J Surg"},{"key":"10.1002\/hep.1840070404-BIB14","first-page":"304","volume":"49","author":"Zapata","year":"1984","journal-title":"Rev Mex Gastroenterol"},{"key":"10.1002\/hep.1840070404-BIB15","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/0016-5085(85)90147-7","volume":"88","author":"Uribe","year":"1985","journal-title":"Gastroenterology"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.1840070404","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-198707000-00003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T11:12:22Z","timestamp":1733051542000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-198707000-00003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1987,7]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1987]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.1840070404","relation":{},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[1987,7]]}}}