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Lactulose is also used to reduce the amount of ammonia in the blood of patients with liver disease. It works by drawing ammonia from the blood into the colon where it is removed from the body.” (Quote from here)

How is ammonia removed from the colon?
In this context it must be some other mechanism than absorbing it into the blood.

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I'd imagine it would be defecated out. –  Rory M Jun 15 '13 at 19:15
    
@RoryM: Do you mean that ammonia would be dissolved in the liquid content of the stool? A stool with ammonia smell? –  winerd Jun 15 '13 at 19:19
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It's an interesting one, the BNF states that it "discourages the proliferation of ammonia-producing organisms" in the GI tract rather than pulling ammonia into the gut lumen, I'll perhaps write a full answer when my exams are out of the way :) –  Rory M Jun 15 '13 at 19:29
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and from MRHA "Lactulose is used to treat hepatic encephalopathy by reducing the pH of the colon causing ammonia to form in the colon, thereby reducing blood-ammonia concentrations." –  Rory M Jun 15 '13 at 19:31
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MRHA approval document though you can also just enter lactulose as a search term at mhra.gov.uk. –  Rory M Jun 16 '13 at 10:48

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