SIDE EFFECTS OF LACTULOSE SYRUP: CAN IT CAUSE BLISTERS IN THE ANUS AND GENITALS
Keywords:
Lactulose Syrup Side Effects, Fixed Drug Eruption, Blisters in Anal, Genital AreasAbstract
Lactulose syrup is commonly used to treat constipation by increasing osmotic pressure in the intestines, which leads to softer stools. However, it may cause side effects, such as a fixed drug eruption—a type of skin reaction that can become chronic if unrecognized. This report presents the case of a 42-year-old male patient who developed blisters in the anal and genital areas after taking lactulose syrup for constipation. Despite self-treatment with gentamicin ointment, the blisters persisted. The mechanism behind fixed drug eruptions is not fully understood but may involve an immune response triggered by drug exposure. This case highlights the potential for unexpected adverse reactions to lactulose syrup, underscoring the need for awareness and careful consideration of patient history in treatment.
References
Milosavljevic T, Popovic DD, Mijac DD, Milovanovic T, Krstic S, Krstic MN. Chronic constipation: gastroenterohepatologist’s approach. Digestive Diseases. 2022 Feb 28;40(2):175-80.
Aït‐Aissa A, Aïder M. Lactulose: production and use in functional food, medical and pharmaceutical applications. Practical and critical review. International journal of food science & technology. 2014 May;49(5):1245-53.
Sharma S, Chauhan A. Use of lactulose in hepatic encephalopathy: is it time to shift targets? Clinical Gastroenterology and Hepatology. 2022 May 1;20(5): e1220-1.
Moon AM, Kim HP, Jiang Y, Lupu G, Bissram JS, Barritt IV AS, Tapper EB. Systematic review and meta-analysis on the effects of lactulose and rifaximin on patient-reported outcomes in hepatic encephalopathy. Official journal of the American College of Gastroenterology| ACG. 2023 Feb 1;118(2):284-93.
Anderson HJ, Lee JB. A review of fixed drug eruption with a special focus on generalized bullous fixed drug eruption. Medicina. 2021 Sep 1;57(9):925.
Karakan T, Tuohy KM, Janssen-van Solingen G. Low-dose lactulose as a prebiotic for improved gut health and enhanced mineral absorption. Frontiers in Nutrition. 2021 Jul 27;8:672925.
Salminen S, Salminen E. Lactulose, lactic acid bacteria, intestinal microecology and mucosal protection. Scandinavian Journal of gastroenterology. 1997 Jan 1;32(sup222):45-8
Panesar PS, Kumari S. Lactulose: production, purification and potential applications. Biotechnology advances. 2011 Nov 1;29(6):940-8.
Gebhardt T, Mackay LK. Local immunity by tissue-resident CD8+ memory T cells. Frontiers in immunology. 2012 Nov 9;3:340.
Hudson M, Schuchmann M. Long-term management of hepatic encephalopathy with lactulose and/or rifaximin: a review of the evidence. European journal of gastroenterology & hepatology. 2019 Apr 1;31(4):434-50.
