Lactulose is a synthetic disaccharide that consists of fructose and galactose. As there is no corresponding disaccharidase in the human intestinal mucosal cells, lactulose is not split in the small intestine and therefore it is not absorbed. In the colon it is metabolized to organic acids in short chains (acetic and lactic acids) by the gut flora. This fermentation acidifies the content of the intestine and it has an osmotic effect. The higher the lactulose dose, the stronger the osmotic effect. The lactulose preparations available on the market also contain smaller amounts of galactose, lactose and other sugars.

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